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1.
Biochemistry (Mosc) ; 84(9): 1040-1046, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31693463

ABSTRACT

Preterm birth is not only medical, but also a social problem. The global goal of medicine is prevention of preterm labor and identification of risk factors leading to preterm birth. The objective of our study was to find the association between polymorphic markers in the cytokine IL-1ß, TNF-α, IL-1Ra, and IL-4 genes and development of preterm labor. The prospective study was conducted in 108 pregnant women with the risk of preterm birth. The main group consisted of 66 women whose pregnancy ended with preterm delivery despite the ongoing therapy. The comparison group included 42 women with the full-term delivery. The dominant T allele of the cytokine IL-1ß gene polymorphism rs1143634 (3953C→T) was 7.6 times more common in women with preterm delivery vs. the comparison group (36.4 and 4.8%, respectively; RR, 1.802; 95% CI, 1.420-2.288; p < 0.05); its homozygous form was detected only in women with preterm delivery at the very early gestation age (less than 26 weeks). The dominant proinflammatory allele 2R of the IL-1 receptor antagonist gene (IL-1Ra) was 1.5 times more common in women with preterm delivery than in the comparison group (63.6 and 42.8%, respectively; RR, 1.400; 95% CI, 1.009-1.943; p < 0.05), which makes the 2R allele the risk factor for preterm birth. The 2R/2R and 2R/4R genotypes led to a very early and early preterm delivery, respectively. The combination of three or four proinflammatory genotypes was detected only in women with a very early preterm delivery, which confirms that the combination of several proinflammatory genotypes is an extremely unfavorable factor for the full-term pregnancy. Identification of genetic polymorphisms in the interleukin genes at the periconceptional stage will help to prevent the risk of preterm delivery, which will reduce the incidence of preterm births, as well as perinatal morbidity and mortality.


Subject(s)
Interleukin 1 Receptor Antagonist Protein/genetics , Interleukin-1beta/genetics , Interleukin-4/genetics , Polymorphism, Genetic/genetics , Premature Birth/genetics , Tumor Necrosis Factors/genetics , Alleles , Female , Humans , Pregnancy , Prospective Studies , Risk Factors
2.
Biochemistry (Mosc) ; 84(2): 181-186, 2019 Feb.
Article in English | MEDLINE | ID: mdl-31216977

ABSTRACT

Preeclampsia (PE) is a severe complication that develops in 10% pregnant women. It is the leading cause of maternal and perinatal morbidity and mortality worldwide. The goal of this study was to reveal the frequency of polymorphisms in the angiotensin-converting enzyme gene (ACE I/D) and type 1 angiotensin II receptor gene (AGTR1 A1166C) in pregnant women with severe early- and late-onset PE. A retrospective case-control study of 55 pregnant women with PE (main group) and 30 patients with uncomplicated pregnancy (control group) was conducted. In the main group, we considered two subgroups - early-onset PE (20 patients) and late-onset PE (36 patients). The I/D polymorphism of the ACE gene is associated with the risk of developing PE. The presence of the D allele increases the risk of severe PE. In case of DD genotype, the probability of early-onset PE is 5 times higher than that of the late-onset PE. The analyzed data confirm the involvement of renin-angiotensin system in the PE development. We conclude that the ACE gene polymorphism is a genetic predictor of the early-onset severe PE. Studying the polymorphic loci of the ACE gene makes it possible to use them for the individualized prognosis of the development and course of PE in patients.


Subject(s)
Polymorphism, Single Nucleotide/genetics , Pre-Eclampsia/genetics , Renin-Angiotensin System/genetics , Adult , Case-Control Studies , Female , Humans , Pregnancy , Retrospective Studies
3.
Vestn Ross Akad Med Nauk ; (11): 50-9, 2008.
Article in Russian | MEDLINE | ID: mdl-19143081

ABSTRACT

Pathogenesis of placental insufficiency during pregnancy with gestosis was investigated by high-tech methods including ultrasonography, dopplerometry, echocardiography, and measurement of placental and endothelial growth factors. Their utility for the evaluation of the severity of placental insufficiency was demonstrated. Diagnostic criteria for compensated and uncompensated placental insufficiency were proposed along with an algorithm for the examination of pregnant women with gestosis and obstetric strategies at different severity of this disorder. Also, criteria for prolongation of pregnancy with uncompensated placental insufficiency, indications for planned and emergency delivery by cesarean section were developed. The importance of differential approach to the choice of obstetric strategy to reduce perinatal and maternal morbidity and mortality in case of gestosis and placental insufficiency is emphasized.


Subject(s)
Delivery, Obstetric/methods , Placental Insufficiency/etiology , Practice Guidelines as Topic , Pre-Eclampsia/diagnosis , Ultrasonography, Doppler/methods , Adult , Diagnosis, Differential , Echocardiography/methods , Female , Follow-Up Studies , Humans , Morbidity/trends , Placental Insufficiency/diagnosis , Placental Insufficiency/prevention & control , Pre-Eclampsia/epidemiology , Pre-Eclampsia/therapy , Pregnancy , Pregnancy Outcome , Retrospective Studies , Risk Factors , Russia/epidemiology , Young Adult
4.
Vestn Ross Akad Med Nauk ; (9-10): 104-14, 2006.
Article in Russian | MEDLINE | ID: mdl-17111934

ABSTRACT

A longitudinal retrospective study of 803 women and a prospective study of 739 women were carried out. A complex system of the examination of women with a high placental insufficiency risk, starting from the first trimester, was developed; the appropriateness of the application of new technologies of placental system and fetal examination were substantiated. The authors offer optimal regimens of pharmacocorrection of fetal condition disturbances and the activation of compensatory and adaptive reactions of the fetoplacental complex in placental insufficiency of various origins. The optimal obstetric tactics, the possibilities of therapy and pregnancy prolongation, and indications to operative delivery were defined on the basis of the features of placental dysfunction pathogenesis and a thorough analysis of the features of placental insufficiency in women with a high risk of perinatal complications.


Subject(s)
Fetal Diseases , Placental Insufficiency , Pregnancy Complications , Pregnancy, High-Risk , Adolescent , Adult , Apgar Score , Female , Fetal Diseases/diagnosis , Fetal Diseases/drug therapy , Fetal Diseases/etiology , Humans , Infant, Newborn , Longitudinal Studies , Menarche , Placental Circulation , Placental Function Tests , Placental Insufficiency/etiology , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/etiology , Pregnancy Complications/therapy , Pregnancy Trimester, First , Pregnancy, Prolonged , Prenatal Diagnosis , Prospective Studies , Retrospective Studies , Risk Factors
5.
Vestn Ross Akad Med Nauk ; (11): 3-8, 2004.
Article in Russian | MEDLINE | ID: mdl-15651656

ABSTRACT

Summarized in the paper is the experience of defining the clinical significance of examination of hemodynamics of mother and fetus in physiological and complicated pregnancy. The normative parameters of blood circulation in the vessels of mother and their central hemodynamics are described. An interrelation between the changes of central hemodynamics of mother and fetus are shown in the development of gestosis and placental insufficiency. The orientation, succession and changes of blood circulation in the arteries and venous vessels of fetus are demonstrated in chromosomal anomalies, congenital malformation, premature pregnancy, gestosis, fetoplacental insufficiency and postmaturity. It was proven as prognostically valuable to study the parameters of blood circulation of mother and fetus not only in diagnostically complicated pregnancy but also in evaluating the therapy efficiency, as well as in choosing a method and time for delivery and in prognosticating a perinatal outcome.


Subject(s)
Fetus/physiology , Pregnancy Complications/physiopathology , Pregnancy/physiology , Female , Fetus/physiopathology , Hemodynamics , Humans , Placental Circulation/physiology , Placental Insufficiency/diagnostic imaging , Placental Insufficiency/physiopathology , Pre-Eclampsia/diagnostic imaging , Pre-Eclampsia/physiopathology , Pregnancy Complications/diagnostic imaging , Ultrasonography, Prenatal
6.
Vestn Ross Akad Med Nauk ; (8): 43-8, 2001.
Article in Russian | MEDLINE | ID: mdl-11552625

ABSTRACT

The study was undertaken to examine the specific features of maternal and fetal hemodynamics in the pathogenesis of gestosis and to develop differential approaches to obstetric policy. For this, a total of 345 pregnant women at risk for gestosis were examined. This condition was prevented using aspirin and trental in 60 women. The findings suggest that hypokinetic central hemodynamics with increased total peripheral vascular resistance and with impaired blood flow in the uterine and spiral arteries are a valid predictor of gestosis. Changes in maternal hemodynamics are revealed just in the late first to early second trimester of gestation. The use of aspirin and trental in patients with hypokinetic central hemodynamics and impaired blood flow in the uterine and spiral arteries reduced the incidence of gestosis by 2.5 times, delayed intrauterine fetal development by 3 times.


Subject(s)
Pre-Eclampsia/etiology , Adolescent , Adult , Aspirin/therapeutic use , Diagnosis, Differential , Female , Hemodynamics , Humans , Models, Theoretical , Pentoxifylline/therapeutic use , Placental Circulation , Platelet Aggregation Inhibitors/therapeutic use , Pre-Eclampsia/diagnosis , Pre-Eclampsia/physiopathology , Pre-Eclampsia/prevention & control , Pregnancy , Prognosis , Risk Factors , Ultrasonography, Prenatal , Vasodilator Agents/therapeutic use
7.
Vestn Ross Akad Med Nauk ; (1): 51-7, 1999.
Article in Russian | MEDLINE | ID: mdl-10078064

ABSTRACT

A total of 810 pregnant women were examined in order to elucidate the pathogenesis of hemodynamic disorders in gestosis. The main group consisted of 460 patients with gestosis of different severity and the control group included 150 women with uneventful pregnancy. Central and regional hemodynamics in normal pregnancy were studied in detail by modern diagnostic methods (echocardiography and dopplerometry) and the relationship between the detected shifts and the function of the utero-placento-fetal circulation was shown. The predominant type of central hemodynamics in gestosis is the hypokinetic. Disorders in renal and cerebral circulation contribute to the pathogenesis of severe gestosis. Pathogenetic variants of hemodynamics shifts in gestosis are analyzed and recommendations on the follow-up of pregnancy are offered. Indications for preterm delivery in the interests of the mother and fetus are defined.


Subject(s)
Decision Making , Hemodynamics , Obstetrics/methods , Pre-Eclampsia/physiopathology , Adult , Female , Follow-Up Studies , Gestational Age , Humans , Pre-Eclampsia/diagnostic imaging , Pre-Eclampsia/therapy , Pregnancy , Ultrasonography, Doppler
9.
Article in Russian | MEDLINE | ID: mdl-9103021

ABSTRACT

117 patients with acute endometritis after induced abortion were examined using markers of wound process phases and treated according to the original method. This consists in combination of constant magnetic field with other modalities. Application of the constant magnetic field produced a significant clinical response and reduced the hospital stay through positive effect on healing of the endometrial wound.


Subject(s)
Abortion, Induced/adverse effects , Endometritis/rehabilitation , Magnetics/therapeutic use , Abortion, Spontaneous/complications , Acute Disease , Adolescent , Adult , Combined Modality Therapy , Endometritis/etiology , Evaluation Studies as Topic , Female , Humans , Pregnancy , Time Factors
10.
Vestn Ross Akad Med Nauk ; (6): 72-7, 1996.
Article in Russian | MEDLINE | ID: mdl-8924842

ABSTRACT

Ninety-one patients with physiological pregnancy and gestosis were studied. This included examinations of maternal central hemodynamics and Doppler study of blood flow in the system of carotids, renal artery and its branches, uterine and umbilical arteries. The volumetric maternal central hemodynamic parameters were found to increase concurrently with a reduction in peripheral vascular resistance during physiological pregnancy, which is associated with the emergence and development of a fetoplacental complex. In gestosis, there are decreases in the volumetric maternal central hemodynamic parameters and increases in peripheral vascular resistance in all the vessels under study. Clear diagnostic criteria for predicting and diagnosing gestotic complications, such as preeclampsia and eclampsia, and fetoplacental failure in time have been defined. A contribution of echocardiographic and Doppler studies is shown in the evaluation of the severity of gestosis and the efficiency of the therapy used.


Subject(s)
Blood Circulation , Hemodynamics , Pre-Eclampsia/physiopathology , Pregnancy/physiology , Adult , Echocardiography , Female , Humans , Pre-Eclampsia/diagnostic imaging , Pregnancy/statistics & numerical data , Pregnancy Outcome , Reference Values , Ultrasonography, Prenatal
11.
Article in Russian | MEDLINE | ID: mdl-8686218

ABSTRACT

The surgical treatment for tubal pregnancy including laparoscopy and antibacterial therapy were combined in 30 females with early start (on postoperative day 1) of rehabilitation: psychotherapy, diet, therapeutic exercise, low-frequency magnetotherapy. Hysterosalpingography and dynamic dopplerography assessed the effect as good.


Subject(s)
Pregnancy, Tubal/rehabilitation , Adult , Combined Modality Therapy , Fallopian Tubes/surgery , Female , Humans , Magnetics/therapeutic use , Postoperative Care , Pregnancy , Pregnancy, Tubal/diagnosis , Psychotherapy, Rational-Emotive
12.
Antibiot Khimioter ; 40(5): 42-7, 1995 May.
Article in Russian | MEDLINE | ID: mdl-8534181

ABSTRACT

One of the major factors of nonspecific immunity i.e. the state of the host interferon system was studied with a purpose of its correction in the treatment of inflammatory diseases of the uterine appendages of the chlamydial etiology. In all the female patients with chronic inflammatory diseases of the uterine appendages of the chlamydial etiology there was observed a disorder in the function of the interferon system link: a decrease in the concentration of blood serum interferon and a lower capacity of the blood cells to produce alpha- and gamma-interferons. The findings were used as a theoretical ground for the inclusion of neovir, an inductor of alpha-interferon to the treatment of such patients. After the completion of the treatment course with the use of neovir the index of the serum interferon proved to be higher than the normal by 2.4 log2IU and the indices of alpha- and gamma-interferons were lower than the normal only by 0.1 and 1.3 log2IU respectively. Therefore, the mechanism of the neovir action included activation of the function of the interferon endogenic system. The morphometrical analysis of the number of the cytoplasmic granules of the polymorphonuclear leukocytes in the peripheral blood before, during and after the therapy with neovir and pefloxacin showed that neovir not only promoted restoration of the digestion function of the neutrophilic leukocytes but also markedly activated it which provided a success of the phagocytic attack.


Subject(s)
Acridines/therapeutic use , Chlamydia Infections/drug therapy , Interferon Inducers/therapeutic use , Pelvic Inflammatory Disease/drug therapy , Adjuvants, Immunologic/therapeutic use , Adolescent , Adult , Chlamydia Infections/complications , Chlamydia Infections/immunology , Chronic Disease , Cytoplasmic Granules/drug effects , Cytoplasmic Granules/ultrastructure , Drug Therapy, Combination , Female , Humans , Lipopolysaccharides/therapeutic use , Microscopy, Electron , Neutrophils/drug effects , Neutrophils/ultrastructure , Pefloxacin/therapeutic use , Pelvic Inflammatory Disease/etiology , Pelvic Inflammatory Disease/immunology , Recurrence , Remission Induction , Time Factors
13.
Akush Ginekol (Mosk) ; (2): 30-5, 1995.
Article in Russian | MEDLINE | ID: mdl-7785736

ABSTRACT

Dopplerometric investigation of pelvic arteries was carried out in 30 women without gynecologic diseases, in 51 patients with internal endometriosis, and 48 ones with uterine myomas. Internal endometriosis of the uterus was found to be characterized by specific qualitative changes in spectral curves of bloodstream velocity in the internal iliac and uterine arteries. Moreover, progressive changes in spectral curves related to dissemination of endometrioid heterotopias were revealed. In patients with uterine myomas combined with internal endometriosis disorders of peripheral circulation typical of endometriosis predominated.


Subject(s)
Endometriosis/diagnostic imaging , Iliac Artery/diagnostic imaging , Leiomyoma/blood supply , Leiomyoma/diagnostic imaging , Ovary/blood supply , Ovary/diagnostic imaging , Uterine Diseases/diagnostic imaging , Uterine Neoplasms/blood supply , Uterine Neoplasms/diagnostic imaging , Uterus/blood supply , Uterus/diagnostic imaging , Adult , Arteries/diagnostic imaging , Arteries/physiology , Endometriosis/physiopathology , Female , Humans , Iliac Artery/physiology , Middle Aged , Reference Values , Regional Blood Flow , Ultrasonography , Uterine Diseases/physiopathology
14.
Akush Ginekol (Mosk) ; (5): 31-3, 1995.
Article in Russian | MEDLINE | ID: mdl-8579203

ABSTRACT

Seventy-six patients with adenomyosis were examined using computer-aided hysterosalpingography and transvaginal ultrasonic scanning in the "pseudocolor" mode. Organ-sparing operation, myometrectomy (removal of the involved myometrium with preservation of the uterus) was performed in 8 patients aged 18 to 34. In the postoperative period, conservative therapy was administered. Fifty percent of patients became pregnant within a year after the operation.


Subject(s)
Endometriosis/surgery , Myometrium/surgery , Uterine Diseases/surgery , Adolescent , Adult , Chronic Disease , Diagnosis, Differential , Endometriosis/diagnosis , Female , Follow-Up Studies , Humans , Hysterectomy , Middle Aged , Uterine Diseases/diagnosis
16.
Vestn Ross Akad Med Nauk ; (8): 34-41, 1994.
Article in Russian | MEDLINE | ID: mdl-7524863

ABSTRACT

The paper outlines the issues of improving and systematizing clinical instrumental diagnostic and therapeutical techniques for internal endometriosis. The results of examining 220 patients with internal endometriosis, out of whom 116 were further operated on, have been prospectively and retrospectively studies. Based on the histological findings of the gross specimens intraoperatively removed, the authors analyzed the predictive value of clinical and instrumental diagnostic criteria, including those of transvaginal echography, Doppler echometry of the arteries supplying the uterus, those of hysteroscopy and the computer hysterosalping graphic technique developed by them. The ovarian morphological and receptor apparatuses were studied in internal endometriosis. The examination and treatment system for patients with internal endometriosis is presented in the paper.


Subject(s)
Endometriosis/diagnosis , Endometriosis/therapy , Uterine Diseases/diagnosis , Uterine Diseases/therapy , Adolescent , Adult , Decision Trees , Female , Humans , Middle Aged , Predictive Value of Tests , Prospective Studies , Retrospective Studies
17.
Akush Ginekol (Mosk) ; (6): 52-7, 1994.
Article in Russian | MEDLINE | ID: mdl-7892952

ABSTRACT

Clinical and immunological studies were carried out in 60 patients with tubal pyoinflammatory diseases and in 20 healthy controls of a reproductive age. The immunity status was studied using IKO monoclonal antibodies to differentiation antigens of peripheral blood mononuclears. An acute purulent process was found to be characterized by an adaptive increase in the count of mononuclears carrying the markers of B lymphocytes (CD22, IgM mu-chain), of activated cells (CD38, HLA-D(r)), and of the total number of positive correlations between immunocompetent cells. A persistent course of tubal inflammation is connected with hyperproduction of antibodies and immune complexes, increased expression of HLA-Dr antigens in combination with congenital or acquired insufficiency of T-helper/inductors and suppressors/cytotoxic T-cells. An important factor in the development of a chronic suppurative process is triggering of immunocomplex mechanisms associated with fixation of IgG, IgM, and the complement in the walls of small vessels in the uterine tubes, with a high level of circulating immune complexes, and appearance of plasma cells containing IgG and IgM in the tissues of uterine tubes.


Subject(s)
Fallopian Tube Diseases/etiology , Immune System Diseases/complications , Adolescent , Adult , Antibodies, Monoclonal , Antigen-Antibody Complex/analysis , B-Lymphocytes/immunology , Complement System Proteins/analysis , Fallopian Tube Diseases/immunology , Female , HLA-DR Antigens/analysis , Humans , Immune System Diseases/diagnosis , Immune System Diseases/immunology , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Immunohistochemistry , Inflammation , Suppuration , T-Lymphocytes/immunology
18.
Akush Ginekol (Mosk) ; (1): 41-4, 1994.
Article in Russian | MEDLINE | ID: mdl-8209955

ABSTRACT

The ovaries and endometrium were examined in 66 patients with internal uterine endometriosis with various degrees of the process dissemination. A high incidence of combinations of uterine endometriosis with hyperplastic processes in the ovaries was revealed (72.7%) and a relatively low incidence of uterine body mucosa involvement (31.7%). The degree of endometriosis dissemination in the myometrium and the incidence of ovarian hyperplasia were in direct proportion. The authors emphasize the usefulness of morphologic studies of the ovaries in patients with internal uterine endometriosis.


Subject(s)
Endometriosis/pathology , Endometrium/pathology , Ovary/pathology , Uterine Diseases/pathology , Adult , Female , Humans , Middle Aged
20.
Akush Ginekol (Mosk) ; (2): 24-30, 1993.
Article in Russian | MEDLINE | ID: mdl-8048664

ABSTRACT

Effects of intravenous and oral hinipral on the uteroplacentofetal blood flow and fetal heart work were studied in tocolytic therapy of preterm labor in 27 pregnant women at terms 25-35 weeks. Intravenous infusions of hinipral resulted in a significant reduction of the systolic-diastolic ratio in the umbilical artery, with the blood flow in the uterine arteries persisting stable, and in a significant reduction of the fetal heart rate and increase of fetal heart rhythm variability, as evidenced by cardiotocogram. In oral tocolysis the reduction of the umbilical artery was related to the pregnancy term; fetal heart rate and heart rhythm variability were within the normal range over the course of the investigation. The results evidence no negative effects of the drug on the uteroplacentofetal blood flow and fetal cardiovascular system both in oral and parenteral forms of tocolysis.


Subject(s)
Fetal Heart/drug effects , Fetus/drug effects , Hexoprenaline/therapeutic use , Obstetric Labor, Premature/drug therapy , Placenta/drug effects , Tocolytic Agents/therapeutic use , Uterus/drug effects , Abortion, Threatened/drug therapy , Abortion, Threatened/physiopathology , Adult , Drug Evaluation , Female , Fetal Heart/physiology , Fetus/blood supply , Hexoprenaline/pharmacology , Humans , Obstetric Labor, Premature/physiopathology , Placenta/blood supply , Pregnancy , Regional Blood Flow/drug effects , Tocolytic Agents/pharmacology , Uterine Contraction/drug effects , Uterus/blood supply
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