10 research outputs found
Π Π°ΡΠΈΠΎΠ½Π°Π»ΡΠ½Π°Ρ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΌΠΈΠΊΡΠΎΠ±Π½Π°Ρ ΡΠ΅ΡΠ°ΠΏΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ ΠΏΠΈΠΎΠ΄Π΅ΡΠΌΠΈΡΠΌΠΈ
The data are given about the history of the invention and development of antimicrobial therapy in the XX-th and the beginning of the XXI-th centuries. There are presented data on the pharmacological effects of antibacterial agents from different groups that are used for the treatment of patients with pyodermatosis, dose schedules, pharmacokinetics, adverse effects, contraindications, and medicine interactions. The main causes leading to the formation of resistant microorganism strains are pointed. Advances of broad-spectrum antibacterial antibiotics for treatment the pyodermic patients are demonstrated on the example of amoxicillin+clavulinic acid, josamycin and doxycycline monohydrate. The arguments justifying the need to refuse empiric administration of antibacterial therapy are presented. To select a rational causal initial therapy of patients with pyoderma it is necessary to use the results of microbiological study of etiology and pathogenic microflora sensitivity to antimicrobial preparations.ΠΡΠΈΠ²Π΅Π΄Π΅Π½Ρ ΡΠ²Π΅Π΄Π΅Π½ΠΈΡ ΠΈΠ· ΠΈΡΡΠΎΡΠΈΠΈ ΠΎΡΠΊΡΡΡΠΈΡ ΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΌΠΈΠΊΡΠΎΠ±Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π² XX ΠΈ Π½Π°ΡΠ°Π»Π΅ XXI ΡΡΠΎΠ»Π΅ΡΠΈΡ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ ΡΠ°ΡΠΌΠ°ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π΄Π΅ΠΉΡΡΠ²ΠΈΠΈ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΡΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ² ΠΈΠ· ΡΠ°Π·Π½ΡΡ
Π³ΡΡΠΏΠΏ, ΠΏΡΠΈΠΌΠ΅Π½ΡΡΡΠΈΡ
ΡΡ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠΈΠΎΠ΄Π΅ΡΠΌΠΈΠ΅ΠΉ, ΡΠ΅ΠΆΠΈΠΌΠ°Ρ
ΠΈΡ
Π΄ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ, ΡΠ°ΡΠΌΠ°ΠΊΠΎΠΊΠΈΠ½Π΅ΡΠΈΠΊΠ΅, ΠΏΠΎΠ±ΠΎΡΠ½ΡΡ
Π΄Π΅ΠΉΡΡΠ²ΠΈΡΡ
, ΠΏΡΠΎΡΠΈΠ²ΠΎΠΏΠΎΠΊΠ°Π·Π°Π½ΠΈΡΡ
, Π»Π΅ΠΊΠ°ΡΡΡΠ²Π΅Π½Π½ΠΎΠΌ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΠΈ. ΠΡΠ΄Π΅Π»Π΅Π½Ρ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ ΡΠ°ΠΊΡΠΎΡΡ, ΠΏΡΠΈΠ²ΠΎΠ΄ΡΡΠΈΠ΅ ΠΊ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ΅Π·ΠΈΡΡΠ΅Π½ΡΠ½ΡΡ
ΡΡΠ°ΠΌΠΌΠΎΠ² ΠΌΠΈΠΊΡΠΎΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠΎΠ². ΠΠ° ΠΏΡΠΈΠΌΠ΅ΡΠ΅ Π°ΠΌΠΎΠΊΡΠΈΡΠΈΠ»Π»ΠΈΠ½Π° + ΠΊΠ»Π°Π²ΡΠ»Π°Π½ΠΎΠ²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ, Π΄ΠΆΠΎΠ·Π°ΠΌΠΈΡΠΈΠ½Π° ΠΈ Π΄ΠΎΠΊΡΠΈΡΠΈΠΊΠ»ΠΈΠ½Π° ΠΌΠΎΠ½ΠΎΠ³ΠΈΠ΄ΡΠ°ΡΠ° ΠΏΠΎΠΊΠ°Π·Π°Π½Ρ ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π° Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΠ² Ρ ΡΠΈΡΠΎΠΊΠΈΠΌ ΡΠΏΠ΅ΠΊΡΡΠΎΠΌ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΌΠΈΠΊΡΠΎΠ±Π½ΠΎΠ³ΠΎ Π΄Π΅ΠΉΡΡΠ²ΠΈΡ ΠΏΡΠΈ Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠΈΠΎΠ΄Π΅ΡΠΌΠΈΠ΅ΠΉ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Ρ Π΄ΠΎΠ²ΠΎΠ΄Ρ, ΠΎΠ±ΠΎΡΠ½ΠΎΠ²ΡΠ²Π°ΡΡΠΈΠ΅ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΡ ΠΎΡΠΊΠ°Π·Π° ΠΎΡ ΡΠΌΠΏΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π½Π°Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π°Π½ΡΠΈΠ±Π°ΠΊΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ. ΠΠ»Ρ Π²ΡΠ±ΠΎΡΠ° ΡΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ ΡΡΠΈΠΎΡΡΠΎΠΏΠ½ΠΎΠΉ ΡΡΠ°ΡΡΠΎΠ²ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΠΈΠΎΠ΄Π΅ΡΠΌΠΈΠ΅ΠΉ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°ΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΏΠ°ΡΠΎΠ³Π΅Π½Π½ΠΎΠΉ ΠΌΠΈΠΊΡΠΎΠ±Π½ΠΎΠΉ ΡΠ»ΠΎΡΡ ΠΊ ΠΏΡΠΎΡΠΈΠ²ΠΎΠΌΠΈΠΊΡΠΎΠ±Π½ΡΠΌ ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ°ΠΌ
Potential use of lactic acid in obstetrics and gynecology
A.M. Savicheva1,2, P.A. Shadrova3
1D.O. Ott Research Institute of Obstetrics, Gynecology, & Reproduction, St. Petersburg,
Russian Federation
2St. Petersburg State Pediatric Medical University, St. Petersburg, Russian Federation
3Pirogov Russian National Research Medical University, Moscow, Russian Federation
Inflammatory diseases and dysbiosis provoked by opportunistic microbes currently rank first among lower reproductive tract infections in women. Lactobacilli are predominant in the vaginal microecosystem that is considered the first line of defense against infectious agents. Changes in hormonal profile, the pattern of intimate hygiene and sex life, and other factors impair the vaginal microecosystem. Diseases resulting from the activation of aerobic and anaerobic opportunistic microbes are particularly harmful during pregnancy, since they cause serious reproductive disorders and significantly increase the risks of perinatal complications. Frequent recurrences due to growing antibiotic resistance and the lack of potential antimicrobial treatment in the first trimester of pregnancy force to search for alternative therapeutic tools with good efficacy and safety. Topical agents containing lactic acid decrease vaginal pH and provide unfavorable conditions for the activity o f opportunistic microbes, thereby maintaining the protective functions of Lactobacilli. Lactic acid is a natural chemical for this locus. As a result, agents containing this compound are virtually lacking side effects. They can be used along with antibiotics or as monotherapy.
Keywords: bacterial vaginosis, aerobic vaginitis, lactic acid, opportunistic microbes, vaginal microbiota, Lactobacilli, dysbiosis, pregnancy, normal flora.
For citation: Savicheva A.M., Shadrova P.A. Potential use of lactic acid in obstetrics and gynecology. Russian Journal of Woman and Child Health. 2022;5(2):138β145 (in Russ.). DOI: 10.32364/2618-8430-2022-5-2-138-145.
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Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΏΠΎΠ΄Ρ ΠΎΠ΄Ρ ΠΊ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΏΠ»Π°ΡΠ΅Π½ΡΠ°ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΡΠΎΠΊΠΎΠ³ΡΠ°ΡΠΈΠΈ
Purpose. The goal is to determine the real possibilities of assessing the fetal condition in the ante- and intranatal periods according to the data of cardiotocography Patients and methods. 73 patients with physiological pregnancy at 24-40 weeks were prospectively examined. The practical significance of the g6b plus General MEDITECH automated fetal monitor, which allows to determine the condition of the mother and fetus at the same time, was evaluated. Results. The average blood pressure in the examined women was 127.2 Β± 3.6 by 73.7 Β± 2.3 mm. gt; pillars, pulse - 76 Β± 1,5 beats/min. As for the contractile capacity of the uterus, 47 (64,4%) pregnant women in 24-30 weeks. associated with diagnosis, and 19 (26%) - are harbingers of the forthcoming birth. The average SpO2 was 99.12 Β± 0.11%. Regardless of the gestational age, in 7 (9.6%) pregnant women - 97%, 40 (54.8%) - 99% and 21 (28.8%) - 100%. In order to assess the fetal condition by the nature of his heartbeat, we performed an automated CTG analysis according to W. Fisher, D. Redman, FIGO: according to W. Fisher, depending on the gestational age of 6-7 points, 12 (16.4%) pregnant women in 25-26 weeks and 9 (12.3%) - 40 weeks, which according to the ball scale corresponds to a suspicious type. The Doze-Redman criteria were met in 47 (64.4%) pregnant women and were not met - in 26 (35.6%). Interpretation according to FIGO guidelines as normal was detected in 64 (87.7%) pregnant women and in 9 (12.3%) - doubtful. Depending on the period of pregnancy, this group consisted of the same 9 (12.3%) pregnant women in a period of 40 weeks. Conclusion. Automated analysis allows for the correlation between the main indicators of the well-being of the maternal organism (SpO2, blood pressure, pulse, body temperature, ECG) and fetal CTG parameters (Fisher scale, Dowz Redman criteria and FIGO guidelines) to develop obstetric tactics for each specific patient during pregnancy and childbirth.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΠ΅Π°Π»ΡΠ½ΡΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ»ΠΎΠ΄Π° Π² Π°Π½ΡΠ΅- ΠΈ ΠΈΠ½ΡΡΠ°Π½Π°ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π°Ρ
ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΡΠΎΠΊΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ’Π). ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ 73 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ Ρ ΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ Π² 24-40 Π½Π΅Π΄. ΠΡΠ΅Π½ΠΈΠ²Π°Π»Π°ΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ Π°Π²ΡΠΎΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠΎΠ½ΠΈΡΠΎΡΠ° G6B plus GENERAL MEDITECH, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡΠ΅Π³ΠΎ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΌΠ°ΡΠ΅ΡΠΈ ΠΈ ΠΏΠ»ΠΎΠ΄Π°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ΅Π΄Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄Π°Π²Π»Π΅Π½ΠΈΡ Ρ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΠΆΠ΅Π½ΡΠΈΠ½ ΡΠΎΡΡΠ°Π²ΠΈΠ» 127,2 Β± 3,6 Π½Π° 73,7 Β± 2,3 ΠΌΠΌ ΡΡ. ΡΡ., ΠΏΡΠ»ΡΡ - 76 Β± 1,5 Π² 1 ΠΌΠΈΠ½. Π§ΡΠΎ ΠΊΠ°ΡΠ°Π΅ΡΡΡ ΡΠΎΠΊΡΠ°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ ΠΌΠ°ΡΠΊΠΈ, ΡΠΎ Ρ 47 (64,4%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π² 24-30 Π½Π΅Π΄ ΠΎΠ½Π° ΡΠ²ΡΠ·Π°Π½Π° Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΎΠΉ, Π° Ρ 19 (26%) - ΡΡΠΎ ΠΏΡΠ΅Π΄Π²Π΅ΡΡΠ½ΠΈΠΊ ΠΏΡΠ΅Π΄ΡΡΠΎΡΡΠΈΡ
ΡΠΎΠ΄ΠΎΠ². Π‘ΡΠ΅Π΄Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ SpO2 ΡΠΎΡΡΠ°Π²ΠΈΠ» 99,12 Β± 0,11%, Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΠΎ ΠΎΡ ΡΡΠΎΠΊΠ° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ, Ρ 7 (9,6%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
- 97%, 40 (54,8%) - 99% ΠΈ 21 (28,8%) - 100%. Π‘ ΡΠ΅Π»ΡΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ»ΠΎΠ΄Π° ΠΏΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΡ Π΅Π³ΠΎ ΡΠ΅ΡΠ΄ΡΠ΅Π±ΠΈΠ΅Π½ΠΈΡ Π½Π°ΠΌΠΈ ΠΏΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½ Π°Π²ΡΠΎΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΠ’Π ΠΏΠΎ W.Fisher, Π.Π Π΅Π΄ΠΌΠ°Π½Ρ, FIGO: ΠΏΠΎ W.Fisher Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΡΠΎΠΊΠ° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ 6-7 Π±Π°Π»Π»ΠΎΠ² Π²ΡΡΠ²Π»Π΅Π½ΠΎ Ρ 12 (16,4%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π² 25-26 Π½Π΅Π΄ ΠΈ Ρ 9 (12,3%) - Π² 40 Π½Π΅Π΄, ΡΡΠΎ ΠΏΠΎ Π±Π°Π»Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΠ΅Ρ ΠΏΠΎΠ΄ΠΎΠ·ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌΡ ΡΠΈΠΏΡ. ΠΡΠΈΡΠ΅ΡΠΈΠΈ ΠΠΎΡΠ·Π°-Π Π΅Π΄ΠΌΠ°Π½Π° Π±ΡΠ»ΠΈ ΡΠΎΠ±Π»ΡΠ΄Π΅Π½Ρ Ρ 47 (64,4%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΈ Π½Π΅ ΡΠΎΠ±Π»ΡΠ΄Π΅Π½Ρ - Ρ 26 (35,6%). ΠΠ½ΡΠ΅ΡΠΏΡΠ΅ΡΠ°ΡΠΈΡ ΠΏΠΎ Π΄ΠΈΡΠ΅ΠΊΡΠΈΠ²Π°ΠΌ FIGO ΠΊΠ°ΠΊ Π½ΠΎΡΠΌΠ°Π»ΡΠ½Π°Ρ Π²ΡΡΠ²Π»Π΅Π½Π° Ρ 64 (87,7%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΈ Ρ 9 (12,3%) - ΡΠΎΠΌΠ½ΠΈΡΠ΅Π»ΡΠ½Π°Ρ. Π Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΡΠΎΠΊΠ° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ ΡΡΡ Π³ΡΡΠΏΠΏΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ ΡΠ΅ ΠΆΠ΅ 9 (12,3%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π² ΡΡΠΎΠΊΠ΅ 40 Π½Π΅Π΄. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ²ΡΠΎΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΠΎΠ½Π½ΡΡ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ ΠΌΠ΅ΠΆΠ΄Ρ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ Π±Π»Π°Π³ΠΎΠΏΠΎΠ»ΡΡΠΈΡ ΠΌΠ°ΡΠ΅ΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ° (SpO2, Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠ΅ Π΄Π°Π²Π»Π΅Π½ΠΈΠ΅, ΠΏΡΠ»ΡΡ, ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ° ΡΠ΅Π»Π°, ΠΠΠ) ΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°ΠΌΠΈ ΠΠ’Π ΠΏΠ»ΠΎΠ΄Π° (ΠΏΠΎ ΡΠΊΠ°Π»Π΅ Π€ΠΈΡΠ΅ΡΠ°, ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ΠΠΎΡΠ·Π°-Π Π΅Π΄ΠΌΠ°Π½Π° ΠΈ ΠΏΠΎ Π΄ΠΈΡΠ΅ΠΊΡΠΈΠ²Π°ΠΌ FIGO) Ρ ΡΠ΅Π»ΡΡ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΊΠ°ΠΆΠ΄ΠΎΠΉ ΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΠΎΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ Π²ΠΎ Π²ΡΠ΅ΠΌΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ ΠΈ Π² ΡΠΎΠ΄Π°Ρ
Π‘ΠΠ¦ΠΠΠΠ¬ΠΠ-ΠΠΠΠΠΠΠΠ§ΠΠ‘ΠΠΠ― Π₯ΠΠ ΠΠΠ’ΠΠ ΠΠ‘Π’ΠΠΠ ΠΠΠΠ©ΠΠ Π‘ ΠΠΠ‘Π£ΠΠΠΠΠΠΠΠΠ‘ΠΠΠ«Π Π‘ΠΠ₯ΠΠ ΠΠ«Π ΠΠΠΠΠΠ’ΠΠΠ ΠΠΠΠΠ‘ΠΠΠΠ‘Π’Π ΠΠ’ Π₯ΠΠ ΠΠΠ’ΠΠ Π Π’ΠΠ§ΠΠΠΠ― ΠΠΠΠΠΠΠΠΠΠΠ―
Diabetes mellitus (DM) is an endocrine pathology, defined by WHO as a noΠΏinfectious epidemic of the 21st century. It is noted, that pregnancy associated with DM is accompanied by obstetric and diabetic complications in 80-93 % of cases.The aim of the study is to present social and biological characteristics of women with insulin-dependent diabetes mellitus according to the nature of the disease.Materials and Methods. The work was carried out on the basis of the Department of Obstetrics and Gynecology with the course of perinatology in the Peoplesβ Friendship University of Russia (RUDN), Moscow City Clinical Hospital No. 29 (gynecology department and pathologic pregnancy department). Two main groups of pregnant women with insulin-dependent diabetes mellitus and two comparison groups (a total of 200 patients) were identified using the paired-comparison method.Results. The following procedures can help to increase favorable outcomes of pregnancy in patients with insulin-dependent diabetes mellitus: effective types of contraception to prevent unplanned pregnancy and as a result reproductive losses; complex pre-conceptional training together with other medical and health specialists who have special education in obstetric diabetology; target blood sugar level at a preconceptional stage and early pregnancy.Π‘Π°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ (Π‘Π) - ΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½Π°Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½Π°Ρ ΠΠΠ ΠΊΠ°ΠΊ Π½Π΅ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½Π°Ρ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΡ XXI Π². ΠΠΎ Π΄Π°Π½Π½ΡΠΌ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π°Π²ΡΠΎΡΠΎΠ², Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡ Π½Π° ΡΠΎΠ½Π΅ Π‘Π Π² 80-93 % ΡΠ»ΡΡΠ°Π΅Π² ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΈΠΌΠΈ ΠΈ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΠΌΠΈ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ - ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΡ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΡ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎ Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ° ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Π°Π±ΠΎΡΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° Π½Π° Π±Π°Π·Π΅ ΠΊΠ°ΡΠ΅Π΄ΡΡ Π°ΠΊΡΡΠ΅ΡΡΡΠ²Π° ΠΈ Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ Ρ ΠΊΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π€ΠΠΠΠ£ ΠΠ Β«Π ΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ ΡΠ½ΠΈΠ²Π΅ΡΡΠΈΡΠ΅Ρ Π΄ΡΡΠΆΠ±Ρ Π½Π°ΡΠΎΠ΄ΠΎΠ²Β», ΠΠΠ β 29 Π³. ΠΠΎΡΠΊΠ²Ρ (Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
). ΠΠ΅ΡΠΎΠ΄ΠΎΠΌ Β«ΠΊΠΎΠΏΠΈΡΠΏΠ°ΡΠ°Β» Π²ΡΠ΄Π΅Π»Π΅Π½Ρ Π΄Π²Π΅ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ Π³ΡΡΠΏΠΏΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Ρ ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎΠ·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ ΠΈ Π΄Π²Π΅ Π³ΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ (Π²ΡΠ΅Π³ΠΎ 200 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π΅Π·Π΅ΡΠ²Π°ΠΌΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ Ρ ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎΠ·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ ΡΠ²Π»ΡΡΡΡΡ Π½Π°Π΄Π΅ΠΆΠ½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΠ΅ΠΏΡΠΈΠΈ Π΄Π»Ρ ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ΅Π½ΠΈΡ Π½Π΅Π·Π°ΠΏΠ»Π°Π½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ ΠΊΠ°ΠΊ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ° ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΡΡ
ΠΏΠΎΡΠ΅ΡΡ; ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½Π°Ρ ΠΏΡΠ΅Π΄Π³ΡΠ°Π²ΠΈΠ΄Π°Π½Π° ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠ° ΡΠΎΠ²ΠΌΠ΅ΡΡΠ½ΠΎ ΡΠΎ ΡΠΌΠ΅ΠΆΠ½ΡΠΌΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠ°ΠΌΠΈ, ΠΏΡΠΎΡΠ΅Π΄ΡΠΈΠΌΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π² ΠΎΠ±Π»Π°ΡΡΠΈ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΎΠΉ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ; Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅Π»Π΅Π²ΡΡ
ΡΡΠΎΠ²Π½Π΅ΠΉ Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΠΈ Π½Π° ΡΡΠ°ΠΏΠ°Ρ
ΠΏΡΠ΅Π΄Π³ΡΠ°Π²ΠΈΠ΄Π°ΡΠ½ΠΎΠΉ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠΈ ΠΈ ΡΠ°Π½Π½ΠΈΡ
ΡΡΠΎΠΊΠ°Ρ
Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ
Π‘ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΏΠΎΠ΄Ρ ΠΎΠ΄Ρ ΠΊ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΏΠ»Π°ΡΠ΅Π½ΡΠ°ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΡΠΎΠΊΠΎΠ³ΡΠ°ΡΠΈΠΈ
Purpose. The goal is to determine the real possibilities of assessing the fetal condition in the ante- and intranatal periods according to the data of cardiotocography Patients and methods. 73 patients with physiological pregnancy at 24-40 weeks were prospectively examined. The practical significance of the g6b plus General MEDITECH automated fetal monitor, which allows to determine the condition of the mother and fetus at the same time, was evaluated. Results. The average blood pressure in the examined women was 127.2 Β± 3.6 by 73.7 Β± 2.3 mm. gt; pillars, pulse - 76 Β± 1,5 beats/min. As for the contractile capacity of the uterus, 47 (64,4%) pregnant women in 24-30 weeks. associated with diagnosis, and 19 (26%) - are harbingers of the forthcoming birth. The average SpO2 was 99.12 Β± 0.11%. Regardless of the gestational age, in 7 (9.6%) pregnant women - 97%, 40 (54.8%) - 99% and 21 (28.8%) - 100%. In order to assess the fetal condition by the nature of his heartbeat, we performed an automated CTG analysis according to W. Fisher, D. Redman, FIGO: according to W. Fisher, depending on the gestational age of 6-7 points, 12 (16.4%) pregnant women in 25-26 weeks and 9 (12.3%) - 40 weeks, which according to the ball scale corresponds to a suspicious type. The Doze-Redman criteria were met in 47 (64.4%) pregnant women and were not met - in 26 (35.6%). Interpretation according to FIGO guidelines as normal was detected in 64 (87.7%) pregnant women and in 9 (12.3%) - doubtful. Depending on the period of pregnancy, this group consisted of the same 9 (12.3%) pregnant women in a period of 40 weeks. Conclusion. Automated analysis allows for the correlation between the main indicators of the well-being of the maternal organism (SpO2, blood pressure, pulse, body temperature, ECG) and fetal CTG parameters (Fisher scale, Dowz Redman criteria and FIGO guidelines) to develop obstetric tactics for each specific patient during pregnancy and childbirth.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΠ΅Π°Π»ΡΠ½ΡΠ΅ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ»ΠΎΠ΄Π° Π² Π°Π½ΡΠ΅- ΠΈ ΠΈΠ½ΡΡΠ°Π½Π°ΡΠ°Π»ΡΠ½ΠΎΠΌ ΠΏΠ΅ΡΠΈΠΎΠ΄Π°Ρ
ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΊΠ°ΡΠ΄ΠΈΠΎΡΠΎΠΊΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ’Π). ΠΠ°ΡΠΈΠ΅Π½ΡΡ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ 73 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ Ρ ΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ Π² 24-40 Π½Π΅Π΄. ΠΡΠ΅Π½ΠΈΠ²Π°Π»Π°ΡΡ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠ°Ρ Π·Π½Π°ΡΠΈΠΌΠΎΡΡΡ Π°Π²ΡΠΎΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΡΠ΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΌΠΎΠ½ΠΈΡΠΎΡΠ° G6B plus GENERAL MEDITECH, ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡΠ΅Π³ΠΎ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΡΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΌΠ°ΡΠ΅ΡΠΈ ΠΈ ΠΏΠ»ΠΎΠ΄Π°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ΅Π΄Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π΄Π°Π²Π»Π΅Π½ΠΈΡ Ρ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΡ
ΠΆΠ΅Π½ΡΠΈΠ½ ΡΠΎΡΡΠ°Π²ΠΈΠ» 127,2 Β± 3,6 Π½Π° 73,7 Β± 2,3 ΠΌΠΌ ΡΡ. ΡΡ., ΠΏΡΠ»ΡΡ - 76 Β± 1,5 Π² 1 ΠΌΠΈΠ½. Π§ΡΠΎ ΠΊΠ°ΡΠ°Π΅ΡΡΡ ΡΠΎΠΊΡΠ°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡΠΈ ΠΌΠ°ΡΠΊΠΈ, ΡΠΎ Ρ 47 (64,4%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π² 24-30 Π½Π΅Π΄ ΠΎΠ½Π° ΡΠ²ΡΠ·Π°Π½Π° Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΎΠΉ, Π° Ρ 19 (26%) - ΡΡΠΎ ΠΏΡΠ΅Π΄Π²Π΅ΡΡΠ½ΠΈΠΊ ΠΏΡΠ΅Π΄ΡΡΠΎΡΡΠΈΡ
ΡΠΎΠ΄ΠΎΠ². Π‘ΡΠ΅Π΄Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ SpO2 ΡΠΎΡΡΠ°Π²ΠΈΠ» 99,12 Β± 0,11%, Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΠΎ ΠΎΡ ΡΡΠΎΠΊΠ° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ, Ρ 7 (9,6%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
- 97%, 40 (54,8%) - 99% ΠΈ 21 (28,8%) - 100%. Π‘ ΡΠ΅Π»ΡΡ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ»ΠΎΠ΄Π° ΠΏΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΡ Π΅Π³ΠΎ ΡΠ΅ΡΠ΄ΡΠ΅Π±ΠΈΠ΅Π½ΠΈΡ Π½Π°ΠΌΠΈ ΠΏΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½ Π°Π²ΡΠΎΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΠ’Π ΠΏΠΎ W.Fisher, Π.Π Π΅Π΄ΠΌΠ°Π½Ρ, FIGO: ΠΏΠΎ W.Fisher Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΡΠΎΠΊΠ° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ 6-7 Π±Π°Π»Π»ΠΎΠ² Π²ΡΡΠ²Π»Π΅Π½ΠΎ Ρ 12 (16,4%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π² 25-26 Π½Π΅Π΄ ΠΈ Ρ 9 (12,3%) - Π² 40 Π½Π΅Π΄, ΡΡΠΎ ΠΏΠΎ Π±Π°Π»Π»ΡΠ½ΠΎΠΉ ΡΠΊΠ°Π»Π΅ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΡΠ΅Ρ ΠΏΠΎΠ΄ΠΎΠ·ΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΌΡ ΡΠΈΠΏΡ. ΠΡΠΈΡΠ΅ΡΠΈΠΈ ΠΠΎΡΠ·Π°-Π Π΅Π΄ΠΌΠ°Π½Π° Π±ΡΠ»ΠΈ ΡΠΎΠ±Π»ΡΠ΄Π΅Π½Ρ Ρ 47 (64,4%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΈ Π½Π΅ ΡΠΎΠ±Π»ΡΠ΄Π΅Π½Ρ - Ρ 26 (35,6%). ΠΠ½ΡΠ΅ΡΠΏΡΠ΅ΡΠ°ΡΠΈΡ ΠΏΠΎ Π΄ΠΈΡΠ΅ΠΊΡΠΈΠ²Π°ΠΌ FIGO ΠΊΠ°ΠΊ Π½ΠΎΡΠΌΠ°Π»ΡΠ½Π°Ρ Π²ΡΡΠ²Π»Π΅Π½Π° Ρ 64 (87,7%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΈ Ρ 9 (12,3%) - ΡΠΎΠΌΠ½ΠΈΡΠ΅Π»ΡΠ½Π°Ρ. Π Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΡΠΎΠΊΠ° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ ΡΡΡ Π³ΡΡΠΏΠΏΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ ΡΠ΅ ΠΆΠ΅ 9 (12,3%) Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π² ΡΡΠΎΠΊΠ΅ 40 Π½Π΅Π΄. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ²ΡΠΎΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΠΊΠΎΡΡΠ΅Π»ΡΡΠΈΠΎΠ½Π½ΡΡ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ ΠΌΠ΅ΠΆΠ΄Ρ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌΠΈ Π±Π»Π°Π³ΠΎΠΏΠΎΠ»ΡΡΠΈΡ ΠΌΠ°ΡΠ΅ΡΠΈΠ½ΡΠΊΠΎΠ³ΠΎ ΠΎΡΠ³Π°Π½ΠΈΠ·ΠΌΠ° (SpO2, Π°ΡΡΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠ΅ Π΄Π°Π²Π»Π΅Π½ΠΈΠ΅, ΠΏΡΠ»ΡΡ, ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ° ΡΠ΅Π»Π°, ΠΠΠ) ΠΈ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°ΠΌΠΈ ΠΠ’Π ΠΏΠ»ΠΎΠ΄Π° (ΠΏΠΎ ΡΠΊΠ°Π»Π΅ Π€ΠΈΡΠ΅ΡΠ°, ΠΏΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡΠΌ ΠΠΎΡΠ·Π°-Π Π΅Π΄ΠΌΠ°Π½Π° ΠΈ ΠΏΠΎ Π΄ΠΈΡΠ΅ΠΊΡΠΈΠ²Π°ΠΌ FIGO) Ρ ΡΠ΅Π»ΡΡ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠΈ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΎΠΉ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΊΠ°ΠΆΠ΄ΠΎΠΉ ΠΊΠΎΠ½ΠΊΡΠ΅ΡΠ½ΠΎΠΉ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ Π²ΠΎ Π²ΡΠ΅ΠΌΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ ΠΈ Π² ΡΠΎΠ΄Π°Ρ
China and Gulf Cooperation Council Countries: From Economic Deals to Strategic Partnerships
The Middle East in general and the Persian Gulf sub-region in particular are becoming increasingly strategic for China. The sub-region is not only rich in natural resources, primarily energy, and to a large extent provides them to the dynamically developing Chinese economy, but also opens up access to main global maritime and land routes, as well as African and European markets. The study focuses on Chinaβs interaction with the Gulf Cooperation Council (GCC) countries in the field of energy, trade, and investment in the context of growing economic interdependence that elevates Beijingβs relations with the Arab countries of the sub-region to the level of strategic partnership. Thus, Chinaβs relations with this group of states go beyond purely economic interests and affect the strategic interests of Beijing, such as active promotion of the large-scale βBelt and Road Initiative,β which implies the intensification of Chinaβs policy in the Middle East. The methodological basis of the study is an interdisciplinary approach. The authors adhere to the neorealism, particularly the theory of the balance of power and regional security complexes, the principle according to which the foreign policy of a state is heavily dictated by the logic of the international system and the distribution of power among states. The power transit theory allows us to understand better the current role of China becoming a superpower in world politics. The research also applies such methods of historical science as chronological, genetic, systemic-structural, and comparative methods. The collection and processing of a significant layer of statistical data makes it possible to highlight the emergence of new powerful political actors in the Middle East. Β© Savicheva E.M., Brebdane A.M., Ryzhov I.V., 2022
Π‘ΠΠ¦ΠΠΠΠ¬ΠΠ-ΠΠΠΠΠΠΠΠ§ΠΠ‘ΠΠΠ― Π₯ΠΠ ΠΠΠ’ΠΠ ΠΠ‘Π’ΠΠΠ ΠΠΠΠ©ΠΠ Π‘ ΠΠΠ‘Π£ΠΠΠΠΠΠΠΠΠ‘ΠΠΠ«Π Π‘ΠΠ₯ΠΠ ΠΠ«Π ΠΠΠΠΠΠ’ΠΠΠ ΠΠΠΠΠ‘ΠΠΠΠ‘Π’Π ΠΠ’ Π₯ΠΠ ΠΠΠ’ΠΠ Π Π’ΠΠ§ΠΠΠΠ― ΠΠΠΠΠΠΠΠΠΠΠ―
Diabetes mellitus (DM) is an endocrine pathology, defined by WHO as a noΠΏinfectious epidemic of the 21st century. It is noted, that pregnancy associated with DM is accompanied by obstetric and diabetic complications in 80-93 % of cases.The aim of the study is to present social and biological characteristics of women with insulin-dependent diabetes mellitus according to the nature of the disease.Materials and Methods. The work was carried out on the basis of the Department of Obstetrics and Gynecology with the course of perinatology in the Peoplesβ Friendship University of Russia (RUDN), Moscow City Clinical Hospital No. 29 (gynecology department and pathologic pregnancy department). Two main groups of pregnant women with insulin-dependent diabetes mellitus and two comparison groups (a total of 200 patients) were identified using the paired-comparison method.Results. The following procedures can help to increase favorable outcomes of pregnancy in patients with insulin-dependent diabetes mellitus: effective types of contraception to prevent unplanned pregnancy and as a result reproductive losses; complex pre-conceptional training together with other medical and health specialists who have special education in obstetric diabetology; target blood sugar level at a preconceptional stage and early pregnancy.Π‘Π°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ (Π‘Π) - ΡΠ½Π΄ΠΎΠΊΡΠΈΠ½Π½Π°Ρ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡ, ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½Π°Ρ ΠΠΠ ΠΊΠ°ΠΊ Π½Π΅ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½Π°Ρ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΡ XXI Π². ΠΠΎ Π΄Π°Π½Π½ΡΠΌ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
Π°Π²ΡΠΎΡΠΎΠ², Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡ Π½Π° ΡΠΎΠ½Π΅ Π‘Π Π² 80-93 % ΡΠ»ΡΡΠ°Π΅Π² ΡΠΎΠΏΡΠΎΠ²ΠΎΠΆΠ΄Π°Π΅ΡΡΡ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΈΠΌΠΈ ΠΈ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΠΌΠΈ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ - ΠΏΡΠ΅Π΄ΡΡΠ°Π²ΠΈΡΡ ΡΠΎΡΠΈΠ°Π»ΡΠ½ΠΎ-Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΡΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΡ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎ Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ° ΡΠ΅ΡΠ΅Π½ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Π°Π±ΠΎΡΠ° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° Π½Π° Π±Π°Π·Π΅ ΠΊΠ°ΡΠ΅Π΄ΡΡ Π°ΠΊΡΡΠ΅ΡΡΡΠ²Π° ΠΈ Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ Ρ ΠΊΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π€ΠΠΠΠ£ ΠΠ Β«Π ΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ ΡΠ½ΠΈΠ²Π΅ΡΡΠΈΡΠ΅Ρ Π΄ΡΡΠΆΠ±Ρ Π½Π°ΡΠΎΠ΄ΠΎΠ²Β», ΠΠΠ β 29 Π³. ΠΠΎΡΠΊΠ²Ρ (Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
). ΠΠ΅ΡΠΎΠ΄ΠΎΠΌ Β«ΠΊΠΎΠΏΠΈΡΠΏΠ°ΡΠ°Β» Π²ΡΠ΄Π΅Π»Π΅Π½Ρ Π΄Π²Π΅ ΠΎΡΠ½ΠΎΠ²Π½ΡΠ΅ Π³ΡΡΠΏΠΏΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Ρ ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎΠ·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ ΠΈ Π΄Π²Π΅ Π³ΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ (Π²ΡΠ΅Π³ΠΎ 200 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ).Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π Π΅Π·Π΅ΡΠ²Π°ΠΌΠΈ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ Ρ ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎΠ·Π°Π²ΠΈΡΠΈΠΌΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ ΡΠ²Π»ΡΡΡΡΡ Π½Π°Π΄Π΅ΠΆΠ½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΠ΅ΠΏΡΠΈΠΈ Π΄Π»Ρ ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ΅Π½ΠΈΡ Π½Π΅Π·Π°ΠΏΠ»Π°Π½ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ ΠΊΠ°ΠΊ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ° ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΡΡ
ΠΏΠΎΡΠ΅ΡΡ; ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½Π°Ρ ΠΏΡΠ΅Π΄Π³ΡΠ°Π²ΠΈΠ΄Π°Π½Π° ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠ° ΡΠΎΠ²ΠΌΠ΅ΡΡΠ½ΠΎ ΡΠΎ ΡΠΌΠ΅ΠΆΠ½ΡΠΌΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΡΡΠ°ΠΌΠΈ, ΠΏΡΠΎΡΠ΅Π΄ΡΠΈΠΌΠΈ ΡΠΏΠ΅ΡΠΈΠ°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ΅ ΠΎΠ±ΡΡΠ΅Π½ΠΈΠ΅ Π² ΠΎΠ±Π»Π°ΡΡΠΈ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΎΠΉ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ; Π΄ΠΎΡΡΠΈΠΆΠ΅Π½ΠΈΠ΅ ΡΠ΅Π»Π΅Π²ΡΡ
ΡΡΠΎΠ²Π½Π΅ΠΉ Π³Π»ΠΈΠΊΠ΅ΠΌΠΈΠΈ Π½Π° ΡΡΠ°ΠΏΠ°Ρ
ΠΏΡΠ΅Π΄Π³ΡΠ°Π²ΠΈΠ΄Π°ΡΠ½ΠΎΠΉ ΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠΈ ΠΈ ΡΠ°Π½Π½ΠΈΡ
ΡΡΠΎΠΊΠ°Ρ
Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ
ΠΡΠΎΡΠΈΠ»Ρ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ ΠΊΠΈΡΠ»ΠΎΡ Ρ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ Π½Π΅ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΠ΅ΠΉΡΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡΡ
Aim. To determine the role of organic acids in the pathogenesis of missing abortion.Materials and Methods. To analyze the endometrial organic acid content, we applied high performance liquid chromatography. Sampling was performed from 20 women with missed abortion and 10 patients with normal pregnancy utilising the vacuum aspiration. Following protein separation by means of double centrifugation and ultrafiltration, supernatant was profiled for the organic acids.Results. Women who experienced missing abortion had significantly higher concentrations of serum and endometrial lactic acid concentrations (10.01 Β± 0.16 and 8.28 Β± 0.20 mmol/L, respectively) than those with healthy pregnancy (8.16 Β± 0.24 and 7.57 Β± 0.20 mmol/L, respectively). In contrast, endometrial pyruvic acid level was lower in abortion group (27.71 Β± 0.04 mmol/L) as compared to the controls (34.1 Β± 0.40 mmol/L). Furthermore, 4-hydroxyphenylacetic acid was found exclusively in women with missed abortion.Conclusion. Changes in organic acid profile may play a major role in pathogenesis of missed abortion. Serum and endometrial 4-hydroxyphenylacetic acid can be suggested as a novel biomarker of early pregnancy loss.Π¦Π΅Π»Ρ. ΠΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΠΎΠ»Ρ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΊΠΈΡΠ»ΠΎΡ Π² ΠΏΠ°ΡΠΎΠ³Π΅Π½Π΅Π·Π΅ Π½Π΅ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΠ΅ΠΉΡΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠ»ΠΈ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ 2 Π³ΡΡΠΏΠΏΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ (Π²ΡΠ΅Π³ΠΎ 30 ΠΆΠ΅Π½ΡΠΈΠ½): ΠΎΡΠ½ΠΎΠ²Π½ΡΡ Π³ΡΡΠΏΠΏΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΈ 20 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ Π½Π΅ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΠ΅ΠΉΡΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡΡ (ΠΠ), Π³ΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ - 10 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈ ΠΏΡΠΎΡΠ΅ΠΊΠ°ΡΡΠ΅ΠΉ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡΡ. ΠΡΠ±ΠΎΡ Π²ΡΠ΅Ρ
ΠΎΠ±ΡΠ°Π·ΡΠΎΠ² ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΠ»ΡΡ Π½Π΅ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²Π΅Π½Π½ΠΎ ΠΏΡΠΈ Π²Π°ΠΊΡΡΠΌΠ°ΡΠΏΠΈΡΠ°ΡΠΈΠΈ ΡΠΎΠ΄Π΅ΡΠΆΠΈΠΌΠΎΠ³ΠΎ ΠΏΠΎΠ»ΠΎΡΡΠΈ ΠΌΠ°ΡΠΊΠΈ. ΠΠΎΡΠ»Π΅ Π΄Π²ΡΠΊΡΠ°ΡΠ½ΠΎΠ³ΠΎ ΡΠ΅Π½ΡΡΠΈΡΡΠ³ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π°, ΠΎΡΠ±ΠΎΡΠ° Π½Π°Π΄ΠΎΡΠ°Π΄ΠΊΠ° ΠΈ Π΅Π³ΠΎ ΡΠ»ΡΡΡΠ°ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΊΠΈΡΠ»ΠΎΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Π²ΡΡΠΎΠΊΠΎΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠ½ΠΎΠΉ Ρ
ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠΠΠ₯). ΠΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ ΠΎΡΠ΅Π½ΠΊΡ ΠΎΡΠ³Π°Π½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΊΠΈΡΠ»ΠΎΡ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ, ΡΡΠ°Π²Π½ΠΈΠ²Π°Ρ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ Π°Π½Π°Π»ΠΈΠ·Π° ΠΏΡΠΎΠ± Ρ Π²Π½Π΅ΡΠ½ΠΈΠΌΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ°ΠΌΠΈ ΠΏΡΠΈ 214 Π½ΠΌ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π£ ΠΆΠ΅Π½ΡΠΈΠ½ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΡ Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ ΠΈ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΈ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΡ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 10,01Β± 0,16 ΠΈ 8,28Β± 0,20 ΠΌΠΌΠΎΠ»Ρ/Π» ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ, ΡΡΠΎ Π±ΡΠ»ΠΎ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ Π²ΡΡΠ΅, ΡΠ΅ΠΌ Ρ ΠΆΠ΅Π½ΡΠΈΠ½ Π² Π³ΡΡΠΏΠΏΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ (8,16 Β± 0.24 and 7,57 Β± 0,20 ΠΌΠΌΠΎΠ»Ρ/Π»). Π ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ Π² ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΠΈ Π±ΡΠ»ΠΈ ΡΠ½ΠΈΠΆΠ΅Π½Ρ ΠΊΠΎΠ½ΡΠ΅Π½ΡΡΠ°ΡΠΈΠΈ ΠΏΠΈΡΠΎΠ²ΠΈΠ½ΠΎΠ³ΡΠ°Π΄Π½ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ Π±ΠΎΠ»Π΅Π΅ ΡΠ΅ΠΌ Π½Π° 10 ΠΌΠΌΠΎΠ»Ρ/Π» (27,71 Β± 0.04 ΠΌΠΌΠΎΠ»Ρ/Π»), ΡΡΠΎ ΡΠ°ΠΊΠΆΠ΅ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎ ΠΎΡΠ»ΠΈΡΠ°Π»ΠΎΡΡ ΠΎΡ Π³ΡΡΠΏΠΏΡ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ (34,1 Β± 0.40 ΠΌΠΌΠΎΠ»Ρ/Π»). Π’Π°ΠΊΠΆΠ΅ Ρ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΠΠ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»Π°ΡΡ 4-Π³ΠΈΠ΄ΡΠΎΠΊΡΠΈΡΠ΅Π½ΠΈΠ»ΡΠΊΡΡΡΠ½Π°Ρ ΠΊΠΈΡΠ»ΠΎΡΠ°, Π² ΡΠΎ Π²ΡΠ΅ΠΌΡ ΠΊΠ°ΠΊ Π² Π³ΡΡΠΏΠΏΠ΅ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΠΎΠ½Π° Π½Π΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»Π°ΡΡ Π½ΠΈ Ρ ΠΎΠ΄Π½ΠΎΠΉ ΠΆΠ΅Π½ΡΠΈΠ½Ρ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΡΠ²Π»Π΅Π½Π½ΡΠ΅ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΌΠΎΠ³ΡΡ ΠΈΠ³ΡΠ°ΡΡ Π²Π°ΠΆΠ½ΡΡ ΡΠΎΠ»Ρ Π² ΠΏΠ°ΡΠΎΠ±ΠΈΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠ°Ρ
, Π»Π΅ΠΆΠ°ΡΠΈΡ
Π² ΠΎΡΠ½ΠΎΠ²Π΅ Π½Π΅ΡΠ°Π·Π²ΠΈΠ²Π°ΡΡΠ΅ΠΉΡΡ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ, ΠΈ ΡΠ²Π»ΡΡΡΡΡ Π½ΠΎΠ²ΡΠΌΠΈ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠ°ΠΌΠΈ Π³Π΅ΡΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΏΠΎΡΠ΅ΡΡ
ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠΎΠ΄Ρ ΠΈ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΎΠΌΠ½ΡΠΉ Π³ΠΎΠΌΠ΅ΠΎΡΡΠ°Π· ΠΏΡΠΈ Π³Π΅ΡΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΡΠ°Ρ Π°ΡΠ½ΠΎΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠ΅
Diabetes mellitus is an endocrine pathology defined by the world Health Organization (WHO) as an epidemic of non-infectious disease. In 2017, the Russian Federation entered the top 10 countries for prevalence of diabetes, and the number of patients with diabetes was 8.5 million. The aim of the study is to improve perinatal outcomes of programmed labor in patients with diabetes mellitus by optimizing the timing and method of delivery. The work was carried out at the Department of obstetrics and gynecology with the course of perinatology of the Peoples' Friendship University of Russia peoples City Clinical Hospital # 29 named after N.E. Bauman of Moscow (Department of pathology of pregnant women). The copy-pair method was used to distinguish the main group of pregnant women with diabetes mellitus and the comparison group (110 patients in total). The results obtained allow us to conclude that the application of a differentiated approach to the programming of childbirth, not only reduces the frequency of cesarean section, but also improves the perinatal health of the future generation. The abnormal high content of the identified metabolites in this study may subsequently become the basis for the creation of a rapid method for predicting obstetric complications, decompensation of diabetes mellitus, placental insufficiency and fetal deterioration in diabetes mellitus, including diabetic fetopathy.ΠΠ°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΡ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ (Π‘Π) ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΠΡΠ΅ΠΌΠΈΡΠ½ΠΎΠΉ ΠΎΡΠ³Π°Π½ΠΈΠ·Π°ΡΠΈΠ΅ΠΉ Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΊΠ°ΠΊ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΡ Π½Π΅ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠ°. Π 2017 Π³. Π Π€ Π²ΠΎΡΠ»Π° Π² ΡΠΎΠΏ-10 ΡΡΡΠ°Π½ ΠΌΠΈΡΠ° ΠΏΠΎ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΠΎΡΡΠΈ Π‘Π, Π° ΡΠΈΡΠ»ΠΎ Π±ΠΎΠ»ΡΠ½ΡΡ
Π‘Π ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ 8,5 ΠΌΠ»Π½. Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ - ΠΎΡΠ΅Π½ΠΈΡΡ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΎΠΌΠ½ΠΎΠ³ΠΎ Π³Π΅ΠΌΠΎΡΡΠ°Π·Π° Π½Π° ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΡΡ
ΠΈΡΡ
ΠΎΠ΄ΠΎΠ² ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΡΠΎΠ΄ΠΎΠ² Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ Π³Π΅ΡΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ Π½Π° ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠ‘Π ΠΠ) Π΄Π»Ρ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΡΡΠΎΠΊΠΎΠ² ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΡΠΎΠ΄ΠΎΡΠ°Π·ΡΠ΅ΡΠ΅Π½ΠΈΡ. Π Π°Π±ΠΎΡΠ° ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»Π°ΡΡ Π½Π° Π±Π°Π·Π΅ ΠΊΠ°ΡΠ΅Π΄ΡΡ Π°ΠΊΡΡΠ΅ΡΡΡΠ²Π° ΠΈ Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ Ρ ΠΊΡΡΡΠΎΠΌ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π€ΠΠΠΠ£ ΠΠ Β«Π ΠΎΡΡΠΈΠΉΡΠΊΠΈΠΉ ΡΠ½ΠΈΠ²Π΅ΡΡΠΈΡΠ΅Ρ Π΄ΡΡΠΆΠ±Ρ Π½Π°ΡΠΎΠ΄ΠΎΠ²Β» ΠΈ ΠΠΠ£Π Β«ΠΠΎΡΠΎΠ΄ΡΠΊΠ°Ρ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ Π±ΠΎΠ»ΡΠ½ΠΈΡΠ° β 29 ΠΈΠΌ. Π.Π. ΠΠ°ΡΠΌΠ°Π½Π°Β» ΠΠ΅ΠΏΠ°ΡΡΠ°ΠΌΠ΅Π½ΡΠ° Π·Π΄ΡΠ°Π²ΠΎΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΡ Π³. ΠΠΎΡΠΊΠ²Ρ (ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
). ΠΠ΅ΡΠΎΠ΄ΠΎΠΌ Β«ΠΊΠΎΠΏΠΈΡ-ΠΏΠ°ΡΠ°Β» Π²ΡΠ΄Π΅Π»Π΅Π½Ρ ΠΎΡΠ½ΠΎΠ²Π½Π°Ρ Π³ΡΡΠΏΠΏΠ° Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
c ΠΠ‘Π ΠΠ ΠΈ Π³ΡΡΠΏΠΏΠ° ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ (Π²ΡΠ΅Π³ΠΎ 110 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ). ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΡΡ ΡΠ΄Π΅Π»Π°ΡΡ Π²ΡΠ²ΠΎΠ΄, ΡΡΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ΄Ρ
ΠΎΠ΄Π° ΠΊ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΎΠ΄ΠΎΠ² Π½Π΅ ΡΠΎΠ»ΡΠΊΠΎ ΡΠ½ΠΈΠΆΠ°Π΅Ρ ΡΠ°ΡΡΠΎΡΡ ΠΊΠ΅ΡΠ°ΡΠ΅Π²Π° ΡΠ΅ΡΠ΅Π½ΠΈΡ, Π½ΠΎ ΠΈ ΡΠ»ΡΡΡΠ°Π΅Ρ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠ΅ Π·Π΄ΠΎΡΠΎΠ²ΡΠ΅ Π±ΡΠ΄ΡΡΠ΅Π³ΠΎ ΠΏΠΎΠΊΠΎΠ»Π΅Π½ΠΈΡ. ΠΠ½ΠΎΠΌΠ°Π»ΡΠ½ΠΎ Π²ΡΡΠΎΠΊΠΎΠ΅ ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ Π²ΡΡΠ²Π»Π΅Π½Π½ΡΡ
ΠΌΠ΅ΡΠ°Π±ΠΎΠ»ΠΈΡΠΎΠ² Π² Π½Π°ΡΡΠΎΡΡΠ΅ΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ Π²ΠΏΠΎΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠΈ ΠΌΠΎΠΆΠ΅Ρ ΡΡΠ°ΡΡ ΠΎΡΠ½ΠΎΠ²ΠΎΠΉ Π΄Π»Ρ ΡΠΎΠ·Π΄Π°Π½ΠΈΡ ΡΠΊΡΠΏΡΠ΅ΡΡ-ΠΌΠ΅ΡΠΎΠ΄Π° ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΈΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, Π΄Π΅ΠΊΠΎΠΌΠΏΠ΅Π½ΡΠ°ΡΠΈΠΈ ΠΠ‘Π, ΠΏΠ»Π°ΡΠ΅Π½ΡΠ°ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΈ ΡΡ
ΡΠ΄ΡΠ΅Π½ΠΈΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΏΠ»ΠΎΠ΄Π° ΠΏΡΠΈ ΠΠ‘Π, Π²ΠΊΠ»ΡΡΠ°Ρ Π΄ΠΈΠ°Π±Π΅ΡΠΈΡΠ΅ΡΠΊΡΡ ΡΠ΅ΡΠΎΠΏΠ°ΡΠΈΡ