Aim. To analyze the features of the course of pregnancy, childbirth, the condition of newborns in pre-pregnant patients with hypertension. Materials and methods. 65 first-time pregnancies were examined, of which: group 1 (n=35) – first-time pregnancies with chronic arterial hypertension (O10.0 according to ICD X); group 2 (n=30) – first-time pregnancies with physiologically occurring pregnancy. The features of the anamnesis, the course of pregnancy, childbirth, the postpartum period, the condition of newborns were studied. Statistical processing was carried out using the program Statistica 6.0 for Windows. Results. It was revealed that the average age index (M±m) of women of the 1st group (38.6±0.22 years) was significantly higher than that of pregnant women of the 2nd group (26.6±0.22 years); p<0.0001. In women of group 1, pregnancy was complicated by a threatening abortion in the first and second trimesters (34.3 and 40%, respectively), 34.3% of fetuses had intrauterine development delay syndrome. Cesarean section was performed in 12 (34.3%) women of group 1. In group 1, during childbirth through the natural birth canal, in 13 (65.7%) after the birth of the fetus, the afterbirth separated independently in 11 (84.6%), in 2 (15.4%), manual separation and isolation of the afterbirth was performed. Conclusion. In pre-pregnant women with chronic arterial hypertension, pregnancy, childbirth and the postpartum period are complicated, with a high frequency of threatening abortion, cesarean section and increased blood loss in the postpartum period, low indicators of newborn health.
Background: pregnancy and diabetes mellitus (GDM) developed during this period are extremely unfavorable combinations for both the mother and the fetus, leading to severe consequences in the gestational period. GDM significantly increases the frequency of undesirable outcomes of pregnancy and childbirth, and also poses a serious medical and social problem for both the mother and the fetus. Aims: Тo study the level of cytokines (TGFb and IL-1b), oxytocin and relaxin in patients with gestational diabetes mellitus (GDM) in the blood serum and placenta and to show their role in the choice of delivery tactics. Materials and methods: We examined 230 women who made up 2 groups the control (with the physiological course of pregnancy, n = 95) and the main (with gestational diabetes, n = 135). All studies were performed in the blood serum and placenta of women of these groups. The content of TGFb and IL-1b was determined by enzyme-linked immunosorbent assay using the RD system (USA) and Cytimmune systems (USA) kits, and the level of relaxin and oxytocin was measured using BIOSOURCE (USA) kits. Results: We studied the production of cytokines and relaxants in the blood serum and placenta of women with GDM is in close relationship, which is confirmed by the revealed correlation dependencies: between relaxin before birth and after they have ended (among themselves, r = 0, 79, p 0, 05), as well as oxytocin (among themselves, r = 0, 78, p 0, 05) in the same period. After the end of labor, a negative relationship was found in the placenta between relaxin and IL-1b (r = -0, 61, p 0, 01). Conclusions: The ratios of relaxin to oxytocin in blood serum revealed by us can be considered as possible prognostic indicators for choosing the tactics of labor management. The use of identified biochemical markers will allow timely selection of the method of delivery in women with GDM in order to reduce the risk of complications in childbirth and thereby favorably influence perinatal outcomes and reduce the incidence of newborns.
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