ABSTRACT
AIM: To clarify factors of risk for unfavourable variants of gestational chronic glomerulonephritis (CGN) and poor pregnancy outcomes in CGN; to determine prognostic implications of changes in some renal and uteroplacental indices. MATERIAL AND METHODS: Variants of CGN gestational course and pregnancy outcomes have been analysed for 156 CGN patients. The women were examined before pregnancy, in the course of pregnancy and 3-24 months after the delivery. Measurements were made of 24 h proteinuria, glomerular filtration rate, blood transaminases activity, functional renal reserve (FRR), uricemia, blood level of alpha-phetoprotein. Placentas were studied morphologically, uterine and umbilical artery circulation was assessed by dopplerometry. RESULTS: The following abnormalities were registered: high proteinuria (34.6%), progression of hypertension (29.5%), renal function deterioration (15.4%), fetal and neonatal losses (15.4%), fetal underdevelopment (25%), preterm delivery (17.3%), preeclampsia (7.7%), preterm placental detachment (1.9%). There is morphological, dopplerometric and biochemical evidence for placental insufficiency in CGN pregnant women. CONCLUSION: Activity of CGN (nephritic or acute nephritic syndromes), hypertension, renal failure, disorders of renal hemodynamics are factors of risk for unfavourable gestational course of CGN and pregnancy complications. Placental insufficiency deteriorates pregnancy outcomes in CGN, but changes in uterine and umbilical circulation as well as blood levels of alpha-fetoprotein are not prognostically significant.
Subject(s)
Glomerulonephritis , Pregnancy Complications , Pregnancy Outcome , Adolescent , Adult , Case-Control Studies , Chronic Disease , Female , Gestational Age , Glomerular Filtration Rate , Glomerulonephritis/etiology , Glomerulonephritis/physiopathology , Humans , Pregnancy , Pregnancy Complications/physiopathology , Risk FactorsSubject(s)
Glomerulonephritis, Membranoproliferative/drug therapy , Pregnancy Complications/drug therapy , Adult , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Aspirin/administration & dosage , Diagnosis, Differential , Dipyridamole/administration & dosage , Drug Therapy, Combination , Female , Glomerulonephritis, Membranoproliferative/diagnosis , Humans , Nephrotic Syndrome/diagnosis , Nephrotic Syndrome/drug therapy , Parity , Prednisolone/administration & dosage , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Trimester, SecondABSTRACT
Study of voluntary autoregulation of the heart rate (HR) by means of artificial biofeedback (BFB) using a display, has revealed the possibility of changing the HR voluntarily within a wide range of (from 50 to 140 beats per minute). Respective fluctuations occurred in the arterial pressure. A decrease in the HR and reactive alarm, increase in the self-assessment of physical state, activity, mood and work level occurred in result of the HR-BFB training.
Subject(s)
Adaptation, Physiological , Biofeedback, Psychology/physiology , Homeostasis/physiology , Adult , Head-Down Tilt/physiology , Heart Rate/physiology , Hemodynamics , Humans , Male , Middle Aged , PsychophysiologySubject(s)
Hypertension/diagnosis , Kidney Diseases/diagnosis , Pregnancy Complications, Cardiovascular/diagnosis , Pregnancy Complications/diagnosis , Adolescent , Adult , Cesarean Section , Chronic Disease , Combined Modality Therapy , Female , Humans , Hypertension/therapy , Kidney Diseases/therapy , Pregnancy , Pregnancy Complications/therapy , Pregnancy Complications, Cardiovascular/therapy , Referral and ConsultationABSTRACT
A controlled clinical trial included 64 pregnant females suffering from chronic glomerulonephritis (CGN) and hypertension: 31 patients received acetylsalicylic acid (ASA) in a dose 125 mg/day and curantyl (150-225 mg/day) from gestation week 12-19 till delivery, 33 control females were not given the drugs. Prenatal care and labour management were similar. Total number of the complications (fetal and natal deaths, preterm labour, intrauterine fetal retardation, late toxicosis, premature detachment of normally located placenta) as well as the number of pregnancies with complications were less in the test group. The same was true for the second pregnancies versus the first ones when ASA and curantyl were not given. It is suggested that low-dose ASA plus curantyl improve placental circulation eventually resulting in less frequent occurrence of pregnancy complications and in better pregnancy outcomes in CGN and hypertensive women.
