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Early neonatal sepsis in COVID-19 era COVID-19时代新生儿早期脓毒症
Obstetrics, Gynecology and Reproduction Pub Date : 2023-06-17 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.389
A. L. Karpova, A. V. Mostovoi, E. Dudkina, O. V. Avdei, N. Karpov
{"title":"Early neonatal sepsis in COVID-19 era","authors":"A. L. Karpova, A. V. Mostovoi, E. Dudkina, O. V. Avdei, N. Karpov","doi":"10.17749/2313-7347/ob.gyn.rep.2023.389","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.389","url":null,"abstract":"Introduction. Early-onset neonatal sepsis (EONS) remains the leading cause of serious mobility and mortality worldwide. At the present time, the impact of the COVID-19 pandemic on the incidence of other infections is of particular interest. Aim: to conduct a comparative analysis of the features of the course of EONS in newborns before the COVID-19 pandemic (2018) and during the COVID-19 pandemic (2021). Materials and Мethods. A retrospective cohort single-center continuous study included 73 newborns born and hospitalized in the Regional Kaluga Perinatal Center (PC) based on Kaluga Regional Clinical Hospital. The data for the period of stay in the PC from January to October 2018 and the same period in 2021 were analyzed and compared. Newborns were divided into two groups: group 1 (n = 26) – in 2018, and group 2 (n = 47) – in 2021. The following parameters of EONS severity were selected: the need for the use of norepinephrine, surfactant and fresh-frozen plasma (FFP). Results. The incidence of EONS in 2021 (n = 47) was significantly higher than in 2018 (n = 26): odds ratio (OR) = 3.27; 95 % confidence interval (CI) = 1.57–6.40; p = 0,001. Gestational age and Apgar score at the 1st and 5th minutes were significantly higher in group 1 than in group 2: 36.2 [33.3; 38.0] weeks vs. 33.3 [28.5; 36.1] weeks (p = 0.016); 7.0 [5.0; 7.0] vs. 5.0 [3.0; 7.0] (p = 0.019) and 9.0 [6.8; 8.0] vs. 6.0 [5.0; 8.0] (p = 0.012), respectively. Newborns with EONS in 2021 compared with 2018 showed a significant increase in norepinephrine administration of (42/47 vs. 16/26 newborns, respectively; OR = 5.25; 95 % CI = 1.58–17.44; p = 0.007), FFP transfusions (47/47 vs. 19/26 newborns, respectively; OR = 36.54; 95 % CI = 2.05–649.84; p < 0.001) and surfactant therapy (32/47 vs. 7/26 newborns, respectively; OR = 5.79; 95 % CI = 2.04–16.45; p = 0.001). Mortality among patients with EONS in 2021 compared to 2018 was significantly higher: 13/47 (21.3 %) vs. 2/26 (7.7 %) newborns, respectively (OR = 9.56; 95 % CI = 1.22–74.96; p = 0.014). Conclusion. Among the newborns of the Kaluga region there is a significant rise in the incidence and mortality of EONS on the background of the COVID-19 pandemic. In 2021 there is a significant increase in the need for surfactant administration, use of vasopressors, and transfusion of FFP in infants with EONS.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84047263","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}
引用次数: 0
Early neonatal sepsis caused by Haemophilus influenzae 由流感嗜血杆菌引起的新生儿早期败血症
Obstetrics, Gynecology and Reproduction Pub Date : 2023-06-16 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.415
A. L. Karpova, A. V. Mostovoi, S. Martirosyan, O. E. Orlova, L. N. Karpov, A. Zaplatnikov
{"title":"Early neonatal sepsis caused by Haemophilus influenzae","authors":"A. L. Karpova, A. V. Mostovoi, S. Martirosyan, O. E. Orlova, L. N. Karpov, A. Zaplatnikov","doi":"10.17749/2313-7347/ob.gyn.rep.2023.415","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.415","url":null,"abstract":"Neonatal sepsis still remains a serious problem of modern health care, being one of the main causes of neonatal and infant mortality, as well as disability in surviving children. Due to the high risk of adverse outcomes, the problem of early neonatal sepsis (ENS), especially in preterm infants, attracts special attention. At the same time, if in the previous decades the main causative agents of ENS were Escherichia coli and Streptococcus group B, then in recent years it has been noted that while maintaining the leading value in the etiological structure of Escherichia coli, the frequency of detection of Haemophilus influenzae began to increase. The article contains a review of modern publications on the role of Haemophilus influenzae in the formation of perinatal losses, as well as the significance of this pathogen in the development of neonatal sepsis. The article also presents a clinical case report of ENS caused by Haemophilus influenzae. Particular attention is paid to the issues of timely diagnosis of ENS, which is possible only with a comprehensive analysis of the results of clinical and laboratory-instrumental examination.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78454943","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}
引用次数: 0
Ovarian stimulation methods at a single-assisted reproductive technology institution: a retrospective study of successful outcomes 单辅助生殖技术机构的卵巢刺激方法:成功结果的回顾性研究
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-22 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.394
Y. Horibe, A. Nakabayashi, S. Murata, T. Hashimoto, T. Tabata
{"title":"Ovarian stimulation methods at a single-assisted reproductive technology institution: a retrospective study of successful outcomes","authors":"Y. Horibe, A. Nakabayashi, S. Murata, T. Hashimoto, T. Tabata","doi":"10.17749/2313-7347/ob.gyn.rep.2023.394","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.394","url":null,"abstract":"Aim: to examine an efficacy of various stimulation methods in a group of successful pregnancies.Materials and Methods. In a single center retrospective study 47 pregnancy cases were examined after performing embryo transfers at our institution from the years 2017 to 2021. Patients were divided into four groups: i) clomiphene hyperstimulation (CH), ii) stimulation with gonadotropin-releasing hormone (GnRH) agonist, iii) with GnRH antagonist, and iv) progestin-primed ovarian stimulation (PPOS). Age, anti-Mullerian hormone, presence of chronic disease, number of in-vitro fertilizations prior to conception, dosage of follicle stimulating hormone (FSH), presence of premature luteinizing hormone surge, number of egg retrievals, fertilization rate, and live birth rate were assessed.Results. The number of pregnancies obtained by CH, agonist, antagonist, and PPOS methods comprised 25, 12, 2, and 8 cases, respectively. No significant difference in parameters between CH group and non-CH groups, excepting FSH was observed. The FSH was used in CH group and non-CH group at dose of 1108 ± 468 IU and 1756 ± 394 IU, respectively (p < 0.0001).Conclusion. CH is not commonly used due to potential luteal phase defects, but it is thought to be cost-effective, requiring lower FSH doses, requiring no ovulation suppression antagonists, and exerting no effect on frozen embryos or fetuses. Hence, CH could be a suitable protocol for egg retrieval in Japan.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86609654","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}
引用次数: 0
Clinical significance of ADAMTS-13/vWF axis in pregnant women at different trimesters of gestation 不同妊娠期孕妇ADAMTS-13/vWF轴的临床意义
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-22 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.405
K. Grigoreva, N. R. Gashimova, V. Bitsadze, L. Pankratyeva, J. Khizroeva, M. Tretyakova, V. Tsibizova, N. Degtyareva, A. V. Mulenkova, J. Gris, M. V. Kvaratskheliia, E. Grandone, F. Yakubova, D. Blinov, A. Makatsariya
{"title":"Clinical significance of ADAMTS-13/vWF axis in pregnant women at different trimesters of gestation","authors":"K. Grigoreva, N. R. Gashimova, V. Bitsadze, L. Pankratyeva, J. Khizroeva, M. Tretyakova, V. Tsibizova, N. Degtyareva, A. V. Mulenkova, J. Gris, M. V. Kvaratskheliia, E. Grandone, F. Yakubova, D. Blinov, A. Makatsariya","doi":"10.17749/2313-7347/ob.gyn.rep.2023.405","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.405","url":null,"abstract":"Introduction. The pandemic of a novel coronavirus infection has demonstrated the importance of assessing the ADAMTS-13/vWF axis in patients with COVID-19, because a decline in this ratio mirrors disease severity. However very few data in the global literature on crosstalk and ADAMTS-13/vWF levels in pregnant women remaining very contradictory are available. Taking into consideration an impact of the ADAMTS-13/vWF axis on prevalence of thrombosis and disorders in the hemostasis system, investigation of this issue is highly demanded.Aim: to assess the functioning of the ADAMTS-13/vWF axis during physiological pregnancy.Materials and Methods. A controlled non-randomized study was conducted: main group included 44 women with physiologically occurring pregnancies at I, II and III trimesters; the control group consisted of 45 healthy non-pregnant women. The plasma level of ADAMTS-13 inhibitor (ADAMTS-13:i), ADAMTS-13 antigen (ADAMTS-13:Ag), vWF antigen (vWF:Ag), and ADAMTS-13 activity (ADAMTS-13:Ac) as well as relevant ratio (ADAMTS-13:Ac/vWF:Ag) were measured.Results. It was shown that in parallel with increasing gestational age, significant changes occurred in the ADAMTS-13:Ac/vWF:Ag ratio. In main group, patients at II trimester were found to have level of ADAMTS-13:Ac/vWF:Ag 0.359 ± 0.121, in III trimester –0.253 ± 0.741, which significantly differed (p < 0.01) compared to control group with non-pregnant women (1,134 ± 0,308).Conclusion. Our study provides new insights into the functioning of the ADAMTS-13:/vWF axis in women with physiologically occurring pregnancy at I, II and III trimesters. Decline in ADAMTS-13:Ac was demonstrated along with increasing vWF:Ag level observed in parallel with increasing gestational age. Apparently, the progressive decrease of ADAMTS-13 concentration during pregnancy is associated with its increased consumption due to high vWF level. However, due to the small single-center patient cohort, further studies with larger-scale studies are needed.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82690311","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}
引用次数: 1
Multiple pregnancy in fine arts 美术中的多胎妊娠
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-22 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.401
N. Makatsariya, V. Bitsadze, J. Khizroeva
{"title":"Multiple pregnancy in fine arts","authors":"N. Makatsariya, V. Bitsadze, J. Khizroeva","doi":"10.17749/2313-7347/ob.gyn.rep.2023.401","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.401","url":null,"abstract":"Here, we highlight aspects of visualizing twins in the fine arts. The works of artists Leonardo da Vinci, Jacopo Pontormo, Ker-Xavier Roussel, Jean-Bruno Gassies, Peter Paul Rubens, Sebastiano Ricci and others are presented.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89581180","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}
引用次数: 0
Alexander Makatsariya, Academician of RAS, was awarded the title Academician of the International Academy of Perinatal Medicine 俄罗斯科学院院士Alexander Makatsariya被授予国际围产期医学会院士称号
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-22 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.416
A. Editorial
{"title":"Alexander Makatsariya, Academician of RAS, was awarded the title Academician of the International Academy of Perinatal Medicine","authors":"A. Editorial","doi":"10.17749/2313-7347/ob.gyn.rep.2023.416","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.416","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"10 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72471424","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}
引用次数: 0
Hemostasis parameters as prognostic biomarkers in gynecological cancer patients 止血参数作为妇科肿瘤患者预后的生物标志物
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-22 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.406
E. Slukhanchuk, V. Bitsadze, A. Solopova, J. Khizroeva, J. Gris, I. Elalamy, D. V. Shcherbakov, A. Shkoda, L. Pankratyeva, J. Y. Ungiadze, L. Ashrafyan, A. Makatsariya
{"title":"Hemostasis parameters as prognostic biomarkers in gynecological cancer patients","authors":"E. Slukhanchuk, V. Bitsadze, A. Solopova, J. Khizroeva, J. Gris, I. Elalamy, D. V. Shcherbakov, A. Shkoda, L. Pankratyeva, J. Y. Ungiadze, L. Ashrafyan, A. Makatsariya","doi":"10.17749/2313-7347/ob.gyn.rep.2023.406","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.406","url":null,"abstract":"Hypercoagulation is a typical condition for cancer patients. In addition, various arms of the hemostasis system become involved in tumor growth, invasion, metastasis, neoangiogenesis as well as immunoevasion. The magnitude of activated hemostasis is driven by tumor phenotype. Parameters characterizing coagulation, intensity of fibrinolysis processes, platelet aggregation and activation as well as endothelial activation mirror magnitude of hemostasis activation in oncological process, but may also be considered as candidate markers of tumor progression and predictors of oncological diseases outcome. This review summarizes the study data assessing a value of predictive hemostasis biomarkers for overall survival and response to therapy in oncogynecology and mammology. The most promising biomarkers have been identified and used in the future for risk stratification as well as personalized patient management.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74140602","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}
引用次数: 0
Intrauterine activation of the fetal immune system in response to maternal COVID-19 胎儿免疫系统响应母体COVID-19的宫内激活
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-19 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.404
N. R. Gashimova, L. Pankratyeva, V. Bitsadze, J. Khizroeva, N. Makatsariya, M. Tretyakova, A. Shkoda, K. Grigoreva, V. Tsibizova, J. Gris, F. Yakubova, D. Blinov, A. Makatsariya
{"title":"Intrauterine activation of the fetal immune system in response to maternal COVID-19","authors":"N. R. Gashimova, L. Pankratyeva, V. Bitsadze, J. Khizroeva, N. Makatsariya, M. Tretyakova, A. Shkoda, K. Grigoreva, V. Tsibizova, J. Gris, F. Yakubova, D. Blinov, A. Makatsariya","doi":"10.17749/2313-7347/ob.gyn.rep.2023.404","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.404","url":null,"abstract":"Introduction. During pregnancy COVID-19 poses a serious threat to both maternal health and health of paired unborn child. Pregnant women have a high probability of complications due to respiratory viral infections followed by developing critical conditions caused by physiologically altered immune and cardiopulmonary systems. However, asymptomatic COVID-19 in pregnant women may be accompanied by fetal inflammatory response syndrome (FIRS) that results in unfavorable sequelae for neonatal life and health.Aim: to assess a fetal inflammatory response resulting from maternal COVID-19 in pregnancy.Materials and Мethods. A prospective randomized comparative study involving 92 pregnant women was carried out. The main group included 62 pregnant COVID-19 convalescent women: subgroup 1 consisted of 30 pregnant women found to be positive for SARS-CoV-2 by using polymerase chain reaction (PCR) 4–6 weeks before delivery; subgroup 2 – 32 pregnant women with SARS-CoV-2 detected by PCR earlier during pregnancy. The control group enrolled 30 healthy pregnant women. The level of circulating cytokines – interleukins (IL) IL-1α, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor alpha (TNF-α), interferon gamma (IFN-γ), macrophage inflammatory protein-1β (MIP-1β), C-X-C motif chemokine ligand 10 (CXCL-10) and cell markers (CD86, CD80, CD4, CD25, CD25, CCR7) were analyzed. In addition, all neonates underwent thymus gland ultrasound screening.Results. Cord blood dendritic cells from neonates born to mothers in subgroup 1 vs. control group showed a significantly upregulated expression of CD80 and CD86 (p = 0.023). Moreover, such cord blood samples in subgroup 1 were found to have increased percentage of CD4+, CCR7+ T cells paralleled with decreased proportion of naive CD4+ T cells as compared with control group (p = 0.016). It was found that count of maternal regulatory CD4+CD25+Foxp3+ T cells (Treg) did not differ significantly, whereas Treg cell functional activity in mothers with severe COVID-19 (subgroup 2) was significantly suppressed. Significantly higher level of neonatal proinflammatory cytokines and chemokines was detected in subgroup 1 vs. control group (p < 0.05). However, the cytokines level in maternal peripheral blood samples in main and control groups upon delivery was changed insignificantly. SARS-CoV-2-positive pregnant women showed a strong antigen-specific T cell response. A reduced thymus size was found in neonates born to paired COVID-19 mothers.Conclusion. Fetal inflammatory response syndrome occurs upon COVID-19, which is characterized by activated fetal immune system and increased production of pro-inflammatory cytokines. The disease severity in pregnant women has no correlation with FIRS intensity during neonatal period and can vary from minimally altered laboratory parameters to developing sequelae at organ and body system levels.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90966230","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}
引用次数: 0
Complications and outcomes of pregnancy in patients with antiphospholipid antibodies during various treatment methods 抗磷脂抗体患者妊娠期间各种治疗方法的并发症及结局
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-19 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.414
Y.S. Bagdasarova, M. S. Zainulina, M. Nikolaeva
{"title":"Complications and outcomes of pregnancy in patients with antiphospholipid antibodies during various treatment methods","authors":"Y.S. Bagdasarova, M. S. Zainulina, M. Nikolaeva","doi":"10.17749/2313-7347/ob.gyn.rep.2023.414","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.414","url":null,"abstract":"Introduction. Antiphospholipid antibodies (APAs) exert multifaceted effects on the course of pregnancy by disrupting microcirculation, affecting the hemostasis, as well as damaging the endothelial membranes, leading to early reproductive loss and development of placenta-associated complications depending on the affected gestation stage. Planning and management of pregnancy in women in the absence of criteria for complete antiphospholipid syndrome (APS) currently remains unresolved issue. The absence of generally accepted treatment standards for this category of patients and inability to substantiate the diagnosis according to the APS classification criteria complicate selection of therapeutic tactics.Aim: to conduct a comparative analysis of therapy-based complications and outcomes of pregnancy in APA carriers.Materials and Methods. During the period 2019–2021 a prospective study of 150 patients who entered pregnancy with aggravated obstetric and gynecological history, serum APA level was examined. Considering the risks of developing obstetric and thrombotic complications, all patients were prescribed prophylactic doses of low molecular weight heparins (LMWHs) and low doses of acetylsalicylic acid (ASA). The patients were divided into 3 groups using a random number generator. Group 1 (n = 50), in addition to the prescribed LMWH (enoxaparin sodium 40 mg 1 time per day) and ASA (150 mg 1 time per day), also underwent plasmapheresis (PF) 4 sessions per 1 course in 6–8, 12–14 and 22–24 weeks of pregnancy; group 2 (n = 50) received courses of intravenous immunoglobulins (IVIG) at a course dose of 300 ml (15 g) simultaneously; group 3 (n = 50) received no additional therapies. Rate of pregnancy complications was comparatively assessed – development of fetal growth retardation (FGR), low birth weight fetus, gestational arterial hypertension (AH), moderate and severe preeclampsia (PE), anemia and delivery outcomes.Results. It was found that in group 3 there was a higher incidence of gestational hypertension (p2,3 < 0.0001), moderate PE (p 1,3 =0.071; p 2,3 = 0.0019), low weight fetus for gestational age (p2,3 = 0.0002) and FGR (p2,3 = 0.003). In group 1, compared with group 2, there were more often observed small weight for gestational age fetus (p1,2 = 0.018) and FGR (p1,2 = 0.024), gestational hypertension (p1,2 = 0.0008), anemia (p1,2 < 0.0001) and latent iron deficiency (p1,2 < 0.0001). Also, groups 2 and 3 vs. group 1 were more likely to have intrahepatic cholestasis during pregnancy (p1,2 = 0.013; p1,3 = 0.003).Conclusion. In the group of patients receiving complex therapy consisting of LMWHs prophylactic doses, low ASA doses and IVIG courses, the risks of developing placenta-associated complications and iron deficiency were reduced compared to other groups indicating about a higher efficiency of this therapy regimen. However, the development of intrahepatic cholestasis during pregnancy was less common in the group of patients receiving PF courses,","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"54 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72430935","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}
引用次数: 0
Predicting a clinically narrow pelvis using neural network data analysis 应用神经网络数据分析预测临床上骨盆狭窄
Obstetrics, Gynecology and Reproduction Pub Date : 2023-05-19 DOI: 10.17749/2313-7347/ob.gyn.rep.2023.382
A. M. Ziganshin, G. Dikke, V. Mudrov
{"title":"Predicting a clinically narrow pelvis using neural network data analysis","authors":"A. M. Ziganshin, G. Dikke, V. Mudrov","doi":"10.17749/2313-7347/ob.gyn.rep.2023.382","DOIUrl":"https://doi.org/10.17749/2313-7347/ob.gyn.rep.2023.382","url":null,"abstract":"Aim: to improve the efficiency of predicting a clinically narrow pelvis (СNP) using neural network data analysis and to evaluate its prognostic characteristics.Materials and Мethods. The study was designed as a retrospective non-randomized clinical trial. An analysis of 184 born neonates was carried out: group 1 included 135 female patients whose delivery occurred through the natural birth canal, group 2 – 49 patients whose delivery was complicated by СNP development and ended up with emergency caesarean section. Examination of patients was carried out on the eve of childbirth (1–2 days) and included anamnesis, general and special obstetric examination, including pelvimetry, a clinical assessment of cephalopelvic disproportion was carried out during childbirth. The condition of newborns was assessed using the Apgar scale, height and body weight were measured. Neural network analysis was performed using the built-in Neural Networks module of SPSS Statistics Version 25.0 (IBM, USA).Results. Despite hypothetically important role of anatomically narrowed pelvis in development of cephalopelvic disproportion, no significant inter-group differences were found. Significant parameters (abdominal circumference, uterine fundus height and woman’s weight, fetal head circumference, as well as data on the presence or absence of oligohydramnios and fetal macrosomia) were determined, which were included in the test database to create the basis for training the multilayer perceptron. Out of 135 patients of group 1, the prognosis was negative in 131 (97.0 %), positive in 4 (3.0 %); out of 49 patients in group 2, negative in 0 (0.0 %), positive in 49 (100.0 %). The forecast accuracy of the developed model was 98 % (sensitivity – 100 %, specificity –97 %). The information content of neural network data analysis in СNP predicting is presented in ROC analysis: area under the curve (AUC) = 0.99 (95 % confidence interval = 0.97–1.00). Neonatal anthropometric parameters were significantly higher in group 2 vs. group 1, and the Apgar score at 1 minute was correspondingly lower.Conclusion. The use of neural network analysis of clinical data obtained on the eve of childbirth allows to predict СNP development at sufficient degree of accuracy (98.0 %), which, in the future, after being introduced into clinical practice, will optimize a choice of delivery method in patients at risk (anatomically narrow pelvis, large fetus), reduce emergency caesarean sections and improve birth outcomes.","PeriodicalId":36521,"journal":{"name":"Obstetrics, Gynecology and Reproduction","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76086882","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}
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