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Information × Registration Number 0217U004317, 0114U004779 , R & D reports Title The study of women's reproductive health Lviv-Volyn region and the development of actions for correction of violations popup.stage_title Head Pyrohova Vira Ivanivna, Registration Date 31-01-2017 Organization Danylo Halytsky Lviv National Medical University popup.description2 This report provides a retrospective analysis of serological 10678 pregnant women and high-risk groups surveys on perinatal pathogen (cytomegalovirus, toxoplasmosis, herpes simplex virus type II); prospective survey of 400 pregnant women in the perinatal pathogen (cytomegalovirus, toxoplasmosis, herpes simplex virus type II), 200 pregnant women with thyroid disorders living in conditions of iodine deficiency; prospective survey of 150 women with a history of miscarriage, 450 pregnant women and women of reproductive age in the presence of vitamin D deficiency; 150 women of reproductive age with reproductive disorders (benign proliferative diseases of the reproductive organs, infertility). Thyroid pathology highest complication rates observed in women with gestational transient hyperthyroidism and subclinical hypothyroidism. The average level of iodine excretion in pregnant women without thyroid pathology during pregnancy below the standard indicators of iodine to ensure not only pregnant, but pregnant. Carrying iodine prophylaxis (potassium iodide, 200 mg / day) leads to normalization of thyroid status, reducing the frequency of subclinical hypothyroidism (median urinary iodine within the standards for pregnant women living in conditions of natural iodine deficiency (150.2 - 166,7mkg / ml) proved. that the amount of the trace element iodine, which is contained in a vitamin and multimineral complexes (150 mg) is insufficient to ensure a normal iodine pregnant endemic regions, requires individualized prevention of iodine potassium iodide appointment at a dose of 200 mg / day during the period of gestation. Habitual miscarriage in women with advanced reproductive losses in history observed in 42.8% of cases - the incidence of preterm birth was 25.7% (11.4% in primiparas, p <0.05), developmental delay syndrome fetus (11.4 %), fetal distress during labor (27.0%) occur twice as often, and premature detachment of normally situated placenta - 5 times more often. The frequency of stillbirth and early neonatal mortality in women with reproductive losses in history, in spite of the delivery is 28.5% surgically, 2.1 times higher than perinatal loss in primigravidae. It was established that between the nature of the professional activity, education level and frequency of reproductive losses is determined by the strong inverse correlation rxy = -0.91117 (95% confidence interval -1.0268, -0.7966) - higher education and stress associated with their professional activities, the more frequently observed reproductive losses. In 34.7% of pregnant women with miscarriage and the risk of miscarriage in the III trimester there is an anaerobic dysbiosis, which, if untreated, leads to premature rupture of membranes and premature birth. Application on antenatal care algorithm predicting fetal loss syndrome, and upon the occurrence of pregnancy - the algorithm of conducting patients with a history of reproductive losses can prevent early pregnancy loss, to reduce the incidence of preterm birth and to prevent fetal loss syndrome in 90% of pregnant women. It was found that the prevalence of seropositivity to CMV in pregnant women is in the Lvov-Volyn region, 78.2%, and the group risk primary CMV infection during pregnancy make up 21.8% of women. A limited number of povtornoobstezhenih during gestational seronegative pregnant process does not allow generalizations about the level of seroconversion in this region. It was found that 71% of women with recurrent miscarriage history found in the placenta changes that are markers of placental dysfunction: multiple psevdoinfarkty, sclerotic changes with small focal areas of necrosis and focal proliferative changes syncytiotrophoblast; focus hemorrhage, thrombosis and mononuclear infiltrates in intervilizievih spaces, is the result of uncompensated pregnancy endometrial pathological conditions, such as chronic endometritis. It was found that vitamin D deficiency at the stage of preparation for pregnancy occurs in 68.3% of women of reproductive age, with very severe deficiency of vitamin D (6,50 ± 1,05 ng / mL) is at 35.7% of patients with D -deficiency. The highest level of security vitamin D is in the group with a body mass index of 20-26 kg / m2, the percentage of people with insufficient vitamin D increases with increasing BMI. The use of water-soluble form kolekaltsiferola (Akvadetrim) in a differentiated dosage with different degrees of D-deficit within 3 months pregravid training can effectively carry out correction of the balance of vitamin D. Admission Akvadetrima 1,000 IU daily for three months in 64% of patients with a deficit and a lack of vitamin D can achieve a sufficient level of the lower limit of vitamin D (31,7 ± 1,2 ng / ml), provides the "offset" laboratory value "of vitamin D deficiency "(11,84 ± 4,11 ng / ml)" deficiency of vitamin D "(24,2 ± 1,3 ng / ml) in 72% of patients. Differentiated correction and lack of vitamin D deficiency with pregravid stage of preparation and during the first trimester of gestation can reduce the incidence of pregnancy loss from 20% to 2,9% (p <0,001), and the later development of gestational complications from 20% to 5.7%. It is proved that for women with chronic endometritis and reproductive dysfunction (miscarriage, secondary infertility) is characterized by deficiency of Vitamin D - 25 (OH), the D is 7 ng / ml to 15 ng / ml (at levels of 25 (OH), the D in women without reproductive disorders from 21 to 30 ng / ml). The effectiveness of staged treatment and therapeutic algorithm of patients with chronic endometritis and reproductive dysfunction in the whole set of parameters estimation of efficiency (offensive and wearing out pregnancy and infertility habitual miscarriage) was 81.0% with 34.6% with conventional treatment schemes. At 72.7% the residents of Lviv and Lviv region found vitamin D deficiency varying degrees of severity. Extremely severe deficiency of vitamin D (8,98 ± 1,68 ng / ml) was detected in 21.5% of patients, a deficiency of vitamin D (14,97 ± 1,74 ng / ml) - in 64.6% of women. Only 13.9% of patients with gynecological proliferative syndrome took place close to the optimal level of vitamin D (22,25 ± 1,45 ng / ml), whereas the control group among women is close to the optimal level of vitamin D (23,07 ± 2 0 ng / ml) - in 75.0% of women (p <0,001), and at 25.0% - the optimal level of vitamin D (34,9 ± 2,73 ng / ml). It should be noted that the more pronounced the D vitamin deficiency (level of 25 (OH) D from 5.9 to 15 ng / ml) were more often in women who are overweight (BMI 27-29,9 kg / m2) and obese (BMI 30 , 0-34,9 kg / m2) (p <0,01). Bring that the pharmacological effects of combination therapy (gestagen therapy in combination with drugs selective fitomolekules) dishormonal combined proliferative diseases of the reproductive organs with parallel correction of subclinical hypothyroidism in women of reproductive age to get in 90.7% recovery of cyclic changes in the endometrium, the full clinical effect, as opposed to progestins alone. It was found that the positive effect of treatment and rehabilitation complex in combined dishormonal proliferative processes of the reproductive organs is based on multifocal effects multicomponent therapy multivector universal anti-estrogenic and anti-proliferative effects, eliminate the state of relative and absolute hyperestrogenism reduce local inflammation in target organs, improve or restore the hierarchical mechanisms of hormonal regulation of the menstrual cycle, as well as the trophism and the receptor apparatus of target organs and the thyroid gland. Product Description popup.authors Вереснюк Н.С. Голота Л.І. Голюк Н.Я. Дмитриєнко В.В. Климишин Д.О. Козак Х.В. Козловський І.В Мазур Ю.Ю. Малачинська М.Й. Ошуркевич О.О. Фейта Ю.Р. Шурпяк С.О. Щурук Н.В. popup.nrat_date 2020-04-02 Close