Features of functional maturation of the central nervous system in fetuses with multiple pregnancies

2021 ◽  
Vol 50 (4) ◽  
pp. 58-63
Author(s):  
V. S. Prokhorova ◽  
N. G. Pavlova ◽  
N. N. Konstantinova
Keyword(s):  
Neurological Disorders ◽  
Risk Group ◽  
Multiple Pregnancy ◽  
Activity Cycle ◽  
High Risk Group ◽  
Multiple Pregnancies ◽  
Functional Maturation ◽  
Cardiac Rhythm Variability ◽  
The Central Nervous System ◽  
Rest Activity

The study was undertaken to detect some peculiarities of fetal rest activity cycle formation in multiple pregnancy. 86 fetuses (43 twins) were observed with the following assessment of the newbornsneurological status. The rest activity cycle parameters and haemodynamic indices of fetoplacental system were examined. Also there was considered the influence of IUGR and twins birth weight discordance on CNSfunctionalformation. The results showed that twins comparing with single pregnancies are characterized by the retardation of rest activity cycle formation that is manifested in shortening оf the quite and prolongation оf the intermediate states, lowering of cardiac rhythm variability and motorcardial reflex. These findings substantiate the necessity of including twins into high-risk group concerning neurological disorders in the newborns. The IUGR appears an additional factor increasing this risk.

scholarly journals PREVENTION OF PREECLAMPSIA IN WOMEN WITH MULTIPLE PREGNANCY AFTER ASSISTED REPRODUCTION

2020 ◽  
Vol 73 (3) ◽  
pp. 494-497
Author(s):  
Tamara G. Romanenko ◽  
Olha M. Sulimenko
Keyword(s):  
Pregnant Women ◽  
Biochemical Markers ◽  
Preventive Measures ◽  
Risk Group ◽  
Plasma Concentrations ◽  
Multiple Pregnancy ◽  
Perinatal Outcomes ◽  
High Risk Group ◽  
Prospective Analysis ◽  
Second Trimester

The aim: To reduce the frequency and severity of preeclampsia, to improve obstetrical and perinatal outcomes in women with multiple pregnancy after assisted reproduction by the development and implementation of the preventive algorithm with biochemical markers of endothelial dysfunction prospective analysis. Materials and methods: Clinical and laboratory prospective analysis of 54 cases of twins in women, treated from infertility with assisted reproductive technologies (ART), using the method of intracytoplasmic sperm injection (ICSI) and frozen embryos transfer, have been made. It was proven, that women with multiple pregnancy are always in a high risk group of placental dysfunction (PD) and preeclampsia (PE). Depending on the treatment algorithm and preventive measures, 2 groups of patients were formed. Group I included 29 pregnant women with twins, managed in accordance with developed recommendations. We didn’t find evidence-based European guidelines, that would recommend routine prescription of progesterone to improve chorion invasion and further placentation in such group of patients, but in order to prevent endothelial dysfunction and to decrease the incidence and severity of preeclampsia, placental abnormalities and intrauterine growth restriction (IUGR), we proposed the following algorithm: – micronized progesterone 200 mg vaginally (PV), as soon as pregnancy was diagnosed by positive hCG-test, till 16 weeks of pregnancy, angioprotector diosmin 600 mg once daily orally (PO), 2 courses: from 8 till 12 and from 16 till 20 weeks of gestation, antiaggregant – acetylsalicylic acid 150 mg from 12 till 36 weeks of gestation. Group II included 25 pregnant women with twins after the same ART procedures, who have not received above mentioned treatment. Plasma concentrations of PlGF, sFlt-1 and the ratio of sFlt-1/PlGF in the second trimester were investigated in both groups of women in order to assess the effectiveness of proposed preventive measures. Results: Usage of preventive algorithm has shown the reduction of PE incidences in 26%, PD in 28.1%, IUGR in 35%, prematurity by 23% and fetal distress in 18%, that led to improvement of obstetrical and perinatal outcomes in I group of women with multiple pregnancies after ART-treated infertility, compared with group II (p<0.05). The evaluation of PlGF, sFlt-1 plasma concentrations and the ratio of sFlt-1/PlGF in the second trimester of pregnancy reflected the effectiveness of our method in women with twins after ART. The level of PlGF in the study group was higher (186.5 ± 12 vs 154.2 ± 10.7; p<0.05), and the level of sFlt-1 was lower (1523.1 ± 40.3 vs 1835.3 ± 33.6; p <0.05). Results of sFlt-1/PlGF ratio analysis in the I group also showed effectiveness of the method proposed (20.3 ± 3.1 vs 28.1 ± 2.2; p<0.05). Conclusions: The observed results suggest, that pregnant women with twins after ART-treated infertility are in a high-risk group of PE, PD and IUGR of one or both fetuses. Implementation of the proposed preventive algorithm allows to reduce the incidence of PE, obstetrical and perinatal complications in this group of patients, and can be widely used in clinical practice. Evaluation and prospective assessment of biochemical markers, such as PlGF, sFlt-1 and sFlt-1/PIGF ratio, in the second trimester of pregnancy in the target groups may likely predict the development of PE and its severity.

scholarly journals Hearing function in twins from spontaneous and induced pregnancy

2019 ◽  
Vol 64 (5) ◽  
pp. 49-54
Author(s):  
I. V. Rakhmanova ◽  
L. G. Sichinava ◽  
S. Yu. Lebedeva
Keyword(s):  
Otoacoustic Emissions ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Reproductive Technologies ◽  
High Risk Group ◽  
Multiple Pregnancies ◽  
Auditory Function ◽  
Vitro Fertilization ◽  
Distortion Product

In recent years, an increase in the frequency of multiple pregnancies has been observed worldwide, which is primarily associated with the widespread use of assisted reproductive technology for the treatment of infertility. Pregnancy resulting from in vitro fertilization is a high-risk group. In the world scientific literature there are practically no works on the study of auditory function in children from multiple pregnancy. As for the studies of the auditory function of children from multiple pregnancies, such works are practically absent in the literature. The article presents the results of an audiological examination of 204 children from twins, 94 of which were born as a result of using assisted reproductive technologies, and 110 from a spontaneous multiple pregnancy. According to an audiological survey using the method of otoacoustic emission at the frequency of product distortion in the expected period of labor, we have proven that the conception method (spontaneous or induced) does not affect the maturation of the auditory function in children from twins: registration of the distortion product otoacoustic emissions (DPOAE) test is 56,1 and 54,4% of cases, respectively. The auditory function of each child from one twin must be considered individually.

The Follow-up History of Children from Multiple Pregnancies

1972 ◽  
Vol 22 (S1) ◽  
pp. 106-108
Author(s):  
T. Banachowa ◽  
M. Miecznikowska ◽  
J. Rosciszewska-Krawczyk
Keyword(s):  
Risk Group ◽  
High Risk Group ◽  
Psychomotor Development ◽  
Multiple Pregnancies ◽  
Acid Base Balance ◽  
Base Balance ◽  
History Of ◽  
Twin Pregnancies ◽  
Equilibration Rate

Infants born from multiple pregnancies were observed for three years, 1969-71. Twin births were 1.88% {full-term 1.23%, premature 0,66%) and perinatal twin mortality was 7.94%. The Apgar scale assessment, acid-base balance, physical and psychomotor development equilibration rate, and morbidity, were determined. Great differences were found beween first and second twins, sometimes differing 1000 g in weight. In postnatal disorders the equilibration period was shorter than in single-born children. Examinations after three years did not show much deviation from the norm, although twin pregnancies and deliveries are dangerous and the children are included in the “high-risk” group.

scholarly journals Psychomotor Development of Children from Multiple Pregnancies. A Psychological Evaluation

1972 ◽  
Vol 22 (S1) ◽  
pp. 135-138
Author(s):  
M. Bogdanowicz
Keyword(s):  
Multiple Pregnancy ◽  
Health Condition ◽  
Individual Development ◽  
Psychomotor Development ◽  
Multiple Pregnancies ◽  
The Central Nervous System ◽  
The One ◽  
The Individual ◽  
Mz Twins ◽  
Made In

Psychological examinations were made in 56 children from quintuplet, quadruplet, and triplet pregnancies. The psychomotor development of these children from multiple pregnancies did not, as a rule, differ much from the one of singletons, although the multiple pregnancy was more inclined to cause lesions of the central nervous system. Out of the 56 children examined, 25 were found to develop properly.It is necessary to examine the development of each child separately, taking into consideration its health condition in the neonatal period and its specific environment which effect the individual development and may be the cause of disturbances, as well as of mental differences not only in children from the same pregnancy but even in MZ twins.

Acromegaly and Obstructive Sleep Apnea: Identifying the High-Risk Group

2019 ◽  
Author(s):  
Xiaojun Zhan ◽  
Chandala Chitguppi ◽  
Ethan Berman ◽  
Gurston Nyquist ◽  
Tomas Garzon-Muvdi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Obstructive Sleep

Comparison of SCORE and Reynolds cardiovascular risk assessments in a cohort without cardiovascular disease

2013 ◽  
Vol 154 (43) ◽  
pp. 1709-1712 ◽  
Author(s):  
Csaba Móczár
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Screening Program ◽  
Risk Group ◽  
Scoring Systems ◽  
High Risk Group ◽  
Risk Assessments ◽  
Gender And Age ◽  
Medium Risk

Introduction: Cardiovascular risk assessment may help in the identification of symptom-free subjects with high cardiovascular risk. Aim: The author studied the correlation between SCORE and Reynolds risk assessment systems based on data from the cardiovascular risk screening program carried out in subjects without cardiovascular disease. Method: Data obtained from 4462 subjects (1977 men and 2485 women; mean age, 47,4 years) were analysed. The comparison was based on risk categories of the SCORE system. Results: There was a strong correlation between the two scoring systems in the low risk population (under <2% SCORE risk the Spearman rho = 1, p < 0.001). A weak correlation was found in the medium risk group (between 3–4% the Spearman rho = 0.59–0.49, p < 0.001 and between 10–14% the Spearman rho = 0.42, ns.) and a stronger correlation in the high risk group (>15% the Spearmen rho = 0.8, p = 0.017). When correlations were analysed in gender and age categories, the weakest correlation was detected in medium risk women over 40 years of age. In cases when the differences between the two scoring systems were significant, the hsCRP levels were significantly higher (4.1 vs. 5.67 mg/L, p < 0.001). Conclusions: Introduction of hsCRP into cardiovascular risk assessments can refine the risk status of symptom-free subjects, especially among intermediate risk middle-age women (two-step risk assessment). Orv. Hetil., 154 (43), 1709–1712.

Anamnestic factors that shape reproductive health of women with repeated unsuccessful popygamy in vitro fertilization

2016 ◽  
pp. 140-143
Author(s):  
N.V. Cotsabin ◽  
◽  
O.M. Makarchuk ◽  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Polycystic Ovary ◽  
High Risk Group ◽  
Stress Factors ◽  
Control Group ◽  
Fertilization In Vitro ◽  
Infertile Women ◽  
Group I

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.

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