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1.
Wiad Lek ; 73(11): 2416-2420, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33454676

RESUMO

OBJECTIVE: The aim: To determine the serum FAMG in the I and II trimester of pregnancy in women with a past history of chronic endometritis, and to clarify its impact on the development of pathology of pregnancy. PATIENTS AND METHODS: Materials and methods: The level of FAMG was determined at 6-8 and 16-18 weeks of gestation in 135 pregnant women with a past history of chronic endometritis, who received treatment of chronic endometritis at the stage of pregravid preparation and 168 women who became pregnant without its prior treatment. The dependence of the development of pre-eclampsia on the level of FAMG at the early stages of pregnancy has been evaluated. RESULTS: Results: At 6-8 weeks of pregnancy, the level of FAMG in women with a past history of chronic endometritis was 20.6% lower (122.4 ± 7.6 ng/ml) compared to the control group. In FAMG of 90.3 ± 4.3 ng/ml at 6-8 weeks of gestation, spontaneous abortion occurred in 100% of cases within the next 2 weeks. FAMG lower than 122,1 ± 3,0 ng/ml can be the predisposing factor for the development of pre-eclampsia. CONCLUSION: Conclusions: Reduced FAMG in the beginning of pregnancy in women with untreated chronic endometritis in the past history increases the incidence of miscarriages at the early stages by 2.6 times, and by 1.8 times the probability of preeclampsia development. Treatment of chronic endometritis at the stage of pregravid preparation promotes the increase of FAMG by 24,6% compared to untreated women that reduces the probability of complications during the subsequent course of pregnancy.


Assuntos
Aborto Espontâneo , Endometrite , Pré-Eclâmpsia , Decídua , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez , Gestantes
2.
Wiad Lek ; 72(4): 562-567, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31055533

RESUMO

OBJECTIVE: Introduction: During pregnancy in the body of a healthy woman there are physiological and psychological changes that contribute to the bearing a child and prepare the female for future labour and motherhood. In women who experience failure at the stage of fertilization or during pregnancy, as a result of prolonged negative emotional states, psycho-emotional stress develops. The aim of the research was to study the psycho-emotional state of women with infertility in history, whose pregnancy resulted from extracorporal fertilization (IVF), and to develop methods for reducing their anxiety. PATIENTS AND METHODS: Materials and methods: At the first stage, the initial psycho-emotional state of 60 women in the second trimester, whose pregnancy resulted from IVF (Group I), was studied; the control group consisted of 20 healthy women with a physiological course of pregnancy (Group II). At the second stage, 10 art therapy exercises with a requestioning of pregnant women from Group I were conducted for improving their psycho-emotional state. RESULTS: Results: Women of Group I had a high level of both situational anxiety (SA) and the personal one (PA). The prevalent type of the psychological component of gestational dominant was anxiety and euphoric types (58.3%). In one third of women with burdened gynecological history examined mild or masked depression was diagnosed. 43 pregnant women from Group I used a method of psychocorrection - art therapy, which included colouring "antistress" pictures of perinatal topic, making flowers from paper and creating a collage of dreams. CONCLUSION: Conclusions: After the art therapy course, a high level of SA (from 46.5% to 7.0%) and OA (from 48.8% to 32.6%) decreased, the index of the optimal type of the psychological component of gestational dominant increased from 25.6% to 53.5%. The number of women without depression increased from 62.8% to 93%.


Assuntos
Ansiedade , Emoções , Fertilização in vitro/psicologia , Infertilidade Feminina/psicologia , Criança , Feminino , Humanos , Gravidez , Gestantes/psicologia , Estresse Psicológico
3.
Wiad Lek ; 72(1): 64-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30796864

RESUMO

OBJECTIVE: Introduction: Detection and treatment of chronic endometritis (CE) is clinically significant, though involves intrauterine intervention to collect endometrium. The aim: To estimate the possibility to use fertility α2-microglobulin (FAMG) as the marker of the high risk for CE. PATIENTS AND METHODS: Materials and methods: 70 women with CE who were planning pregnancy were tested for FAMG in menstrual blood. 40 of them received treatment of CE. The other 30 women refused from the proposed treatment. The control group involved 30 women who had neither CE nor luteal phase deficiency (LPD). Additional group (20 women) had LPD without CE. RESULTS: Results: The decrease of FAMG by 2.4 times was noted in women with CE (16.3 ± 3.9 µg/ml against 39.8 ± 8.3 µg/ml in the controls). In LPD the index was 5.6 times lower. After treatment the level of FAMG was increasing. CONCLUSION: Conclusions: The decrease of the amount of FAMG in menstrual blood is specific for women both with CE and LPD. Detection of abnormally low rates of FAMG in all women with CE enables, with the exception of absolute hypoprogesteronemia and LPD, using it as a simple method of estimation of the functional state of endometrium. Its application can be very useful both for non-invasive diagnosis of CE and subsequent evaluation of treatment of this pathology.


Assuntos
alfa-Globulinas/análise , Endometrite/diagnóstico , Estudos de Casos e Controles , Doença Crônica , Endométrio/patologia , Feminino , Humanos , Infertilidade Feminina , Fase Luteal , Gravidez
4.
Wiad Lek ; 71(8): 1550-1553, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30684339

RESUMO

OBJECTIVE: Introduction: The frequency of the pathological course of pregnancy with hyperandrogenism ranges from 21 to 48%. With the predominance of androgens against the background of lowering the normal products of steroidogenesis, a pro-inflammatory immune imbalance is formed, which causes a premature termination of the development of pregnancy. Many studies indicate that hyperandrogenism is a factor in the development of obstetric pathology, including placental dysfunction. The severity of obstetric complications of pregnancy in women with hyperandrogenism depends on the duration of the disease and the quality of preparation for pregnancy. Establishing early markers of endocrine hyperandrogenic imbalance in the body of a future mother and conducting timely therapy is the key to the successful completion of pregnancy. The aim: the establishment of hormonal-immunological changes and morphological and receptive structure peculiarities of the endometrium correlations in women with PCOS at the pregnancy planning stage. PATIENTS AND METHODS: Materials and methods: 139 women with PCOS were screened at the stage of pregnancy planning. Diagnosis of PCI was conducted in accordance with the International Recommendations of Endocrine Society 2013 and the Rotterdam criteria of 2003. Endometrial aspiration was studied for the study of T and B lymphocyte populations, cytokine levels and endometrial receptors. Hormonal parameters were determined using the radioimmunological method using Immunotech (Czech Republic) and Siena Ire Sorin (France) kits. Normal values of the studied hormones in accordance with the recommendations of the manufacturer. In order to study the populations of T and B lymphocytes and endometrial receptors the aspirate, obtained by endometrial biopsies, was used taken on the 5-7 and 21-24 days of the menstrual cycle. The cytokines levels (INF-y, TNF-a, Il-4, Il-6, Il-8, Il-10) were estimated in the endometrium with the help of the test system "Protein contour" on immunoenzymatic analyzer "Multyskan EX" (Germany). The assessment of estrogens receptors at stroma and glands and progesterone receptors at stroma and glands was performed by H -Score system, lymphocytes count was carried out by the light microscope at 400 x 3 fields-of-view expansion. Statistical material analysis was carried out on the personal computer using the standard software package with applied statistical analysis (Excel 2003 and Statistica v. 6.0). The assessment of variables connection was carried out by Pirson's coefficient correlations. The statistical significance of differences was performed by the use of nonparametric Mann -Whitney criteria, χ2 and Fisher criterium. The significance threshold of statistical value was considered p = 0.05. RESULTS: Results: In women with hyperandrogenism, there was a significant increase (p <0.05) in the level of DHEA-S, a decrease in the level of E2 and progesterone in the early follicular phase compared with the control group and an increase in body weight by 37.5%. At histological examination of the endometrium on the 5-7th day of the menstrual cycle there was a lag proliferative changes of the endometrium, and in one third of women hyperplastic process against the background of reduced proliferative activity. At GA there was a marked violation of expression of receptors as estrogens and progesterone stroma in all stages of the menstrual cycle. In women with hyperandrogenism, changes in the immunological profile of endometriosis with the prevalence of Th-1 orientation of immunity have been detected. CONCLUSION: Conclusions: In women with hyperandrogenism there is a close correlation between the biochemical form of the domination of androgens, ovulatory dysfunction, immunohistochemical and morphological structure of the endometrium. Revealed features of pro-inflammatory direction of cytokine immunity.


Assuntos
Endométrio/patologia , Hiperandrogenismo/patologia , Síndrome do Ovário Policístico/patologia , Citocinas/análise , Feminino , Hormônios/análise , Humanos , Gravidez , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Fatores de Risco
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