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UDK 618.5-07+618.2-06+616.12-008
PROGNOSTIC SIGNIFICANCE OF CLINICAL AND IMMUNOLOGICAL
PARAMETERS IN PREGNANT WOMEN WITH RHEUMATIC ETIOLOGY OF
MITRAL STENOSIS
M. A. Tukhtaeva
Bukhara Branch of the Specialized Scientific and Practical Medical Center for Maternity and
Health Protection of the Republic this article
Annotation:
This article is dedicated to the topic of changes in blood during pregnancy and
biomarkers of pathology in the circulatory system of your heart, the importance of
diagnosing and treating this disease. Heart disease is an important cause of maternal
mortality in developing countries. Rheumatic heart disease is the cause of most abuse and
deaths, and mitral stenosis is the most common lesion. In accordance with the purpose and
objectives of the study, 110 pregnant women were examined. The results of the study
showed that pregnant women with mitral stenosis show signs of systemic inflammation
(increased levels of CRP, il-α), hypercoagulation (high levels of fibrinogen and d-enzyme)
and impaired immune balance (decreased levels of il-10, increased IL-2). IL
Key words:
pregnancy, mitral valve stenosis, inflammation, hypercoagulation, immunity.
Real service.
Pregnancy and heart disease are mainly a combination of diseases of the div
observed in young women, and therefore the social significance of this problem is great.
This problem is based on heart diseases, circulatory insufficiency leading to death, active
rheumatic process, severe preeclampsia, which increases the risk level, and complications
that occur during pregnancy or in the early postpartum period at the time of rupture,
combined with complex hemodynamics[1, 5].
The most relevant issues of modern methods of early diagnosis and treatment of rheumatic
heart defects in pregnant women are the existing ones: despite maternal mortality, fetal
mortality in the postpartum period is not associated with a downward trend over the past 20
years[1,4,8].
The priority of this health problem is also one of the most important factors in reducing
maternal and child mortality. Pathological etiology the most common heart defects in
pregnant women with mitral rheumatism, 75-90%, are narrowing of the mitral valve, which
often occurs in this case and is one of the opening heart defects[3,6,9].
Many scientific studies have been conducted on the pathology of the heart during pregnancy,
despite the fact that their pregnancy goes beyond the tactics of influencing the circulatory
process in the initial stages of the development of pregnancy forms and the predicted
damage to the subclinics of the active rheumatoid process, it matters whether pregnancy
occurs or stops the transition to solving the issue of choosing management methods in
accordance with openness the course of the disease still remains.
Research objective
. A pregnant woman with mitral stenosis studies the hemostatic system.
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Research objects and materials.
110 students were required to examine pregnant women in accordance with the goals and
objectives of the work. The scientific program of the 2nd Department of Obstetrics and
Gynecology of the perinatal Center of the Bukhara State Medical Institute, together with a
number of Bukhara, Bukhara, is carried out on the basis of a combination of complications.
Traditional diagnostic methods include clinical and biochemical laboratory tests - general
blood control, rheumatological tests, sr, as well as determination of blood urea, creatinine,
hemostasis, and parameters of li - fibrinogen, pta, D-enzyme, and INR art. Immunological
tests - il-8, il-2, il-10, FN-a. Doppler imaging, maternal hemodynamics, ultrasound and fetal
functional studies in the uterus, umbilical cord and midbrain, as well as determining blood
flow in the arteries, covers their exocardiography.
the training of 110 students in pregnant women is deep. Group I consists of 40 people
studying physiological pregnancy, pregnant women, group II of mitral stenosis in late
pregnancy of 35 people, pregnant women, group III, which determines the level of risk of
developing this pathology at the initial stages of pregnancy, assessment of the duration of
pregnancy, timely drug therapy and the therapeutic antirheumatic drug used cardiotonic,
consists of 35 women.
In the Center for Perinatal Treatment of Women in Bukhara, all checks of the Bukhara State
Medical Institute are carried out on the basis of complex 2 complications-together with the
Department of Obstetrics and Gynecology.
The main indicators of biochemical studies of blood serum samples taken from patients for
the study of heart and functional activity by the "yoldosh" Doppler method using research
methods and ultrasound were determined.
Results.
Coagulation hemostasis consists of a cascade of reactions involving plasma factors,
if it is carried out in 3 stages. In particular, activated partial thromboplastin time in stage 1
description (FQTV), 2-step prothrombin index (pta) assessment, and 3-step international
relations assessment (xmm), while fibrinogen was used in the IZ assessment (1 see table).
1-table
Indicators of pregnant hemostasiologists participating in the study, M±m
Indicators
of
the
control
group, n=35
1-sinof the spirit,
n=35
2-guruh, n=35
FQTV, sec
36,8,8±0,30
29,4±0,31***^^
32,8±0,91 %***∞∞
PTA, %
92.2,2±0.51
89,9±0,69**^^
87,2±1,50*∞
Hmm
0,88±0,03
1,03±0,003**^
0,92±0,02**∞
Fibrinogen, g / l
2,9,95±0,39
4,35±0,71**^
3,51±0,15**∞
Comments on: * - differences between the control and the data are statistically significant
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(*P<0.05 to,
* * - P<0.01, * * * - P<0.001), ^ - 2 groups, significant differences compared to the data
(^- P<0.05 to, ^ ^ - P<0.01, ^^^ - P<0.001),∞ - differences are 1-significant compared to the
group data (∞- P<up to 0.05, ∞ ∞ - P < 0.01)
1- as can be seen from the table, in pregnant women of the 1st group, plasma FQTV
decreased by 29.4±0.31 seconds, in the 2nd-group, that is, for taking treatment measures in
pregnant women, while 32.8±0.91 percentaccounted for seconds, i.e. by 1.25 compared to
the control group (P<0.001) and 1.12 (P<0.01) time reduction.
Thus, he showed the results of the study, and in the treatment of pregnant women
complicated by mitral stenosis, the hole was not used, because when the pregnancy period is
shortened, there is an increased risk, which means that the risk level increases. Active high
coagulation, which occurs when activity in the system decreases, may be a sign of
hypercoagulation, this probably increases the risk of thrombosis and indicates the height of
thromboembolism.
As a proof of this, in the 1st pregnant woman participating in the group, FQTV (activated
time of partial thromboplastination) was 29.4±0.31 seconds before the determination of
kishkarish. Compared to the control group, this indicator decreased by 1.25 times (P<0.001).
In the control group, the AQTV time was 36.8±0.30 seconds, respectively.According to the
results obtained, 1 and 2 pregnant women showed hypercoagulation of the blood clotting
time and plasma group compared to the control group of qisqarganligi hemostazide
(increased blood clotting). This condition of the blood clotting system used in an active
rheumatic process complicated by pregnancy has increased, and the development of events
shows that the probability of thrombosis is high. The special prothrombin index was
calculated according to the formula in the control group and from 9to 2.2,2±0.5 to1%,
respectively. The 1st group of pregnant women who take therapeutic measures, this indicator
is 89.9±0.69 therapeutic receptions in a pregnant woman, while 87.2±1.50% if they are
equal, this indicates the presence of hypercoagulation during pregnancy.
As can be seen from the data shown in Table 3.2, the relationship also extends to 1 month in
pregnant women of the international group, in whom y was observed in ily: 1-in the xmm
group 1.03±0.003 v, in 2-in group b-0.92±0.02, respectively. In the control group, this
indicator is 0.88±0.03, respectively. As can be seen from the results obtained, in the 1st
group of pregnant women who participated in the second stage of blood clotting, it was
shown that it significantly shifted towards hypercoagulation.
So the results of the study showed, since the level of fibrinogen in the blood plasma
increased significantly, this showed that there was a shift in hypercoagulation (Karalsin table
3.2). The indicator of the control group in the 1st group of pregnant women was 1.47. The
amount of fibrinogen (P<0.01) increased by a factor of 4.35±0.71 g / l / L. 2-pregnant
women engaged in the group, while in 1.18 of the control group (P<0.01) time increases,
3.51±0.15 g/l, respectively. The highest indicator 1 is a group of women, that is, women
come who take medical measures.
Needless to say, fibrinogen is synthesized mainly in the liver. The amount of protein in the
blood and the infectious factors that it has access to will increase in the acute phase, with
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inflammation, stress and injuries.
The studies presented in the literature are compared with the results obtained, they are consistent
with the data, complicated pregnancy in women is accompanied by preeclampsia and kidney
diseases, systemic connective tissue diseases, rheumatism in pregnant women, in whom this
indicator is not recorded during pregnancy.
Conclusion.
Thus, our study showed that the results obtained indicate that in the case of
mitral stenosis complicated by an orifice, used in pregnant women during mo
hypercoagulationуin il track, changes in hemostasis were not observed as reliable as possible
and extended in the direction of the duration of the increase in statistical indicators in
pregnant women of the 1st group. Pregnant women go to reduce the duration of pregnancy,
marker hypercoagulation develops, and the amount of fibrinogen increases in it. According
to our conclusion, the blood coagulogram is an indicator in predicting the risk of pregnancy
complications, since it can be used to detect these changes, the mother-companion-staz
shows the development of the o'zan microcirculatory bed in the fetus.
References:
1.
V. A. kondrashev, V. E. Chaplygina, and E. V. Human composition as a
morphological reflection of the adaptive capabilities of other Xarlamov components in the
div. - 2008. - Vol. 133. - No. 2. - pp. 66-66.
2.
V. F. Lukyanchikova, G. V. Chizhova, Z. P. Pregnancy and childbirth with a tactical
goal: Tactical optimization of the management of children from heart disease
//Cardiovascular preventive therapy. - 2005. - Vol. 4. - No. 2.
3.
This is the insufficiency and early preventive diagnosis of R. E. Fazleeva with a heart
and a plasma reaction to undifferentiated dysplasia of the connective TV system.
4.
R. T. Masharipova's occurrence of rheumatism in the area of a pregnant woman of
fertile age //Science, education and technical. – 2022. – №. 1 (84). – Pp. 99-101.
5.
Rudaeva E. V. Et al. Malformation and pregnancy in the birth of the heart / / Clinical
Fundamental Medicine. - 2019. - Vol. 4. - No. 3. - pp. 102-112.
6.
Sosnova E. A., M. V., It's me And Berishvili's pregnancy for early heart defects
//Archive of gynecologists in obstetrics and named after V. F. Snegirev. 2015, vol. 2, No. 4,
pp. 4-9.
7.
Stryuk R. I., et al. Diagnostics of cardiovascular diseases pride 2018. National
recommendations //Russian Journal of Cardiology, 2018, no. 7, pp. 156-200.
8.
M. Charakida et al. Violation of the heart activity of the mother in the first trimester
of pregnancy in the middle of pregnancy determines your diagnosis / / Ultrasound
examination in obstetrics and gynecology. - 2024. - Vol. 64. - n. 2. - pp. 173-179.
9.
Cardiovascular dysfunction in fetal growth retardation has become possible as a
critical perinatal outcome and a prognostic marker of cardiovascular diseases in childhood. –
2013.
10.
Gibbone E. et al. Development of preeclampsia and cardiac activity of the mother in
the middle of pregnancy / / Journal of the American College of Cardiology. - 2022. - Vol. 79.
- No. 1. - pp. 52-62.
