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Information × Registration Number 0219U000466, 0116U001021 , R & D reports Title To develop diagnostic and therapeutic measures for women with obstetric pathology with the intergenetic interval popup.stage_title Head Tumanova L.E., Zhabchenko I.A., Registration Date 31-01-2019 Organization State organization "Institute of pediatrics, obstetrics and gynecology NAMS of Ukraine" popup.description2 The study found that pregnant women with a high intergenetic interval represent a significant segment in the total number of pregnant women and there is a clear tendency to increase them. The given contingent of pregnant women is markedly marked by burdened somatic and obstetric-gynecological anamnesis, high level of complications of the course of labor and the postpartum period. In these women, mastopathy was detected significantly more often, with an elevated level of precancerous cervical pathology (22.5%). In pregnant women with a high intergenetic interval partial impairment of the local immune system of the cervical canal is formed, which is realized by the lack of synthesis of secretory immunoglobulins of Class A and is accompanied by the appearance in the cervical mucus of each fifth pregnant immunoglobulin of the class M. This is regarded as a compensatory and adaptive reaction that may occur It is associated with the activation of persistent chronic infections in the genital tract of women on the eve of childbirth. The course of purpurea in women with an increased intergenetic interval is characterized by a decrease in the rate of involution of the size of the uterus in the first 5 days postpartum period, increasing the frequency of subinvolution of the uterus. These women found an increase in the incidence of inflammatory processes in the vagina (relative number of leukocytes> 50 in the field of view). The normal vaginal biocenose is found to be less than 3%. In women with a high intergenetic interval during the first year after childbirth there is a decrease in the level of stress, high level of anxiety and stress. For this group of women characterized by prolonged restoration of menstrual function, as well as insufficient education in relation to modern methods of contraception, which, in turn, violates quality of life and reproductive health. 54.1% of women with a high intergenetic interval fed their children for less than six months, while 90% of women with the optimal interval between deliveries fed their children more than six months and 50% of them more than a year. In these women, 6-12 months after childbirth, the inflammatory type of vaginal microbiocenosis was found in 30% of women. In the spectrum of the isolated microflora, yeasts and pseudomyceses (up to 80%), E.coli (35%), lactobacilli were present in 50% of these women. The increased level of precancerous pathology of the cervix in these women in 6-12 months after delivery was 35.1%. On the basis of the obtained data, a complex of treatment and prophylactic measures for women with a large intergenetic interval has been developed, which contributed to the improvement of the postpartum period and the restoration of reproductive health during the year after childbirth, namely, they were favorably noted on the psychoemotional state, quality of life, duration of lactation, development of menstrual function, adequate contraception and vaginal biocenosis.. The study examined 82 pregnant women with a violation of the obstructive function of the cervix, which carried out diagnostic and therapeutic and prophylactic measures, depending on the violation of the obstructive function of the cervix. Pregnant women were divided into 2 groups: 43 women constituted a risk group for prolonged pregnancy and 37 pregnant women with cervical obstructive function. In turn, women of both experimental groups were distributed depending on the treatment and prevention measures. Group 1 included 23 women at risk of prolonged pregnancy, who received commonly accepted therapy according to current protocols. Up to 1 (A) - a group of 20 women at risk of overweight, who received an advanced set of treatment and prevention measures. The 2nd group includes 17 pregnant women with ischemic-cervical deficiency who received a common treatment. 22 pregnant women with ischemic-cervical deficiency were referred to the 2 (A) group, who received an advanced complex of treatment-and-prophylactic measures. The effectiveness of the treatment was evaluated based on the results of studies, estimates of the course of pregnancy and the results of the end of pregnancy in 39-40 weeks. In the group of women 1 (A), timely births occurred in 85% of women against 69.5% of women in group 1. With an assessment of 8 points in women 1 (A), 75.0% of children were born, compared with 47.8% of newborns in the 1st group. In pregnant women 2 (A) urgent childbirth occurred in 86.4% of the surveyed and 81.8% of healthy babies were born with a score of Apgar 8 points against 47.1% of newborns from women of the 2nd group. In the 2 (A) group receiving the developed therapy, the indicators of hormone homeostasis: cortisol (761.9 ± 29.7) nmol / l (837.2 ± 35.7) nmol / l, in women of group 1 improved the indicator of TSH (1.6 ± 0.19) mO / l, the concentration of progesterone was (293.2 ± 22.4) nmol / l, the physiological type of colpositogram was found in 70.0% of women 1 (A) group versus 34, 8% of women in group 1. In pregnant women 2 (A) also increased the concentration of progesterone to (293,2 ± 22,4) nmol / l (p <0,05). Against the background of the proposed therapy, the "optimal type" of the psycho-emotional state was detected in 70% of the examined group 1 (A) and in 66.7% of pregnant women in group 2 (A), the relative amount of the collagen synthesis marker, the amino terminus prokolagene I type (Total P1NP) collagen, was reduced by 13.6% against stabilization of the marker of resorption of collagen I type (?-CrossLaps). There was also an increase in the amount of ionized magnesium in the blood by 25.4%, with a simultaneous decrease in the total Ca content by 7.3%, and ionized - by 8.6% and a decrease in total phosphorus concentration by 4.7%. The signs of placental dysfunction were 15.8% of pregnant women in group 1 (A), compared with 30.2% of women in group 1, and destructive changes in the placenta were twice lower in obtaining developed therapy. The proposed treatment contributed to an increase in the concentration of lactobacilli in the genital tract to the limits of the physiological norm in 86.9% of women in the 1 (A) group and in 85% of women in the 2 (A) group. The novelty of the work is to develop a method for predicting cervical changes in pregnant women with isthmic-cervical insufficiency, in the early stages of transvaginal ultrasound. This method is implemented in the practice of maternity hospitals Product Description popup.authors Іщенко Г. Бадзюк Н. Бондаренко О.М. Буткова О.І. Деменіна Н. Зосіменко Л. Коваленко Т.М. Коломієць О. Ліщенко І.С. Лисяна Т.. Лук'янова І.С Мілєвський О. Олешко В.Ф Подольський В. Стамболі Л. Стрижак С.К Сюдмак О.Р. Тищенко В.К. Травнікова Н. Чернишов В. popup.nrat_date 2020-04-02 Close