• Peculiarities of course of pragnancy, labors, condtiotion of a fetus and a newborn in pregnant women displaced ones (Retrospective analysis)

Peculiarities of course of pragnancy, labors, condtiotion of a fetus and a newborn in pregnant women displaced ones (Retrospective analysis)

HEALTH OF WOMAN. 2018.3(129):83–88; doi 10.15574/HW.2018.129.88

Zhabchenko I. A. , Korniets N. G. , Tertychna-Telyuk S. V.
SE «Institute of Pediatrics, Obstetrics and Gynecology of the National Academy of Medical Sciences of Ukraine», Kyiv
SI «Lugansk State Medical University», Rubizhne

The less investigated problem of modern obstetrics is psychological condition of women during pregnancy and labors, who were affected by negative influence of nowadays, especially the military aggression, because precisely stress hormones determine the failure of adaptation, metabolic disorders and, as a result, an activation of infectious and chronic diseases, which determined the direction, the aim and the task of the work.
The objective: to investigate peculiarities of course of pregnancy and labors, condition of a fetus and a newborn in pregnant women – displaced ones (IDP) in order to develop the improved methods of obstetric and perinatal complication prophylaxis in such women.
Materials and methods. In order to achieve the object view, retrospective clinic and statistic analysis of 225 case histories of pregnancies and labors of IDP (the main group) and 51 pregnant women (control group), who continuously has been living in the territories controlled by Ukraine and did not stay in the military actions area during the process of investigation, were conducted. Pregnant women from the main and control groups were giving birth in the Delivery Departments of Central Cities Multyfield Hospitals of Belokurakino and Rubizhne of Luhansk Region in 2014–2017 years.
Results. Pregnancy in IDP women is coursing under the maximal psycho emotional tension and stress, which promote complications development during gestation and labors.
The risk factors which affects of the manifestation of pregnancy complications are: violations in psycho emotional condition of pregnant women, high infectious morbidity during puberty period, presents of chronic somatic pathology and high rate of inflammatory diseases of the female reproductive organs.
Develop of placental-associated complications of pregnancy are typical in majority of IDP pregnant women: threatening of early and late spontaneous abortions, preterm labors, early gestosis, placental dysfunction and asiderotic anemia.
Violations of labor act complications such as preterm and early rupture of amniotic membranes, weakness of labor activity and traumas of maternal ways, which lead to increase of specific gravity of complicated labors up to 20.3% and operative deliveries by the means of the Caesarian Section up to 23.6%, are most common for the main group of pregnant women.
Newborns of the IDP women had an average weight less than 217 grams after delivery, in the asphyxia of different degrees one in eleven children was born. 34.8% of IDP women newborns had a pathological course of neonatal period which caused the further supervision on the 2nd level of neonatal care and was the reason of extra charges from the side of the parents.
Conclusion. It is desirable to provide a full-fledged psychological support and routine treatment of chronic extragenital diseases at the periconceptional stage in IDP women. The preventive measures during pregnancy must foresee the violation of psychological condition correction and development of placental-associated complications.
Key words: pregnancy, labors, complication, psychological violations, forced displaced people.

REFERENCES

1. Abdurahmanov FM, Muhamadiev IM, Rafieva ZH, Nadyirova AV. 2008. The influence of psychoemotional stress on the course and outcomes of pregnancy. The Russian bulletin of the obstetrician-gynecologist 3:38–41.

2. Aylamazyan EK, Kulakov VI, Radzinskiy VE, Saveleva GM. 2009. Obstetrics. National guide 1200.

3. BIlko TM, AhtemIychuk OS. 2016. Influence of the nutritional state of the food ration on the immune state of mucous membranes in women. Obstetrics. Gynecology. Genetics 1:71–76.

4. Ventskіvska IB, Zagorodnya OS. 2013. Clinical and laboratory manifestations of immunological mechanisms of preterm birth. Actual. issues of pediatrics, obstetrics and gynecology 1:100–102.

5. Veropotvelyan PN, Veropotvelyan NP, Tarasova LA, Krocha VN. 2009. Immunological and infectious aspects of pregnancy loss. Female doctor 4:16–19.

6. Gromova AM, MіtyunIna NI, Talash VV. 2012. Intrauterine infection as a cause of preterm birth. Sb. sciences Ave Plenum of the Association of Obstetricians-Gynecologists of Ukraine (Annex): 19–21.

7. Davyidova YuV. 2013. Prevention of perinatal infections and their consequences in pregnant women. Reproductive endocrinology 3:17–33.

8. Dikke G. 2014. Preventing the loss of pregnancy and premature birth in women at risk groups. With care for a woman 2:28–32.

9. Dobryakov IV. 2010. Perinatal psychology: 272.

10. Dubossarskaya YuA, Lebedyuk VV. 2016. Optimization of tactics of pregnancy management for the purpose of preventing premature birth. Women’s Health 2:20–27.

11. Zhuk SI, Schurevskaya OD. 2016. The course of pregnancy and childbirth in women – forced migrants. Women’s Health 2:16–18.

12. Zhuk SI, Schurevskaya OD. 2016. Threat of prematur birth: psycho-social aspects. Women’s Health 6:86–89.

13. Zabarovskaya ZV. 2010. Disorders of carbohydrate metabolism during pregnancy. Р. І. Hormonal metabolic changes in a physiologically occurring pregnancy. Endocrinologic help and principles of training pregnant women for violations of carbohydrate metabolism: 142.

14. Igitova MB. 2010. Forecasting, diagnosis and treatment of complications of gestation in women with high perinatal risk: аuthor's abstract. dis. for the degree of Doctor of Medicine Sciences: spec. 14.01.01 «Obstetrics and gynecology»: 41.

15. Kovalenko VM, Kornatskiy VM. 2015. Stress and diseases of the circulatory system: A guide: 354.

16. Krasnopolskiy VI, Petruhin VA, Burumkulova FF. 2004. Thyroid gland diseases and pregnancy (obstetric and perinatal aspects). All-Russian conference with international participation «Clinical morphology of the thyroid gland». 51–53.

17. Kushakovskiy MS. 2007. Cardiac arrhythmias (disorders of heart rhythm and conduction disorders: causes, mechanisms, electrocardiographic and electrophysiological diagnostics, clinic, treatment): A guide for physicians: 672.

18. Limanskaya AYu, Davyidova YuV, Ogorodnik AA. 2017. Anemia of a chronic disease in the clinic of extragenital pathology. Health of Ukraine 2(26):54-55.

19. Malkoch AV, Anastasevich LA, Filatova NN. 2013. Iron deficiency and iron deficiency anemia in women of childbearing age. Reproductive endocrinology 5(13):22–27.

20. Malgina GB, Vetchanina EG, Pronina TA. 2001. Perinatal problems associated with psychoemotional stress during pregnancy and their correction. Materials of the All-Russian Conference with International 20. Participation «Perinatal Psychology and Medicine»: 35–38.

21. Medved VI. 2010. Selected lectures on extragenital pathology of pregnant women: 239.

22. Medved VI. 2011. The main questions extragenital pathology. Medical aspects of women's health 6(46):5–11.

23. Melnichenko GA, Fadeev VV, Dedov II. 2003. Diseases of the thyroid gland during pregnancy: diagnosis, treatment, prevention: a manual for doctors: 48.

24. The order of MOH of Ukraine № 417 from 15.07.2011 y. «About the organisation of outpatient obstetrics and gynecology in Ukraine».

25. The order of MOH of Ukraine № 709 from 02.11.2015 y. Iron deficiency anemia.

26. The order of MOH of Ukraine № 906 from 27.12.2006. Perinatal infections.

27. The order of MOH of Ukraine № 977 from 27.12.2011. Caesarean section.

28. Panchenko LA. 2014. Herpes. The role in human pathology. Antiviral drugs: 204.

29. Podolskiy VlV. 2013. Abortion and its implications for the reproductive health of women of childbearing age. Women’s Health 10(86):32–34.

30. Prevention of reproductive loss at the early and late stages of pregnancy: Materials Science. Practice. conf. Sudak, May 3-5, 2012. Women’s Health 8:16–21.

31. Ways to reduce reproductive loss. Results of the XIII All-Russia Forum «Mother and Child». 2013. Reproductive endocrinology 1:95–97.

32. Roytberg GE, Strutyinskiy AV. 2007.  Internal diseases. Cardiovascular system: 856.

33. Sergіеnko LYu, Perets OV, Bondarenko TV, Cherevko GM. 2013. Exogenous stress-inducing disorder of eating behavior and obesity in the descendants of gestationally stressed mothers. International Endocrinology Journal 6(54):178–179.

34. Fadeev VV. 2012. On the basis of materials of clinical recommendations on diagnostics and treatment of diseases of the thyroid gland during pregnancy and in the postpartum period of the American thyroid association. Clinical and experimental thyroidology. 8;1:7–18.

35. Alexander EK, Pearce EN, Brent GA et al. 2017, Mar. Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. Thyroid. 27(3):315-389. https://doi.org/10.1089/thy.2016.0457; PMid:28056690