4 research outputs found
ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠΎΠ΄Ρ ΠΏΡΠΈ Π³Π΅ΡΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΡΠ°Ρ Π°ΡΠ½ΠΎΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠ΅ - ΡΠ΅Π·Π΅ΡΠ² ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠ°ΡΡΠΎΡΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΡΠΎΠ΄ΠΎΡΠ°Π·ΡΠ΅ΡΠ΅Π½ΠΈΡ
Background. In modern obstetric practice, programmed labor is increasingly becoming an alternative to operative delivery. Algorithm for its management is especially important for an ever-increasing group of patients with a burdened somatic and obstetric and gynecological history. Objective. Evaluation of the results and outcomes of programmed labor in patients with preeclampsia (PE), gestational diabetes mellitus (GDM) and a high perinatal risk. Methods A retrospective cohort study included 160 women with a high perinatal risk, singleton pregnancy, full-term gestational age (38-41 weeks) who underwent programmed labor, and their newborns. The patients were divided into 2 groups: the 1st group - with GDM (n=120), the 2nd one - with GDM in combination with PE (n=40). Results. As a result of programmed labor in patients with high perinatal risk and GDM and in the high-risk group - combination of GDM and PE, satisfactory perinatal outcomes were recorded, the incidence of neonatal morbidity decreased by 1.5 times. Conclusion Programmed labor in pregnant women with high perinatal risk serves as an alternative to operative delivery in patients with GDM and patients with GDM in combination with PE.ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅. ΠΠ»ΡΡΠ΅ΡΠ½Π°ΡΠΈΠ²ΠΎΠΉ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠΌΡ ΡΠΎΠ΄ΠΎΡΠ°Π·ΡΠ΅ΡΠ΅Π½ΠΈΡ Π² ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅ Π²ΡΠ΅ ΡΠ°ΡΠ΅ ΡΡΠ°Π½ΠΎΠ²ΡΡΡΡ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠΎΠ΄Ρ. ΠΡΠΎΠ±Π΅Π½Π½ΠΎ Π²Π°ΠΆΠ΅Π½ ΠΈΡ
Π°Π»Π³ΠΎΡΠΈΡΠΌ Π΄Π»Ρ ΠΏΠΎΡΡΠΎΡΠ½Π½ΠΎ ΡΠ²Π΅Π»ΠΈΡΠΈΠ²Π°ΡΡΠ΅ΠΉΡΡ Π³ΡΡΠΏΠΏΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ ΠΎΡΡΠ³ΠΎΡΠ΅Π½Π½ΡΠΌ ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΈ Π°ΠΊΡΡΠ΅ΡΡΠΊΠΎ-Π³ΠΈΠ½Π΅ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ Π°Π½Π°ΠΌΠ½Π΅Π·ΠΎΠΌ. Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ·ΡΡΠΈΡΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΈΡΡ
ΠΎΠ΄Ρ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΡΠΎΠ΄ΠΎΠ² Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ ΠΏΡΠ΅ΡΠΊΠ»Π°ΠΌΠΏΡΠΈΠ΅ΠΉ (ΠΠ), Π³Π΅ΡΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΌ ΡΠ°Ρ
Π°ΡΠ½ΡΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠΎΠΌ (ΠΠ‘Π) ΠΈ Π²ΡΡΠΎΠΊΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ°. ΠΠ΅ΡΠΎΠ΄Ρ. Π ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ ΠΊΠΎΠ³ΠΎΡΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π±ΡΠ»ΠΈ Π²ΠΊΠ»ΡΡΠ΅Π½Ρ 160 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ Π²ΡΡΠΎΠΊΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΡΡ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ°, ΠΎΠ΄Π½ΠΎΠΏΠ»ΠΎΠ΄Π½ΠΎΠΉ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΡΡ, Π΄ΠΎΠ½ΠΎΡΠ΅Π½Π½ΡΠΌ ΡΡΠΎΠΊΠΎΠΌ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ (38-41 Π½Π΅Π΄Π΅Π»Ρ), ΠΊΠΎΡΠΎΡΡΠΌ Π±ΡΠ»ΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Ρ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠΎΠ΄Ρ, ΠΈ ΠΈΡ
Π½ΠΎΠ²ΠΎΡΠΎΠΆΠ΄Π΅Π½Π½ΡΠ΅. ΠΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ ΡΠ°Π·Π΄Π΅Π»Π΅Π½Ρ Π½Π° 2 Π³ΡΡΠΏΠΏΡ: 1-Ρ - Ρ ΠΠ‘Π (n=120), 2-Ρ - Ρ ΠΠ‘Π Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΠΠ (n=40). Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΡΠΎΠ΄ΠΎΠ² ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ Π²ΡΡΠΎΠΊΠΈΠΌ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΡΠΌ ΡΠΈΡΠΊΠΎΠΌ ΠΈ ΠΠ‘Π ΠΈ Π² Π³ΡΡΠΏΠΏΠ΅ Π²ΡΡΠΎΠΊΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° - ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΡ ΠΠ‘Π ΠΈ ΠΠ, Π·Π°ΡΠΈΠΊΡΠΈΡΠΎΠ²Π°Π½Ρ ΡΠ΄ΠΎΠ²Π»Π΅ΡΠ²ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΡΠ΅ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΡΠ΅ ΠΈΡΡ
ΠΎΠ΄Ρ, ΡΠ°ΡΡΠΎΡΠ° ΡΠΎΠ΄ΠΎΠ²ΠΎΠ³ΠΎ ΡΡΠ°Π²ΠΌΠ°ΡΠΈΠ·ΠΌΠ° ΡΠ½ΠΈΠ·ΠΈΠ»Π°ΡΡ Π² 1,5 ΡΠ°Π·Π°. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠΎΠ΄Ρ Ρ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Π²ΡΡΠΎΠΊΠΎΠ³ΠΎ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΡΠΊΠ° ΡΠ»ΡΠΆΠ°Ρ Π°Π»ΡΡΠ΅ΡΠ½Π°ΡΠΈΠ²ΠΎΠΉ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠΌΡ ΡΠΎΠ΄ΠΎΡΠ°Π·ΡΠ΅ΡΠ΅Π½ΠΈΡ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ ΠΠ‘Π ΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ Ρ ΠΠ‘Π Π² ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Ρ ΠΠ
ΠΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΡ Π΄Π»Ρ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ‘Π
Gestational diabetes mellitus (GDM) is a common complication in pregnancy, affecting 5% to 9% of pregnant women. Nowadays screening and diagnosis of GDM is a source of controversy. There is no consensus regarding an optimal and internationally acceptable test for both GDM diagnosis and screening. There is growing concern over the increasing incidence of GDM and its complications for mother and child along with its impact on society. A simple and accurate blood test that will help identify women at risk of developing GDM in the first trimester can reduce further costs and improve results through early prevention and treatment. Meta - analysis consists of studies of 5 major biomarkers thathave prognostically significant value for the diagnosis of GDM in early pregnancy. The authors sought to identify the most significant and reliable biomarker that can be used as a screening test for the diagnosis of GDM in the first trimester of pregnancy. Of the 5 biomarkers, adiponectin, GSPG, and glycated fibronectin can be independent predictors of GDM in the first trimester. These biomarkers have shown high specificity and sensitivity. The use of three biomarkers at the same time significantly increases the efficiency of forecasting GDM.ΠΠ΅ΡΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΉ ΡΠ°Ρ
Π°ΡΠ½ΡΠΉ Π΄ΠΈΠ°Π±Π΅Ρ (ΠΠ‘Π) ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½Π½ΡΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠ΅ΠΌ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ. ΠΠ° ΡΠ΅Π³ΠΎΠ΄Π½ΡΡΠ½ΠΈΠΉ Π΄Π΅Π½Ρ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³ ΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΠ‘Π ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠΎΠΌ ΡΠΏΠΎΡΠΎΠ². Π‘ΡΡΠ΅ΡΡΠ²ΡΡΡ ΠΊΠΎΠ½ΡΡΠ°Π²Π΅ΡΡΠΈΠΈ ΠΊΠ°ΠΊ ΠΏΠΎ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌ ΡΠ°ΠΊ ΠΈ ΠΏΠΎ ΡΡΠΎΠΊΠ°ΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ. Π ΡΠ²ΡΠ·ΠΈ Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΡΠ°ΡΡΠΎΡΡ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΡ ΠΠ‘Π, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ²ΡΠ·Π°Π½Π½ΡΡ
Ρ Π½ΠΈΠΌ Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΡ
ΠΏΠΎΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠΉ ΠΊΠ°ΠΊ Π΄Π»Ρ ΠΌΠ°ΡΠ΅ΡΠΈ, ΡΠ°ΠΊ ΠΈ Π΄Π»Ρ ΡΠ΅Π±Π΅Π½ΠΊΠ°, ΠΎΡΡΡΠΎ Π²ΠΎΠ·Π½ΠΈΠΊΠ°Π΅Ρ Π²ΠΎΠΏΡΠΎΡ ΠΎ ΡΠ°Π½Π½Π΅ΠΌ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ. ΠΡΠΎΡΡΠΎΠΉ ΠΈ ΡΠΎΡΠ½ΡΠΉ Π°Π½Π°Π»ΠΈΠ· ΠΊΡΠΎΠ²ΠΈ, ΠΊΠΎΡΠΎΡΡΠΉ ΠΏΠΎΠΌΠΎΠΆΠ΅Ρ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°ΡΡ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΡΠΈΡΠΊΠΎΠΌ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠ‘Π Π² ΠΏΠ΅ΡΠ²ΠΎΠΌ ΡΡΠΈΠΌΠ΅ΡΡΡΠ΅ Π±ΡΠ΄Π΅Ρ ΠΈΠΌΠ΅ΡΡ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π» Π΄Π»Ρ ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ Π·Π°ΡΡΠ°Ρ ΠΈ ΡΠ»ΡΡΡΠ΅Π½ΠΈΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΏΡΡΠ΅ΠΌ ΡΠ²ΠΎΠ΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠΉ ΡΠ°Π½Π½Π΅ΠΉ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΠ΅ΡΠ° - Π°Π½Π°Π»ΠΈΠ· ΡΠΎΡΡΠΎΠΈΡ ΠΈΠ· ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ 5 ΠΎΡΠ½ΠΎΠ²Π½ΡΡ
Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ², ΠΊΠΎΡΠΎΡΡΠ΅ ΠΈΠΌΠ΅ΡΡ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΡΡ ΡΠ΅Π½Π½ΠΎΡΡΡ Π΄Π»Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΠ‘Π Π½Π° ΡΠ°Π½Π½ΠΈΡ
ΡΡΠΎΠΊΠ°Ρ
Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ. ΠΠ²ΡΠΎΡΡ ΡΡΡΠ΅ΠΌΠΈΠ»ΠΈΡΡ Π²ΡΡΠ²ΠΈΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π·Π½Π°ΡΠΈΠΌΡΠΉ ΠΈ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΡΠΉ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅Ρ, ΠΊΠΎΡΠΎΡΡΠΉ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ Π² ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅ΡΡΠ° Π΄Π»Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΠ‘Π Π² I ΡΡΠΈΠΌΠ΅ΡΡΡΠ΅ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ.ΠΠ· 5 Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ², Π½Π΅Π·Π°Π²ΠΈΡΠΈΠΌΡΠΌΠΈ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠ°ΠΌΠΈ ΠΠ‘Π Π² ΠΏΠ΅ΡΠ²ΠΎΠΌ ΡΡΠΈΠΌΠ΅ΡΡΡΠ΅ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ Π°Π΄ΠΈΠΏΠΎΠ½Π΅ΠΊΡΠΈΠ½, ΠΠ‘ΠΠ ΠΈ Π³Π»ΠΈΠΊΠΈΡΠΎΠ²Π°Π½Π½ΡΠΉ ΡΠΈΠ±ΡΠΎΠ½Π΅ΠΊΡΠΈΠ½. ΠΠ°Π½Π½ΡΠ΅ Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΡ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ Π²ΡΡΠΎΠΊΡΡ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ ΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ. ΠΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΎΠ΄Π½ΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎ ΡΡΠΎΠΈΡ
Π±ΠΈΠΎΠΌΠ°ΡΠΊΠ΅ΡΠΎΠ² Π·Π½Π°ΡΠΈΡΠ΅Π»ΡΠ½ΠΎ ΠΏΠΎΠ²ΡΡΠ°Π΅Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΠ‘Π
ΠΠΈΠΎΡ ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΡΡΡ Π΄Π»Ρ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠ΅ΠΆΠ΄Π΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ ΡΠΎΠ΄ΠΎΠ²
Background. Preterm labor (PL) is the leading cause of perinatal morbidity and mortality in the world. Objective. Comparison of PL prediction accuracy using placental Ξ±-microglobulin-1 (PAMG-1) test and phosphorylated insulin-like growth factor-binding protein (PHIGFBP-1) test. Methods. A comparative, prospective observational study included 49 women with symptoms of threatened PL gestational age from 20/0 to 36/6 weeks, cervical length <30mm and a whole fetal bladder. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for the PAMG-1 and FPSIF-1 test systems were determined, and the time of onset of labor for β€7 days and β€14 days based on the above parameters was estimated. Results. The PHIGFBP-1 test was positive in 10 (20.4%) women, the PAMG-1 test - in 4 (8.2%). PL occurred within 7 days in 5 (10.2%) women. The sensitivity of the PAMG-1 and PHIGFBP-1 tests was 60 and 60%, the specificity was 97.7 and 84.1% (p=0.031), the PPV was 75 and 30%, and the NPV was 95.6 and 94.9% respectively. Within 14 days, PL occurred in 7 (14.3%) women. Sensitivity - 57 and 57%, specificity - 100 and 85.7% (p=0.031), PPV - 100 and 40%, NPV - 93.3 and 92.3% for PAMG-1 and PHIGFBP-1, respectively. There was no PL In women with a cervical length of 25-29 mm. Conclusion. The PAMG-1 test is the best predictor of spontaneous PL for 7 and 14 days than the PHIGFBP-1 test. However, for the widespread introduction of PAMG-1 testing in clinical practice, larger studies are required.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΡΠ΅ΠΆΠ΄Π΅Π²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΡΠΎΠ΄Ρ (ΠΠ ) - Π²Π΅Π΄ΡΡΠ°Ρ ΠΏΡΠΈΡΠΈΠ½Π° ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΠΎΠΉ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Π² ΠΌΠΈΡΠ΅. Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. Π‘ΡΠ°Π²Π½Π΅Π½ΠΈΠ΅ ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΠ Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΠ΅ΡΡΠΎΠ², ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΡΡ
Π½Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠΈ ΠΏΠ»Π°ΡΠ΅Π½ΡΠ°ΡΠ½ΠΎΠ³ΠΎ Π°-ΠΌΠΈΠΊΡΠΎΠ³Π»ΠΎΠ±ΡΠ»ΠΈΠ½Π°-1 (ΠΠΠΠ-1) ΠΈ ΡΠΎΡΡΠΎΡΠΈΠ»ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΠΈΠ½Π°, ΡΠ²ΡΠ·ΡΠ²Π°ΡΡΠ΅Π³ΠΎ ΠΈΠ½ΡΡΠ»ΠΈΠ½ΠΎΠΏΠΎΠ΄ΠΎΠ±Π½ΡΠΉ ΡΠ°ΠΊΡΠΎΡ ΡΠΎΡΡΠ° (Π€ΠΠ‘ΠΠ€Π ). ΠΠ΅ΡΠΎΠ΄Ρ. Π ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠ΅ Π½Π°Π±Π»ΡΠ΄Π°ΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΎΡΠ»ΠΈ 49 ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΠΌΠΈ ΡΠ³ΡΠΎΠΆΠ°ΡΡΠΈΡ
ΠΠ Π² ΡΡΠΎΠΊΠΈ Π³Π΅ΡΡΠ°ΡΠΈΠΈ ΠΎΡ 20/0 Π΄ΠΎ 36/6 Π½Π΅Π΄Π΅Π»Ρ, Π΄Π»ΠΈΠ½ΠΎΠΉ ΡΠ΅ΠΉΠΊΠΈ ΠΌΠ°ΡΠΊΠΈ <30 ΠΌΠΌ ΠΈ ΡΠ΅Π»ΡΠΌ ΠΏΠ»ΠΎΠ΄Π½ΡΠΌ ΠΏΡΠ·ΡΡΠ΅ΠΌ. ΠΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈΡΡ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ, ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅, ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π΄Π»Ρ ΡΠ΅ΡΡ-ΡΠΈΡΡΠ΅ΠΌ Π½Π° ΠΠΠΠ-1 ΠΈ Π€ΠΠ‘ΠΠ€Π -1 ΠΈ ΠΎΡΠ΅Π½ΠΊΠ° Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ Π½Π°ΡΡΡΠΏΠ»Π΅Π½ΠΈΡ ΡΠΎΠ΄ΠΎΠ² Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ Π²ΡΡΠ΅ΠΏΠ΅ΡΠ΅ΡΠΈΡΠ»Π΅Π½Π½ΡΡ
ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ <7 ΠΈ <14 Π΄Π½Π΅ΠΉ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π’Π΅ΡΡ Π€ΠΠ‘ΠΠ€Π Π±ΡΠ» ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΌ Ρ 10 (20,4%) ΠΆΠ΅Π½ΡΠΈΠ½, ΡΠ΅ΡΡ ΠΠΠΠ-1 - Ρ 4 (8,2%). ΠΠ ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΈ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 7 ΡΡΡΠΎΠΊ Ρ 5 (10,2%) ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠΊ. Π§ΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΡΠ΅ΡΡΠΎΠ² ΠΠΠΠ-1 ΠΈ Π€ΠΠ‘ΠΠ€Π ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 60 ΠΈ 60%, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ - 97,7 ΠΈ 84,1% (Ρ=0,031), ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ - 75 ΠΈ 30% ΠΈ ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ - 95,6 ΠΈ 94,9% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. Π ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 14 ΡΡΡΠΎΠΊ ΠΠ ΠΏΡΠΎΠΈΠ·ΠΎΡΠ»ΠΈ Ρ 7 (14,3%) ΠΆΠ΅Π½ΡΠΈΠ½. Π§ΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ - 57 ΠΈ 57%, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ - 100 ΠΈ 85,7% (p=0,031), ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ - 100 ΠΈ 40%, ΠΎΡΡΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ - 93,3 ΠΈ 92,3% Π΄Π»Ρ ΠΠΠΠ-1 ΠΈ Π€ΠΠ‘ΠΠ€Π ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. Π£ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ Π΄Π»ΠΈΠ½ΠΎΠΉ ΡΠ΅ΠΉΠΊΠΈ ΠΌΠ°ΡΠΊΠΈ 25-29 ΠΌΠΌ ΠΠ Π½Π΅ Π±ΡΠ»ΠΎ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π’Π΅ΡΡ ΠΠΠΠ-1 ΡΠ»ΡΠΆΠΈΡ Π»ΡΡΡΠΈΠΌ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠΌ ΡΠ°ΠΌΠΎΠΏΡΠΎΠΈΠ·Π²ΠΎΠ»ΡΠ½ΡΡ
ΠΠ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 7 ΠΈ 14 Π΄Π½Π΅ΠΉ, ΡΠ΅ΠΌ ΡΠ΅ΡΡ Π€ΠΠ‘ΠΠ€Π . ΠΠ΄Π½Π°ΠΊΠΎ Π΄Π»Ρ ΡΠΈΡΠΎΠΊΠΎΠ³ΠΎ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΡ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΠΠΠ-1 Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΡΡ ΠΏΡΠ°ΠΊΡΠΈΠΊΡ Π½Π΅ΠΎΠ±Ρ
ΠΎΠ΄ΠΈΠΌΡ Π±ΠΎΠ»Π΅Π΅ ΠΊΡΡΠΏΠ½ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ
Programmable births in gestational diabetes mellitus: Minimizing risks - Improving maternal and perinatal outcomes [ΠΡΠΎΠ³ΡΠ°ΠΌΠΌΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ ΡΠΎΠ΄Ρ ΠΏΡΠΈ Π³Π΅ΡΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΌ ΡΠ°Ρ Π°ΡΠ½ΠΎΠΌ Π΄ΠΈΠ°Π±Π΅ΡΠ΅: ΠΌΠΈΠ½ΠΈΠΌΠΈΠ·Π°ΡΠΈΡ ΡΠΈΡΠΊΠΎΠ² - ΡΠ»ΡΡΡΠ΅Π½ΠΈΠ΅ ΠΌΠ°ΡΠ΅ΡΠΈΠ½ΡΠΊΠΈΡ ΠΈ ΠΏΠ΅ΡΠΈΠ½Π°ΡΠ°Π»ΡΠ½ΡΡ ΠΈΡΡ ΠΎΠ΄ΠΎΠ²]
Background. Modernity is characterized by an avalanche-like increase in the frequency of gestational diabetes mellitus (in 4-5 times over the past 20 years). The main tasks of the work in the risk strategy of gestational diabetes mellitus are: prediction of pregnancy complications and the searchingh for new technologies for their delivery. To date, there are still very controversial questions about the timing and methods of delivery of patients with gestational diabetes mellitus. Due to the high incidence of unfavourable perinatal outcomes in gestational diabetes mellitus, the percentage of cesarean sections in some countries reaches 60%, which leads to maternal morbidity and a decrease in the reproductive health of the population. Aims - is to improve of maternal and neonatal outcomes based of the rational choice of delivery technology in gestational diabetes mellitus. Methods. A retrospective analysis of delivery methods was performed in 9769 patients with gestational diabetes mellitus at full-term gestation. Results. The developed and implemented programmed delivery technique was an alternative to cesarean sections, it allowed to reduce the frequency of abdominal delivery, while improving maternal and neonatal outcomes. The frequency of cesarean sections in programmed delivery was 2 times lower than in the presented facilities and significantly lower than in the population (10.0-10.7%). In the programmed delivery group there was a significant reducing morbidity of hypoglycemia in newborns compared to planned caesarean section - by 2 times and respiratory distress syndrome - by 2.5 times (p < 0.05). The indices of cerebral status impairment, birth traumatism corresponded to physiological childbirth and did not exceed the average population. Conclusions. The method of programmed delivery presented in this paper was one of the reserves for reducing the frequency of cesarean sections and allowed to personalize delivery in respiratory distress syndrome. Β© 2021 Izdatel'stvo Meditsina. All rights reserved