Навчально-науковий медичний інститут (НН МІ)
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Item Clinical and pathogenetic causes of developing complications in multiple pregnancy(Івано-Франківський національний медичний університет, 2020) Нікітіна, Ірина Миколаївна; Nikitina, Iryna Mykolaivna; Бойко, Володимир Іванович; Boiko, Volodymyr Ivanovych; Бабар, Тетяна Володимирівна; Babar, Tetiana Volodymyrivna; Калашник, Наталія Володимирівна; Kalashnyk, Nataliia Volodymyrivna; Іконописцева, Наталія Анатоліївна; Ikonopystseva, Nataliia Anatoliivna; Бойко, Алеся Валеріївна; Boiko, Alesia Valeriivna; Bolotna, M.To assess the role of the placental growth factor in the development of gestational complications during multiple pregnancy, there was conducted a study of this indicator in serum of 320 pregnant women with multiple pregnancy in the first trimester and 40 pregnant women with singleton pregnancy (the control group). The objective of the research was to study the effect of placental growth factors on the gestational process in multiple pregnancy. Materials and Methods. There was conducted a prospective study of pregnancy and childbirth in 320 females with multiple pregnancy (the main group) and 40 healthy women with singleton pregnancy. The level of serum placental growth factor was determined by enzyme-linked immunosorbent assay using monoclonal antibodies in the first trimester of pregnancy. The indicators of the hemostasis system (vascular, platelet and coagulation components) were evaluated according to generally accepted methods. Doppler ultrasound of the placental and fetal blood flow was performed in the uterine arteries, the umbilical artery and vein, the fetal middle cerebral artery. Results. Women with multiple pregnancy were at high risk of developing gestational complications such as preterm deliveries (67.8%, p < 0.01), placental dysfunction, pre-eclampsia (17.5%, p < 0.05). The disorders of the vascular platelet and coagulation hemostasis in the first trimester of pregnancy were the main risk factors for early termination of pregnancy. Low level of serum placental growth factor in pregnant women with multiple pregnancy in case of preterm delivery, placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg/ml), in comparison with the corresponding indicators in singleton pregnancy (418.2 ± 10.4 pg/ml), was proven to be a prognostic marker for the development of gestational complications. Conclusions. Timely correction of gestational complications in multiple pregnancy with micronized progesterone, low molecular weight heparins, angio-protective agents allowed us to prolong pregnancy with monochorionic placentation type for 3.2 weeks (up to 34.2 ± 2.4 weeks) and provide full-time delivery of dichorionic twin pregnancy.Item Fetal infections optimization of pregnancy and delivery introduction(Aluna Publishing, 2021) Herevych, N.V.; Nochvina, O.A.; Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna MykolaivnaThe aim: Improving perinatal outcomes in pregnant women at high risk of intrauterine infection by developing diagnostic criteria and algorithms for managing pregnancy and childbirth. Materials and methods: The study of pregnancy and childbirth was conducted in 72 patients at high risk of IUI, which formed the main group. The control group consisted of 64 patients with a low infectious risk of IUI. Culture, bacterioscopic and biochemical methods were used to identify microorganisms. Peculiarities of infection in the examined women were investigated by determining the concentration of Ig M and IgG in the blood serum and performed polymerase chain reaction for measles virus, cytomegalovirus, parvovirus B19. Serum for the presence of specific immune globulins to these pathogens was examined by ELISA. Comprehensive ultrasound examination in B-mode was performed to determine the feto metry of the fetus and assess its development with the determination of the estimated mass, location, size and structure of the placenta, the amount of amniotic fluid. To determine the condition of the fetus, a Doppler study of blood flow in the uterine arteries, umbilical artery, middle cerebral artery of the fetus and venous duct. Results: Analyzing the course of this pregnancy in women of the studied groups threatened miscarriage and the threat of premature birth occurred in 24 (33.3%) cases, with signs of isthmic-cervical insufficiency were diagnosed in 13 (18.1%) patients. In the control group of patients, the threat of abortion was diagnosed in 15 (23.4%) patients. According to ultrasound examination, patients in the main group in 12 (16.7%) cases were diagnosed with fetal growth retardation, in 25 (34.7%) patients at high risk of IUI there were changes in the placenta, namely, hyper echogenic inclusions in the placenta occurred in 7 (9.7%) cases, dilation of the intervillous space in 8 (11.1%) cases, placental hyperplasia in 7 (9.7%) cases, polyhydramnios was diagnosed in only 5 (6), 9%) cases, with 1 (1.4%) acute polyhydramnios in patients with signs of acute respiratory viral infection during pregnancy. Conclusions: Women at high risk for IUI require close monitoring of the fetus due to the increased frequency of hemodynamic changes in uteroplacental-fetal circulation, including fetal-placental – 22.2% and the occurrence of intrauterine growth retardation. Women with suspected cytomegalovirus infection require determination of seroconversion; in case of immunologically confirmed infection, it is desirable to recognize PCR for cytomegalovirus in the amniotic fluid in order to determine further management and monitoring of this pregnancy.Item Ехографічні маркери невиношування вагітності у першому триместрі(Сумський державний університет, 2013) Нікітіна, Ірина Миколаївна; Никитина, Ирина Николаевна; Nikitina, Iryna Mykolaivna; Ольховик, Віталій Леонідович; Ольховик, Виталий Леонидович; Olkhovyk, Vitalii Leonidovych; Лукаш, А.В.Серед найважливіших проблем практичного акушерства одне з перших місць займає невиношування вагітності в І триместрі, що є однією з основних причин перинатальної захворюваності та смертності і складає 15 – 20% від бажаних вагітностей. При цитуванні документа, використовуйте посилання http://essuir.sumdu.edu.ua/handle/123456789/32906