Reproductive health of woman最新文献

{"title":"Modern approaches to the correction of age-related skin changes in women","authors":"G. Makurina, V. Siusiuka, A. Chornenka, A. Shevchenko, L. О. Cherneda","doi":"10.30841/2708-8731.4.2023.285761","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285761","url":null,"abstract":"The article is devoted to the literature review on the correction of age-related skin changes in women. Skin aging is a physiological process that is caused by the constant action of unmodified factors, for example, endocrine disorders, shortening of telomeres, etc., in combination with periodic influence of modified (exposomal) factors. Ultraviolet radiation takes first place among external factors affecting the progression of degenerative changes in skin, however, in women, involutional changes in skin are primarily associated with a fading of synthetic function of ovaries. During the first five years from the onset of menopause, content of collagen fibers I and III types is reduced by 30% in combination with a further reduction of 2% annually for the next 15 years.Involutive transformations occur in all layers of skin and are visually characterized by the presence of wrinkles, roughness of the epidermal surface (with photoaging) or a decrease in its thickness (with chronic aging), dryness, pigmentation disorders in the form of uneven hyperpigmented spots, telangiectasias, oval deformations.Today, there are many methods of aesthetic correction of age-related skin changes. In the arsenal of a cosmetologist there are both invasive (PRP-therapy, microneedling, microneedle radio wave lifting, administration of preparations based on calcium hydroxyapatite, polylactic and hyaluronic acid, etc.) and minimally invasive (administration of botulinum neuroprotein, application of chemical acid peelings, IPL-therapy and laser polishing, photodynamic therapy) methods. Patients prefer minimally traumatic procedures due to the fact that they almost do not disturb the processes of socialization, however, each of these methods has both advantages and disadvantages.Modification of a woman life quality in peri- and menopause in form of changes in lifestyle and eating behavior, increasing physical activity, quitting smoking and limiting the use of alcoholic beverages is an integral part of therapeutic care. However, the appointment of menopausal hormonal therapy, including the use of estrogens, progestogens and combined hormonal drugs, allows to achieve a stable and long-lasting effect from cosmetology procedures and home care.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81860728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situational analysis of the problem of maternal mortality in Ukraine and ways to solve it","authors":"N.Y. Zhylka, O. Shcherbinska, I.P. Netskar","doi":"10.30841/2708-8731.4.2023.285759","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285759","url":null,"abstract":"The maternal mortality (MM) rate is considered an integrated indicator of women’s reproductive health, which reflects not only the state of general health, including reproductive one, the quality of medical care for pregnant women and the level of organizational work of maternity institutions, but also the combined interaction of these factors with economic, ecological, sanitary-cultural, social-hygienic and other ones.The objective: to highlight the current problem of MM in Ukraine and the world, finding its main factors and ways to solve it.Materials and methods. Bibliosemantic, analytical, statistical and conceptual methods were used. The research period is 2010–2022.Results. The MM rate is currently an extreme problem worldwide. The World Health Organization (WHO) emphasizes that MM is unacceptably high. In 2020, almost 287,000 women died during and after pregnancy and childbirth. Almost 95% of all maternal deaths in 2020 occurred in low-income and lower-middle-income countries, and most of them were preventable.Conclusions. In Ukraine, there is a negative wave-like situation with the MM indicator, that is fluctuations from decrease to increase. And even the decrease in the MM indicator does not reach its level in developed countries. In 2022, 19.3 per 100,000 live births were registered. The main reasons for the high rates of MM in Ukraine are: the imperfection of the health care system in relation to the formation of reproductive health in adolescents, the loss of the potential of the family planning system, the insufficient level of accessibility of Ukrainian women to reproductive health care services, the low level of organization of perinatal assistance and its effectiveness, lack of a monitoring system for compliance with quality criteria of clinical protocols, as well as an insufficient level of socio-economic support of the population.The implementation of measures of the WHO Global Strategy and goals for the prevention of maternal mortality by 2030 will contribute to the reduction of the MM indicator, namely, the increase in the availability and quality of medical and sanitary services in the health care system of adolescents, mothers and newborns, in reproductive health, for the prevention of maternal mortality, improving the efficiency of the health care system.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84849202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labour as a manifestation of systemic inflammatory reaction (Literature review)","authors":"O. Zahorodnia, Yu. B. Motsyuk, T.V. Amerkhanova","doi":"10.30841/2708-8731.4.2023.285769","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285769","url":null,"abstract":"Childbirth is the result of a rapid biological reaction, in which the humoral and cellular links of immunity take part. Therefore, all attempts to stop the uterine premature contractile activity at the level of the myometrium have only a temporary effect. This review deals with the modern scientific data about the role of immune mechanisms in the labor activity origin from the point of view of the possibilities of predicting its anomalies and pathogenetically based treatment of premature labor.Cytokine balance plays a role already in the process of implantation, during the interaction between the endometrium and the fertilized egg. The increased content of pro-inflammatory cytokines in the endometrium is more typical for the women with normal implantation than for the patients with recurrent reproductive losses. Endometrial decidualization, vascular remodeling occurs under the influence of pro-inflammatory mediators. The traditional view of the preterm labor pathogenesis assumes its infectious nature, which is confirmed by the prevalence of infection in premature newborns and is explained by the activation of pro-inflammatory mediators.Modern opinions regarding the primacy of the inflammatory response in premature rupture of the fetal membranes are outlined. The heterogeneity of the inflammatory response in different patients found an explanation in the polymorphism of genes encoding the main receptors of the immune response – TOLL receptors. The discovery of numerous proteins of the acute inflammation phase led to the search for their role in the implementation of labor activity. So far, the ability to stimulate labor activity has been shown for FCGR3A protein and haptoglobin.Inadequate consideration of the inflammatory reaction role, in particular its systemic nature, in the pathogenesis of premature labor has led to an overestimation of the possibilities of tocolytic therapy. Meta-analyses indicate that the use of tocolytics, despite the effective increase in the duration of pregnancy, does not improve the condition and prognosis of the newborn. Most tocolytic drugs have a point of application of a part of the myocyte, contact with which blocks its contraction. However, all of them, with the exception of indomethacin, do not affect the immunological causes of the development of premature labor, and therefore do not eliminate their effect on the fetus.The inflammatory reaction does not always have an infectious origin, so the management of routinely prescribing antibacterial drugs to prevent premature births has also not spread. At present, it should be recognized that powerful inflammatory processes underlying labor activity, premature in particular, in most cases determine the inevitability of premature birth.Research on finding the regulation of inflammatory mechanisms for the regulation of labor activity can be considered promising, but they are in the early theoretical stages. For a modern doctor, the systemic nature of the inflammatory re","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79516496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features of disorders and methods of correction of the hemostasis system in women with antenatal fetal death","authors":"V. Benyuk, A. Chebotarova, N. M. Hychka, Tetiana Kovaliuk, S. Beniuk, I. Usevych, V. Kurochka, V.O. Polovynka","doi":"10.30841/2708-8731.4.2023.285765","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285765","url":null,"abstract":"The improvement of the providing medical services quality to pregnant women remains an urgent issue in modern obstetrics. Women with perinatal losses deserve special attention, especially in the second half of pregnancy. Changes in the hemostasis system are an integral part of the development of pregnancy. The tendency to hypercoagulation has significant pathogenetic significance and can be the cause of a number of complications – miscarriage in the I trimester of pregnancy and preeclampsia, premature birth, antenatal fetal death (AFD) – in the II and III trimesters of pregnancy. Also, pregnancy is a background process for the activation of a number of diseases, in particular hereditary thrombophilia.The objective: to evaluate the changes in the hemostasis system in women with antenatal fetal death and the effectiveness of the use of low molecular weight heparins for the correction of disorders in the hemostasis system in this category of patients during childbirth and in the postpartum period.Materials and methods. 72 women were examined, including 42 pregnant women with AFD (main group) and 30 pregnant women with a physiological course of pregnancy, childbirth and the postpartum period (control group). The state of the hemostasis system was studied using a standard coagulogram. D-dimer was determined by immunoturbometric analysis.To assess the state of the hemostasis system, the following biochemical tests were used: procoagulant link – fibrinogen content and indicators: prothrombin index, activated partial thrombin time (APTT), thrombin time (TP), ancistrone time (AT), soluble fibrinogen-monomer complex (SFMC), factor X (FX); to evaluate the antithrombin system, the content of antithrombin-III (AT-III), protein C were determined; to characterize the state of the fibrinolytic system – the amount of plasminogen, α2-antiplasmin, fibrinogen degradation products (FDC).Thrombophilia markers and antiphospholipid antibodies were also determined. The preference was given to vaginal childbirth. During childbirth, mechanical compression of the lower limbs was applied using special compression stockings (compression level 2). In 12 hours after delivery thromboprophylaxis with low molecular weight heparins was started, the drug of choice being enoxaparin sodium. After 48 hours of the postpartum period, a comparative analysis of coagulogram indicators was performed to further determine the timing of thromboprophylaxis.Results. Analysis of family thrombotic anamnesis revealed risk factors in 12 (28.6%) patients of the main group. In close relatives of the first line, the presence of peripheral vein thrombosis was found – 5 (41.7%) cases, myocardial infarction under the age of 45 – 3 (25.0%) cases, pulmonary embolism – 1 (8.3%) case, transient ischemic attack of the brain – 3 (25.0%).In the control group only 2 (6.6%) patients had a family history of venous thromboembolism in first-line relatives. The analysis of the coagulation system shows significantly hig","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75413095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evidence bases of etiopathophysiology and preventive clinical management of nausea and vomiting in pregnancy","authors":"V. I. Medved, S. I. Zhuk, D. Konkov, S.K. Litvinov, O.L. Ocheretna","doi":"10.30841/2708-8731.4.2023.285760","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285760","url":null,"abstract":"Nausea and vomiting, or early toxicosis, is a common disorder during pregnancy, affecting up to 80% of pregnant women. The severe form is known as excessive vomiting of pregnancy – hyperemesis gravidarum (HG) and is a debilitating and potentially life-threatening illness during pregnancy which is characterized by persistent nausea and/or vomiting, weight loss, malnutrition and dehydration, increases the risk of adverse maternal and perinatal outcomes.Without the methodical intervention of experienced clinicians, life-threatening complications can develop. Effective prevention and treatment strategies for HG require an understanding of both pathophysiological and psychosocial factors, awareness of potential risks and complications, and proactive assessment and treatment methods using innovative clinical tools. HG is characterized by dehydration, electrolyte and metabolic imbalance, as well as nutritional deficiency, which can lead to hospitalization. The severity of nausea and vomiting during pregnancy can be assessed using the Unique Gestational Vomiting Qualification (scale PUQE-24), which has been shown to be a relatively accurate assessment of the patient’s lifestyle, including hours of sleep.For high-quality differential diagnosis, a focused anamnesis collection and examination are necessary, since the diagnosis of this condition is mainly determined clinically. Laboratory tests are useful tools for evaluating complications such as electrolyte or metabolic imbalances or kidney damage. In addition, they help to determine the etiology in refractory cases.Hypotheses that contribute to the understanding of the pathogenesis of HG have been based on associations that are causal, sequential, or coincidental. Much efforts are needed to precisely establish these relationships in well-designed studies. HG is the most common indication for hospitalization in the first half of pregnancy. Numerous nutrient deficiencies have been identified, such as thiamine deficiency, which can lead to Wernicke’s encephalopathy, vitamin K deficiency, and severe hypokalemia.It is noteworthy that, in addition to the above-mentioned physical complications, HG is also associated with psychological adverse consequences. Although it has been associated with serious complications, little is known about its prognostic factors.The purpose of this systematic review was to find and critically evaluate studies that determined the priority areas of clinical management of vomiting in pregnant women, based on the differentiation and pathophysiological component, the analysis of the safety profile of non-pharmacological agents to prevent the development of the above-mentioned gestational pathology, and the clarification of an effective strategy of interprofessional teams to improve care coordination and outcomes in pregnant women with nausea and vomiting.A systematic data search was carried out in the databases MEDLINE, ISI Web of Science, PubMed, Scopus, Google Scholar, Cochrane Databa","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78416346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology of cervical epithelium in women with various forms of infertility","authors":"K.V. Sereda","doi":"10.30841/2708-8731.4.2023.285764","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285764","url":null,"abstract":"Failure to conceive in a couple, that does not prevent fertilization for 12 months or more, is defined as infertility. This diagnosis is special one both because of the social component and of the involvement of two persons in it, as well as because of polyetiological factors. Pathology of the cervical epithelium is a common problem among women of reproductive age. In patients with infertility, it has its own significance as a factor for fertility disorders. In addition, there is a possible influence of different methods of treatment of pathology of the cervical canal on the course of pregnancy that occurred after treatment.The objective: to study the prevalence of cervical pathology in patients with various types of infertility.Materials and methods. The results of liquid cytology and human papillomavirus (HPV) testing were analyzed in 416 women, who were divided into four groups: I group included 108 patients with infertility associated with anovulation, II group – 101 patients with infertility of tubal origin, III group – 102 women with a male infertility factor in marriage, IV group – 105 women who applied for a preventive examination.Results. The general frequency of early cervical lesions of severity various degrees was differed significantly in the groups of the examined persons – from the lowest 25.9% in the group of patients with infertility associated with anovulation, and 35.2% in the group of women who applied for a preventive examination, to 50.9 % among women with infertility of tubal origin and 52.4% – in the group with a male infertility factor.In the last two mentioned groups, the frequency of severe intraepithelial lesions (7.8% and 7.9%, respectively) was higher than in the other groups, where it was established at a level of no more than 1.5%. A higher rate of HPV infection was also established in the groups infertility of tubal origin – 68.6%, male infertility – 63.4%, while in the group of patients with anovulation infertility its prevalence was at the level of 35.1%, which does not exceed the rate of healthy women in control group – 25.7%.Conclusions. 1. Patients with infertility of tubal origin and male factor infertility have a higher frequency of early cervical changes (50.9% and 52.9%, respectively) than healthy women of reproductive age (35.2%). 2. In cases of tubal and male factor infertility, the frequency of HPV infection is higher than the rate of the cervical epithelium lesions detected by the cytological method (68.6% and 63.4%, respectively), which allows us to recommend the HPV test to include in the list of mandatory examinations during preparation for the program of assisted reproductive technologies.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78388267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biocenosis of the vaginal tract in patients with fertility on the background of chronic endometritis","authors":"O.M. Susidko, O.A. Lubkovska, O. Kovalishin","doi":"10.30841/2708-8731.4.2023.285768","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285768","url":null,"abstract":"The objective: to determine the microbiota profile of vagina, cervical canal and endometrium by chronic endometritis (CE) in patients with a history of infertility.Materials and methods. A prospective study and clinical-laboratory analysis of the microbiocenosis of the vagina, cervical canal and uterine cavity in women with CE and infertility in history was conducted. The 1st group included 100 women of reproductive age with CE and infertility, the 2nd group – 40 women of reproductive age without impaired fertility.The scope of research is pH-metry of vaginal secretions, assessment of vaginal microbiocenosis based on Gram-stained smear microscopy, polymerase chain reaction method, cultural research of vaginal secretions, study of the microflora of the cervical canal and the uterine body.Results. In women with CE and a history of infertility, normobiocenosis of the vagina was found in only 32 patients (32.0±3.1%). In other cases, bacterial vaginosis, vulvovaginal candidiasis, and bacterial vulvovaginitis were detected. Microscopy and PCR-diagnostics of secretions from the cervical canal and uterine cavity in women with CE determined Streptococcus agalactiae, Enterococcus faecalis, Chlamidia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium, HPV, Gardnerella, HSV 1st or 2nd types and CMV.Conclusions. A characteristic feature of the vaginal flora in chronic endometritis is a high level of dysbiotic changes combined with high rates of insemination by opportunistic flora. The microbiota of the cervical canal and endometrium during inflammatory processes of the endometrium is characterized by the predominance of obligate anaerobic microorganisms in the form of associations with viral infection, which are significantly more often (more than 2 times) detected in the endocervix compared to the endometrium.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83454783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy and psychoemotional stress reactions. Age factor","authors":"A.Ye. Husieva","doi":"10.30841/2708-8731.4.2023.285762","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285762","url":null,"abstract":"Pregnancy is a unique period in a woman’s life with an increased likelihood of psychological changes and emotional disorders such as depression, anxiety and stress. Almost 70% of women experience various changes in their mental state during pregnancy. There is a need to consider the physiology and psychology of a pregnant woman not as a separate process, but as a single integrated system and to promote the search for new methods of regulating psychoemotional states.The objective: to determine the relationship between psychoemotional stress reactions and pregnancy, taking into account the age factor.Materials and methods. Special psychometric testing of 100 pregnant women of different ages and at different stages of gestation was carried out. Each of the research participants was asked to complete a survey using three questionnaires. The Spielberger–Hanin scale, the psychological stress measure (PSM-25) and the impact of event scale – revised (IES-R) of a traumatic event were used for analysis. The average age of the examined patients was 30.9±5.54 years; 48 persons were ≤30 years old, 49 women were 31–40 years old, and 3 patients were ≥41 years old.Statistical processing of the results was carried out in the program for working with electronic spreadsheets Microsoft Excel 2016 and the program for comprehensive data analysis - STATISTICA 10 for Windows. Graphic design was done with Microsoft Excel 2016.Results. According to the Spielberger–Hanin survey, 14% of women had a low level of reactive anxiety, 52% – a moderate level, and 34% – a high level. Only 7% of women had a low level of personal anxiety, and their average value was close to a moderate level, 44% of patients had a moderate level and 49% had a high level.According to the data of impact of event scale – revised (IES-R) of a traumatic event, which has 3 subscales, it was established that a low level of the subscale of intrusion among the interviewed pregnant women was found in 16% of women (n=16), an average level in 23%, an elevated level in 15% and high one – in 46%. A low level of the avoidance subscale was determined in 16% of women, an average level – in 12%, a high level – 14%, and a high level – 58%.According to the results of the psychological stress measure PSM-25, the majority of women had a low level of stress – 77%, medium level – 22%, high level – 1%.Conclusions. According to the results of the study, the majority of women had a high level of anxiety during pregnancy, the prevalence of which was the highest one among women 31 to 40 years old; the lowest rate was among pregnant women younger than 30 years old.It is necessary to develop measures aimed at psychoprophylaxis of pregnant women, at their conscious attitude to pregnancy, childbirth and subsequent motherhood.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75306573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal bleeding in pregnant women","authors":"S. Vasyliuk, О.М. Makarchuk, О.М. Ostrovska, I. Labiak, M. Rymarchuk, S. Krymets, V. І. Gudyvok, D.S. Martyniuk","doi":"10.30841/2708-8731.4.2023.285766","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285766","url":null,"abstract":"The article presents a review of scientific literature on the main causes of rectal bleeding in pregnant women. Anatomical, biochemical and hormonal changes during pregnancy often lead to the progression of typical benign diseases (chronic hemorrhoids, anal fissure, etc.), radical surgical treatment of which can be carried out in the puerperal period. However, Crohn’s disease, ulcerative colitis or malignant colorectal polyps can be triggered by pregnancy and affect its course – this requires immediate examination and drug therapy. Pregnancy causes many physiological changes that affect the interpretation of routine biochemical and hematological examination methods. It is known that pregnancy requires increased iron content, the pregnancy courses often with anemia. The erythrocytes sedimentation rate varies significantly depending on the severity of anemia and the pregnancy term. Therefore, it is necessary to carefully analyze the main clinical manifestations of various intraluminal diseases that can potentially cause rectal bleeding in pregnant women.This article also describes the directions of diagnostic search and treatment strategy of rectal bleeding during pregnancy. Chronic hemorrhoids often accompany pregnancy in the third trimester. Some researchers indicate that up to 75% of pregnant women have complaints which are typical for chronic hemorrhoids. An anal fissure in lateral positions should cause suspicion of Crohn’s disease, tuberculosis, syphilis, human immunodeficiency virus, acquired immunodeficiency syndrome, dermatological diseases (most often psoriasis) and anal carcinoma.Bleeding in sexually acquired proctitis is usually mild and is often accompanied by minor purulent discharge. Rectal bleeding can be a sign of both ulcerative colitis and Crohn’s proctitis or sigmoiditis, but it is more typical for ulcerative colitis. Other associated clinical features are diarrhea, abdominal pain, urge to defecate, and specific extraintestinal manifestations (peripheral arthropathy, sacroiliitis, ankylosing spondylitis, conjunctivitis, iridocyclitis, episcleritis, aphthous skin ulcers, erythema nodosum, or pyoderma gangrenosum). If the bleeding is caused by a benign polyp, endoscopic polypectomy solves the bleeding problem.Therefore, rectal bleeding in pregnant women is diagnosed quite often. In most cases, it is caused by benign diseases of the rectum (chronic hemorrhoids or anal fissure), which are amenable to conservative therapy and usually do not threaten the life and health of a woman or a child. However, there is a rate of pregnant women whose rectal bleeding is caused by colorectal diseases, which require a comprehensive approach to diagnosis and treatment. In these women, the benefit and risk should be determined when choosing a diagnostic and treatment algorithm.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86664453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substantiation for the relationship and «closed loop effect» between post-traumatic stress disorder and recurrent pregnancy loss","authors":"А. В. Камінський, І. Л. Харун, Kaminskiy Anatolii, Kharun Iryna","doi":"10.30841/2708-8731.3.2023.283319","DOIUrl":"https://doi.org/10.30841/2708-8731.3.2023.283319","url":null,"abstract":"The objective: to identify and evaluate the changes in immune homeostasis in women with recurrent pregnancy loss (RPL) who had posttraumatic stress disorder (PTSD), and to establish the relationship between psycho-emotional status, the immune system and the role of chronic stress in the pathogenesis of autoimmune disorders as a cause of RPL.Materials and methods. An examination of 150 women of reproductive age was carried out, who were divided into three groups: I group (main group) – 100 patients with RPL and PTSD; II group (comparison one) – patients with RPL without PTSD (30 women) and the III group (control one) – 20 patients with PTSD who are planning pregnancy.Indicators of cellular immunity were studied and antiphospholipid syndrome was diagnosed. The electronic database of primary data was created using the Microsoft Excel 2016 spreadsheet program. Statistical data analysis was performed using the Statistica10.0 statistical analysis package.Results. Based on the results of the screening it was found that there are non-specific antibodies to anionic phospholipids, also known as antiphospholipid antibodies, in some patients of the main group. In the presence of antiphospholipid antibodies, the number of NK cells (CD3-CD16/56+) doubled, increasing the probability of the pregnancy interruption that had already occurred. There was also an increased number of NK cells (CD3-CD16/56+) in the blood of patients with PTSD compared to the control group – the patients with PTSD who are planning pregnancy.Conclusions. The results of the study confirmed the connection between PTSD and RPL and demonstrated significant immune homeostasis disorders, as well as the structural and morphological changes in the reproductive system.Women with RPL may have PTSD, which affects the pathogenesis of autoimmune disorders and RPL. These results lead to more deep understanding of RPL and will help in the development of new preventive and therapeutic measures.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84258511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}