[Polymorphisms of genes of rennin-angiotensine system and their correlation with psychological manifestations of birth stress].

Study of correlation of polymorphisms of genes of the rennin-angiotensine system--insertion-deletion (I/D) polymorphism of the angiotensine-converting enzime (ACE), and the polymorphism of angiotensinogen (AGT), consisting in submission of T into C in the 704 position (M235T)--with various characteristics of psychological functioning and clinical characteristics in women giving birth, was conducted. The group consisted of 56 young female Ss, without chronic diseases in the anamnesis, no complication in the course of pregnancy, birth normal and timely, state of the child normal in all cases. Basing on factor analysis of 7 psychological induces, providing integral assessment of state of the Ss in the course la late pregnancy, giving birth, and the immediately following post partum period, statistically reliable correlation between such first-rate psychological process as creativity, and polymorphism of the gene of angiotensinogene, was demonstrated, as well as difference in distribution of genotypes between the group of women giving birth, and general population. Statistically relevant correlation between presence of the deletion (D) allele of the ACE gene, and heightened level of neuroticization, reported by us earlier, was observed in this case, as well. No significant links between religiosity/spirituality, and genetic data was found. These results are in concordance with present-day views concerning the role of the rennin-angiotensine system in the providing of active adaptation to stressful conditions; they tend to provide fresh outlook upon the comparative study of input of heredity, and education, into the ontogenesis of higher psychological functions in normal humans.

[Possible correlation of polymorphism of angiotensin-converting enzyme gene with psychological aspects of birth stress].

The paper presents results of a pilot study of genetic correlates of adaptive strategies characteristic for religious and (or) spiritual people in stress, induced by unusual and (or) extreme conditions. Birth stress, experienced by 79 young normal female urban dwellers Ss in the course of late pregnancy, giving birth, and the immediately following period post partum, was chosen as model of stress in general. Their state, as well as the state of the child, was monitored in each case by professional physicians, and assessed according to standard obstetric procedures. 3 kinds of standard psychological tests, providing assessment of neurotization, creativity, and the scope of religious/spiritual sensations, were conducted. The latter formed focal point of our research. As in has recently been supposed, religious/spiritual people tend to be more adaptive in illness and stress, which is quite important for clinical practice. The first aim of our study was to test whether religious/spiritual sensations in stress tend to occur as part of general neurotization; or, as part of creative response in the service of the ego; or, finally, they form a specific dimension of adaptive strategies. In home to simultaneously assess possible genetic determination of each of these options, we have introduced intro our study a module of assessment of genetic I/D polymorphisms of ACE gene, primarily linked to the status of the renin-angiotensin system. As a result of factor analysis, existence of 3 strong trends was demonstrated. 1. Neurotization, creativity, religious/spiritual processes tend to form 3 independent aspects of response of normal humans to birth stress. 2. Frequency of occurrence of D-allele tends to reveal strong correlation with only one of these 3 options, which is the generall level of neurotization. The latter conclusion corresponds well to what is currently known about the role of renin-angiotensin system primarily in regulation of cardiovascular system, and probably adaptation to stress. 3. Frequency of occurrence of D-allele in the mother tends to reveal inverse correlation with the Apgar index of the child (assessment of its physiological state in the course of the first several minutes after birth, based upon such characteristics as heart beat rate, ability to independent breathing, state of the skin, etc.), and is not linked to usual standard biometric parameters of newborn children. Continuing to work on this model, we intend to formally assess possible impact of heredity via other genes upon psychological, especially religious and spiritual aspects of adaptation to stress of women in birth; and also approach to possible genetic correlates of the state of newborn children.

[Effect of ryodipine, fenigidin, verapamil, and manganese ions on the contractile strength and the myometrium potential duration during rhythmic stimulation and at rest]. / Vliianie riodipina, fenigidina, verapamila i ionov margantsa na silu sokrashcheniia i dlitel'nost' potentsialov miometriia pri ritmicheskoi stimuliatsii i v pokoe.

Action of the calcium channels blocking agents was studied using their strong but reversible concentrations, in different regimens. Riodypine and phenihydine suppressed the contraction strength and shortened the AP duration in the myometrium muscle stripes equally effectively both in resting and under stimulation (0.3 Hz). Verapamyl and manganese ions suppressed the contraction strength and shortened the AP duration more effectively under rhythmic stimulation than in resting.

[Opioid inhibition of oxytocin release from the posterior lobe of the hypophysis and its significance for obstetrical anesthesiology]. / Opioidnoe tormozhenie vydeleniia oksitotsina na zadnei doli gipofiza i ego znachenie dlia akusherskoi anesteziologii.

The review of literature presents modern experimental and clinical data on opioid inhibition of oxytocin release from posterior hypophysis lobe during pregnancy and in childbirth. The impact of various narcotic analgesics on oxytocin secretion, myometrium contractility and the condition of the fetus and newborn has been assessed. The data on oxytocin blood plasma level are of importance in the clinical practice for selecting the most suitable anesthesia technique during physiological and pathological labour, especially when modern narcotic analgesics (morphine, promedol, fentanyl, tramadol, etc.) are used.

[Prevention of hypotonic hemorrhage in the placental and early puerperal period with prostenone]. / Profilaktika gipotonicheskikh krovotechenii v poslerodovom i rannem poslerodovom periodakh prostenonom.

To prevent afterbirth and early postpartum hemorrhages the authors used prostenone in 46 (the main group) and oxytocin in 20 females (control group). Intraplacental blood pressure and coagulation parameters were studied. With prostenone, the mean amount of the blood loss turned to be significantly lower (137 +/- 13 ml) than with oxytocin (208 +/- 17 ml). Administration of prostenone led to a significant elevation of prothrombin index alone and tolerance to heparine. As there was an insignificant difference between the parameters in the main and control groups, the mechanism of prostenone's effect on the myometrium required further studies.

[Laminaria in obstetrical and gynecological practice]. / Laminarii v akuishersko-ginekologicheskoi praktike.

PIP: Literature data on the mechanism of Laminaria-induced dilatation of he cervix uteri are reviewed. Laminaria sticks are made of the stems of the algae laminaria digitate or Laminaria japonica; the standard stick is 6-7 mm in length and 2-3 mm in diameter. Laminaria acts on the cervix uteri by applying the radial force and by removing water from the cervical stroma. One of the mechanisms of action of Laminaria is associated with the stimulation of synthesis and release of endogenous prostaglandins. The most widely used method of sterilization is gamma-irradiation of individually packaged Laminaria sticks. The thread attached to the proximal end of the stick simplifies its removal. Dilatation of the cervix uteri during 1st trimester requires insertion of 1-4-6 sticks for 6-12-16 hours. The methods of Laminaria insertion during the 2nd trimester vary depending upon the clinical situation. THe major disadvantage of Laminaria is acute or spastic pain during insertion. Complications include migration of the Laminaria stick into the vagina or uterus and the risk of infection. Recently developed synthetic Laminaria have a number of advantages over natural Laminaria (guaranteed sterility, uniform shape, more rapid swelling, relative insensitivity to pressure). The most widely used synthetic Laminaria are manufactured from the polyvinyl alcohol (Lamicel, Merocel) and hydrogel polymer (hypan and Dilapan). Merocel and Lamicel are impregnated with magnesium sulfate providing for additional absorption of the fluid.^ieng

[Central hemodynamics in women during labor with combined use of prostaglandin E2 and prolonged epidural analgesia]. / Tsentral'naia gemodinamika u rozhenits pri sochetannom primenenii prostaglandina E2 i dlitel'noi épidural'noi anal'gezii.

Changes in central hemodynamics have been studied in 60 women with weak labour efforts treated with prostenon and subject to prolonged epidural analgesia (PEA). It has been established that PEA has a pronounced antihypertensive effect, decreases the heart rate (HR), cardiac index (CI), reserve coefficient (RC) and integral tonic coefficient (ITC) and increases significantly stroke index (SI). Prostenon, having a modulating effect on the cardiovascular system, induces an increase in mean blood pressure (MBP) in hypotensive patients and a decrease in MBP in hypertensive patients, lowers SI and ITC and elevates HR, CI and RC. In combined application, prostenon compensates for a number of hemodynamic shifts caused by PEA. The method of labour stimulation described seems advisable in women with late toxemia of pregnancy, provided labour stimulation is started with prostenon administration.

[Termination of pregnancy in the first and second trimester using natural and synthetic laminaria tents]. / Preryvanie beremennosti v I i II trimestrakh estestvennymi i sinteticheskimi laminariami.

PIP: Literature data on the mechanism of Laminaria-induced dilatation of the cervix uteri during abortion in the 2nd and 3rd trimesters are reviewed. Laminaria sticks are made of the stems of the algae Laminaria digitata or Laminaria japonica; the standard stick is 6-7 mm in length and 2-3 mm in diameter. Laminaria acts on the cervix uteri by applying the radial force and by removing water from the cervical stroma. One of the mechanisms of action of Laminaria is associated with the stimulation of synthesis and release of endogenous prostaglandins. The most widely used method of sterilization is gammairradiation of individually packaged Laminaria sticks. The thread attached to the proximal end of the stick simplifies its removal. Dilatation of the cervix uteri during 1st trimester requires insertion of 1-4-6 sticks for 6-12-16 hours. The methods of Laminaria insertion during the 2nd trimester vary depending upon the clinical situation. The major disadvantage of Laminaria is acute or spastic pain during insertion. Complications include migration of the Laminaria stick into the vagina or uterus and the risk of infection. Recently developed synthetic Laminaria have a number of advantages over natural Laminaria (guaranteed sterility, uniform shape, more rapid swelling, relative insensitivity to pressure). The most widely used synthetic Laminaria are manufactured from the polyvinyl alcohol (Lamicel, Merocel) and hydrogel polymer (hypan and Dilapan). Merocel and Lamicel are impregnated with magnesium sulfate providing for additional absorption of the fluid.^ieng