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Vol 7, No 4 (2020)

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Literature reviews
The role of carotenoids in the physiological course of pregnancy and their significance in the development of preeclampsia and fetal development delay syndrome
Shavayeva R.K., Murashko A.V.
Abstract

Carotenoids are fat-soluble pigments synthesized by plants and some microorganisms. Thus far, more than 700 carotenoids have been identified and belong to groups of carotenes (e.g., β-carotene, α-carotene, and lycopene) as well as their hydroxylated derivatives-xanthophylls (e.g., lutein and zeaxanthin, β-cryptoxanthin, and astaxanthin). About 50 of these carotenoids can be found in the human diet, mainly of plant origin, and some are present in dietary supplements. Plasma levels of carotenoids are determined by their intakes from the diet, but about 95% of plasma carotenoids are represented by only six compounds: β-carotene, α-carotene, lycopene, and β-cryptoxanthin as well as lutein and zeaxanthin (often analyzed together; the nutritional and health effects of carotenoids are due to their multidirectional biological effects in humans, including antioxidant, anti-inflammatory and immunomodulatory properties). Furthermore, some carotinoids (β-carotene, α-carotene, and β-cryptoxanthin) can be converted to vitamin A in humans, which can contribute to meeting the reguirement for this essential vitamin. The β-carotene conversion ratio to vitamin A is 12:1 (24:1 for others carotinoids), and is altered by individuals vitamin A status, food matrices, food preparations and the fat content of are meal. The WHO estimates the about 19 million pregnant women in low-income countries are affected by vitamin A deficiency. Many biological properties of carotenoids help maintain health by decreasing the risk of chronic non-communicable diseases, such as cancer, cardiovascular disease, some eye disorders and age-related decline in cognitive functions, which has been shown in association studies.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):172-175
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Modern ideas about toxoplasmosis
Kaptilnyy V.A., Reyshtat D.Y.
Abstract

Toxoplasmosis is an infectious disease caused by Toxoplasma gondii, a protozoan, intracellular parasite that infects up to a third of the World’s population. Infection occurs when food or water is consumed with oocysts secreted from cat feces, or by eating undercooked or raw meat containing cysts.

Primary infection is usually subclinical, but some patients may have lymphadenopathy or eye disease such as chorioretinitis. An infection acquired during pregnancy can cause serious damage to the fetus. In immunocompromised patients, reactivation of latent disease can cause life-threatening encephalitis.

The diagnosis of toxoplasmosis can be established by direct detection of the parasite or using serological methods.

The most commonly used and probably most effective therapeutic treatment is a combination of pyrimethamine with sulfadiazine and folic acid.

The review contains information on the management of patients with acute Toxoplasma infection, as well as pregnant women infected during pregnancy. The issues of fetal toxoplasmosis and neonatal toxoplasmosis, eye diseases associated with toxoplasmosis, and the course of toxoplasmosis in immunocompromised individuals are discussed. Contradictions concerning the effectiveness of primary and secondary prevention in pregnant women are considered.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):176-190
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Application of hardware physiotherapy in the treatment of genitourinary syndrome in menopause: review of literature
Bakhtiyarov K.R., Ryp’yanchin U.S.
Abstract

People`s Friendship University of Russia, Medical Institute, 117198, Moscow, Russian Federation

Genitourinary syndrome in menopause is a symptom complex that occurs in women against the background of a deficiency of estrogens and other sex hormones, including changes in the vagina, urethra, bladder, external genitalia and perineum. To improve the efficiency of prevention, comprehensive treatment and rehabilitation of patients with chronic pelvic inflammatory disease, genitourinary syndrome and bladder hyperactivity proposed method of local brainpulse therapy — gynecologic (intravaginal) pneumovibromassage using MV-01 “Iwavita” apparatus.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):191-194
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Original papers
Production of some angiogenic factors and cytokines during physiological and complicated pregnancy, depending on the fetus sex
Botasheva T.L., Rymashevskiy A.N., Mikhelson A.F., Fabrikant A.D., Khloponina A.V., Zheleznyakova E.V., Zavodnov O.P.
Abstract

Objective of the study was to evaluate the levels of certain vascular-endothelial factors and cytokines in women at various stages of uncomplicated pregnancy, depending on the gender of the fetus.

Materials and methods. 1101 pregnant women were examined. Group 1st with physiological pregnancy included 584 women, among them 280 women were pregnant with female fetuses and 304 were pregnant with male fetuses. Group 2nd with placental dysfunction included 517 pregnant women (253 pregnant women with female fetuses and 264 with male fetuses). Serum levels of epidermal growth factor (EGF), vascular endothelial growth factor A (VEGF-A), tumor necrosis factor α (TNF-α), placental growth factor (PLGF), endothelin-1 (ET-1) and interleukins (IL-1, IL-6, IL-10, IL-12) were determined using ELISA method in the second and third trimesters of pregnancy.

Results. Statistically significant differences in the levels of some angiogenic factors and cytokines were revealed in pregnant women with uncomplicated gestation and placental dysfunction, depending on the sex of the fetus: in the case of the female gender, their higher levels were revealed, which indicates a more pronounced activity of the mother’s immune system during gestational adjustment with this form of fetal gender. With placental dysfunction, a decrease in the levels of certain cytokines is noted.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):195-200
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Assessment of changes in blood circulation in the vessels of the uterus and ovaries in patients after myomectomy by various operating access
Van Y., Romadanova Y.A., Bakhvalova A.A., Fedina E.V., Zinov’yev A.A., Shabanova D.D., Bryunin D.V.
Abstract

The aim of the study is to assess the restoration of anatomical and functional integrity of the uterus and the blood flow in the uterine and ovarian vessels after laparoscopic and abdominal myomectomy.

Material and methods. 58 patients aged 36.2 ± 5.9 year old with uterine myoma underwent myomectomy: 31 patients underwent laparoscopic myomectomy and 27 patients underwent abdominal myomectomy.

The selection of surgical approach didn´t depend on the size, the number and localization of uterine myomas and the patient´s concomitant pathology.

Postoperative assessment was performed on day 5th–8th after surgery and in 1 and 6 months after myomectomy. 3D ultrasound examination with color Doppler mapping was used to assess the structure of the uterine scars after myomectomy and the blood flow in the uterine and ovarian arteries.

Results. No significant differences were found in the processes of reparation of the uterus and in the blood flow in the uterine and ovarian arteries after laparoscopic or abdominal myomectomy. The time, required for the patients´ reabilitation and for the total restoration of the uterine morphological structure was about 6 months and was similar in both groups.

Conclusion. Restoration of the anatomical and functional uterine integrity and the blood flow in the uterine and ovarian arteries after myomectomy doesn´t depend on the surgical approach if myomectomy is performed by experienced surgeon after the correct assessment of the clinical situation.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):201-204
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Comparative characteristics of oximetry and electrolyte balance of arterial and venous cord blood in normal conditions
Samchuk П.М., Tsaroyeva I.K., Ishchenko A.I., Azoyeva E.L.
Abstract

Objective — to conduct a comparative characterization of oximetry indicators and electrolyte balance of arterial and venous umbilical cord blood in normal conditions.

Methods and patients. Evaluation of blood samples of the artery (n = 42) and umbilical vein (n = 42) from 42 newborns after natural birth in the term and uncomplicated course of pregnancy was performed. Blood samples were collected immediately after birth, using the BD Preset™ system. No later than 10 minutes after blood sampling, the study was performed using the ABL 800 BASIC gas analyzer.

Results. Comparison of 18 average indicators of oximetry and electrolytes revealed statistically significant differences in the norm for six of them: pH, pCO2, p50, Hct, FHbF, cK+ (p < 0.05). In the blood from the umbilical artery, there were increased pCO2, p50, Hct, cK+ and decreased pH, FHbF compared to the blood parameters of the umbilical vein (p < 0.05). There were no differences in the level indicators pO2, ctHb, sO2, FO2Hb, FCOHb, FHHB, FMetHb, cNa+, cCa2+, cCl-, mOsm, ctO2 (р > 0,05).

Conclusion. The obtained data showed that there are differences between the indicators of oximetry and the electrolyte balance of blood from the artery and vein of the umbilical cord in the case of independent delivery in time without complications (p < 0.05), which should be taken into account when assessing the condition of the newborn.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):205-209
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Peculiarities of electroencephalographic and emotional and personal characteristics of pregnant women with excessive vomiting
Vasil’yeva V.V., Botasheva T.L., Fabrikant A.D., Shakhanova A.V., Mikhelson A.A., Zavodnov O.P., Zheleznyakova E.V.
Abstract

The aim of the study is to reveal comparative characteristics of electroencephalographic and emotional-personal characteristics of pregnant women with severe vomiting and with physiological gestation.

Material and methods. An electroencephalographic and complex psychological examination of 84 women with a gestation period of 7–13 weeks was performed. The main group consisted of 45 pregnant women with a diagnosis of “severe vomiting of pregnant women”, and the comparison group — 39 women with uncomplicated gestation.

Results. It has been proven that the recorded EEG parameters in women with a complicated pregnancy reflect their diencephalic nature. According to psychological testing, pregnant women with severe vomiting had high anxiety, tension, emotional instability, reduced adaptability to gestational processes, and lack of readiness for motherhood.

Conclusion. It is assumed that the pathogenesis of severe vomiting of pregnant women is associated with impaired centralperipheral integration, contributing to the formation of maladaptive processes in the body of pregnant women

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):210-215
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Clinical observations
The first experience of using alteplase in the treatment of venous thromboembolic complications in women while taking oral contraceptives
Shpilyanskiy E.M., Murashko A.V., Sukhareva T.V., Morozov K.M., Larina D.V., Veselkova Y.A., Kolesnik D.I., Kir’yanova E.N.
Abstract

Introduction. Pulmonary embolism (PE) is potentially life-threatening complication that could develop in hormonal contraceptive users. Therapeutic thrombolysis is safe, relatively modern and effective method of treatment.

Aim of the study — to summarize our own experience of thrombolytic therapy of PE in women OC users.

We presented three cases of PE developed in association with oral contraceptive use. Tree female patients aged 20 years, 34 years, 47 years at admittance to hospital were diagnosed PE.

Result. All patients got thrombolytic therapy with alteplase 100 mg iv (10 mg bolus iv, then 90 mg continuous iv injection by infusomat). Good clinical outcomes were reached in all cases.

Conclusion. Our experience shows that alteplase is highly effective agent in PE treatment in women with TE after hormonal contraception.

Keywords: hormonal contraception; venous thrombosis; pulmonary embolism; thrombolysis.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(4):216-224
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