Risk factors for spontaneous miscarriage and preterm birth in patients with isthmic-cervical insufficiency

Objectives. To define the factors that determine spontaneous miscarriage and preterm birth in pregnant women with isthmic-cervical insufficiency (ICI), to develop recommendations for providing medical care depending on the individual risk. Material and methods. The object of the study was 300 pregnant women with ICI (main group) and their newborns: subgroup 1 – 91 patients with spontaneous miscarriage and ICI, subgroup 2 – 106 patients with preterm labor and ICI, subgroup 3 – 103 patients with term labor and ICI. The control group (subgroup 4) consisted of 100 women with term labor without ICI. All patients received treatment in Vitebsk region hospitals in 2016-2022. Results. The anamnestic data, the features of the current pregnancy course, the results of laboratory and instrumental diagnostic methods, the effectiveness of a vaginal cerclage, an obstetric pessary, and a hormonal method of treating ICI were studied. An assessment of the influence of the studied factors on the timing of the completion of pregnancy, the morbidity of newborns and the need for the second stage of nursing was made. Risk factors for ICI and factors influencing pregnancy outcomes in ICI in the 2nd and the 3rd trimesters have been established, which will enable the prediction of gestational complications, timely performing of primary and secondary prevention of miscarriage, and improvement of perinatal morbidity rates. Conclusions. A high risk of spontaneous miscarriage in patients with ICI is determined by the following risk factors: ≥ 3 deliveries; history of premature birth; ICI in the anamnesis; severe undifferentiated connective tissue dysplasia (UCTD); hyperprolactinemia; cervical dysplasia during the current pregnancy; asymptomatic bacteriuria during the current pregnancy; cervical length ≤25 mm at 16 weeks of gestation. Risk factors for preterm delivery against the background of ICI during the current pregnancy are: severe UCTD; cervical length ≤25 mm at 22 weeks of gestation. To reduce the likelihood of spontaneous miscarriage in patients with ICI the use of prophylactic progesterone; dynamic ultrasonic cervicometry; diagnosis and treatment of asymptomatic bacteriuria; prophylactic vaginal cerclage when the cervical length is 25-30 mm at 14-16 weeks of pregnancy may be useful. To reduce the rate of preterm birth in patients with ICI prophylactic administration of progesterone; dynamic ultrasonic cervicometry; prophylactic vaginal cerclage when the cervical length is 25-30 mm at 20-22 weeks of pregnancy may be recommended

Vortex merger near a topographic slope in a homogeneous rotating fluid

This work is a contribution to the PHYSINDIEN research program. It was supported by CNRS-RFBR contract PRC 1069/16-55-150001.The effect of a bottom slope on the merger of two identical Rankine vortices is investigated in a two dimensional, quasi-geostrophic, incompressible fluid. When two cyclones initially lie parallel to the slope, and more than two vortex diameters away from the slope, the critical merger distance is unchanged. When the cyclones are closer to the slope, they can merge at larger distances, but they lose more mass into filaments, thus weakening the efficiency of merger. Several effects account for this: the topographic Rossby wave advects the cyclones, reduces their mutual distance and deforms them. This along shelf wave breaks into filaments and into secondary vortices which shear out the initial cyclones. The global motion of fluid towards the shallow domain and the erosion of the two cyclones are confirmed by the evolution of particles seeded both in the cyclone sand near the topographic slope. The addition of tracer to the flow indicates that diffusion is ballistic at early times. For two anticyclones, merger is also facilitated because one vortex is ejected offshore towards the other, via coupling with a topographic cyclone. Again two anticyclones can merge at large distance but they are eroded in the process. Finally, for taller topographies, the critical merger distance is again increased and the topographic influence can scatter or completely erode one of the two initial cyclones. Conclusions are drawn on possible improvements of the model configuration for an application to the ocean.PostprintPeer reviewe

PROJECT AND THE PRELIMINARY RESULTS OF THE EXPERIMENTS ON THE 57Fe MÖSSBAUER LEVEL EXCITATION USING SYNCHROTRON RADIATION

Un dispositif expérimental est proposé pour réaliser des expériences de résolution en temps.An experimental arrangement is proposed for the performance of time resolution experiments