Epidural analgesia for childbirth in pregnant with COVID-19

One clinical case is presented. Specific feature of this case was the presence of COVID-19. She-patient was suffering during painful and severe course of labor. Childbirth was successfully performed under epidural analgesia. Epidemiological anamnesis of this she-patient and necessarity to work according to special regulations in third-level protective equipment determined the specificity and exclusive feature of this clinical case

URIC ACID CONTENT, RENIN CONCENTRATION IN PATIENTS WITH PRE-ECLAMPSIA, DEPENDING ON THE LEVEL OF VITAMIN D AND CHARACTERISTICS OF EPIDURAL ANALGESIA IN LABOR

The objective: to investigate the correlation of renin concentration and uric acid content in pregnant women with pre-eclampsia and vitamin D deficiency and their impact on the course of pregnancy, childbirth, and infant status.Subjects and methods. The content of uric acid, vitamin D, endothelin and renin concentration were studied in pregnant women with pre-eclampsia and the control group; enzyme immunoassay and spectrophotometric tests were used. Venous blood was used as a specimen for tests.Results. Hyperuricemia (435.61 ± 24.05 μmol/l) and a 10-fold increase of renin concentration were observed in patients with severe pre-eclampsia and vitamin D deficiency (11.23 ± 1.60 ng/ml). Vitamin D deficiency is associated with a higher need for epidural administration of local anesthetics during labor analgesia in patients with pre-eclampsia versus the control group; it is also associated with unfavorable perinatal outcomes.Conclusions. The following was detected in the patients with pre-eclampsia: low levels of vitamin D, hyperuricemia, elevated blood renin concentration, which was associated with the severity of pain and increased blood pressure. For adequate analgesia and blood pressure control during labor, they needed a higher rate of local anesthetic administration. Perhaps, replenishing vitamin deficiencies during pregnancy may improve perinatal outcomes

СОДЕРЖАНИЕ МОЧЕВОЙ КИСЛОТЫ, КОНЦЕНТРАЦИЯ РЕНИНА У ПАЦИЕНТОК С ПРЕЭКЛАМПСИЕЙ В ЗАВИСИМОСТИ ОТ УРОВНЯ ВИТАМИНА D И ОСОБЕННОСТИ ЭПИДУРАЛЬНОЙ АНАЛЬГЕЗИИ РОДОВ

The objective: to investigate the correlation of renin concentration and uric acid content in pregnant women with pre-eclampsia and vitamin D deficiency and their impact on the course of pregnancy, childbirth, and infant status.Subjects and methods. The content of uric acid, vitamin D, endothelin and renin concentration were studied in pregnant women with pre-eclampsia and the control group; enzyme immunoassay and spectrophotometric tests were used. Venous blood was used as a specimen for tests.Results. Hyperuricemia (435.61 ± 24.05 μmol/l) and a 10-fold increase of renin concentration were observed in patients with severe pre-eclampsia and vitamin D deficiency (11.23 ± 1.60 ng/ml). Vitamin D deficiency is associated with a higher need for epidural administration of local anesthetics during labor analgesia in patients with pre-eclampsia versus the control group; it is also associated with unfavorable perinatal outcomes.Conclusions. The following was detected in the patients with pre-eclampsia: low levels of vitamin D, hyperuricemia, elevated blood renin concentration, which was associated with the severity of pain and increased blood pressure. For adequate analgesia and blood pressure control during labor, they needed a higher rate of local anesthetic administration. Perhaps, replenishing vitamin deficiencies during pregnancy may improve perinatal outcomes. Цель: изучение связи концентрации ренина и содержания мочевой кислоты у беременных с преэклампсией на фоне дефицита витамина D и влияния на течение беременности, исходов родов и состояние новорожденных.Материал и методы. У беременных с преэклампсией и группы контроля изучены содержание мочевой кислоты, витамина D, эндотелина и концентрация ренина, использованы иммуноферментные и спектрофотометрический методы. Материал исследования ‒ венозная кровь.Результаты. У пациенток с тяжелой преэклампсией на фоне дефицита витамина D (11,23 ± 1,60 нг/мл) отмечены гиперурикемия (435,61 ± 24,05 мкмоль/л), повышение концентрации ренина в крови в 10 раз. Дефицит витамина D связан с более высокой потребностью введения эпидурально местных анестетиков при анальгезии родов у пациенток с преэклампсией по сравнению с группой контроля и неблагоприятными перинатальными исходами.Выводы. У пациенток с преэклампсией выявлены: низкий уровень витамина D, гиперурикемия, повышенная концентрация ренина в крови, что ассоциировано с выраженностью болевого синдрома и повышением артериального давления. Для адекватной анальгезии и контроля артериального давления в родах им необходима более высокая скорость введения местных анестетиков. Возможно, восполнение дефицита витамина во время беременности улучшит перинатальные исходы.