Volume 03 Issue 04-2023
55
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
55-61
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Placental insufficiency, as well as its complication intrauterine chronic fetal hypoxia, is one of the important problems
of modern perinatology. At the same time, its numbers have been increasing in recent years. Purpose - Evaluation of
the effect of ozone therapy on the blood circulation of the mother and fetus, fetoplacental blood flow and the degree
of adaptation of the fetus to hypoxia according to the results of cardiotocography, ultrasound and dopplerometry.
Material and methods: 38 pregnant women who applied to the Department of Obstetrics and Gynecology of Clinic
No. 1 of the Samara State Medical University with fetoplacental insufficiency were divided into two groups according
to the type of treatment: patients who received complex treatment with ozone therapy, and patients who received
standard medical procedures. Results: about a third of women in each group had a combined extragenital pathology.
Women in both groups were statistically comparable when compared in terms of general clinical characteristics, basic
anthropometric data, extragenital diseases and reproductive history. The most common complications of childbirth
were premature rupture of amniotic fluid (4 in the 1st group - 22.2% and 5-25% in the 2nd group) and acute fetal hypoxia
(3-16.7% and 3-15%). Conclusion: Thus, the indicators of maternal-fetal circulation, fetoplacental circulation in women
in the ozone therapy group were more positive than in the 2nd group, and the level of fetal adaptability to hypoxia
was higher.
KEYWORDS
Placental insufficiency (PI), mother-placenta-fetus system, ozone therapy, fetal growth retardation syndrome.
Research Article
FETOPLACENTAL INSUFFICIENCY AND OZONE THERAPY
Submission Date:
April 08, 2023,
Accepted Date:
April 13, 2023,
Published Date:
April 18, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue04-08
Todjieva Nigina Iskandarovna
Assistant, Department Of Obstetrics And Gynecology №1, Samarkand State Medical University, Samarkand,
Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 04-2023
56
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
04
P
AGES
:
55-61
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
INTRODUCTION
Placental insufficiency, as well as its complication,
intrauterine chronic hypoxia of the fetus, is one of the
important problems of modern perinatology. At the
same time, its frequency has been increasing in recent
years.
According to the research of a number of authors, the
frequency of placental insufficiency (PE) is high in
women with chronic extragenital pathology, including
inflammatory diseases of the urinary system up to 35%,
in anemia up to 30%, in women with cardiovascular
diseases from 30% - 45 %, up to 25% in women with
endocrine pathology [4, 9].
PE is often diagnosed in pregnant women with arterial
hypertension, its frequency increases to 27% in the I
stage of hypertension, and 59% in the II stage [11].
Severe pathology of the cardiovascular system, heart
defects with impaired blood circulation, and chronic
hypoxia of the mother lead to a significant increase in
morbidity with slowing of fetal development [2, 14, 18].
Among pregnancy complications that lead to PE, the
second place in terms of frequency of occurrence is the
threat of long-term abortion. Among the risk factors
for the delay in fetal development, the frequency of
this pathology is up to 23%. A long and repeated
increase in myometrial tone leads to a decrease in
arterial blood flow to the placenta, and an increase in
venous blood flow and congestion. As a result of such
hemodynamic disturbances, the gas exchange
between the mother and the fetus decreases, which
makes it difficult for the fetus to receive oxygen,
nutrients, release metabolic products, and contributes
to the development of fetal hypoxia [1, 3, 12, 15].
In general, PE can occur as a result of various factors
affecting pregnancy and cause many defects in the
development of the fetus. Therefore, in this case, it is
considered urgent to develop tactics for carrying and
treating pregnant women.
Purpose
–
Evaluation of the effects of ozone therapy
on maternal-fetal circulation, fetoplacental circulation,
and the degree of fetal hypoxia adaptation.
Materials and metohds: 38 women with chronic
fetoplacental insufficiency were analyzed during
pregnancy, delivery, postpartum period, fetus and
newborns. The research was carried out on the basis of
the Department of Obstetrics and Gynecology No. 1 of
SamSMU. Women were divided into 2 groups
according to the method of treatment: group 1
complex treatment (with ozone therapy) - 18 women
and group 2 - 20 pregnant women with chronic
placental insufficiency, only traditional treatment
methods were used. The control group consisted of 16
women with physiological pregnancy.
Volume 03 Issue 04-2023
57
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
03
ISSUE
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(2021:
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6.
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
In addition to clinical examinations using standard
methods and standard laboratory analysis methods,
special
research
methods
-
analysis
of
hemostasiological parameters, biochemical blood
analysis
and
ultrasound
examination
from
instrumental studies (fetal screening), dopplerography
of blood flow in the "Mother-placenta-fetus" system,
antenatal cardiotocography.
Variation-statistical processing of the obtained data
was carried out using the "Statistica 6.0" program by
determining the main indicators of variation: average
values (M), average errors (m), standard deviation (p).
If the p-value is less than 0.05, the difference between
the two indicators is considered significant.
Results: The age of the patients ranged from 18 to 39
years, with an average of 27.4±4.1 years. No deviations
from the population norms were found in the analysis
of mass-height ratio in the examined women. Before
pregnancy, the average div weight was 61.2+2.5 kg,
the average height was 165.3+5.8 cm. The most
common diseases were otolaryngological diseases
(33.3% in group 1 and 35% in group 2) and diseases of the
urinary system (38.9% and 30% in groups, respectively).
A significant share of chronic diseases of the thyroid
gland (16.7% and 20%) and gastrointestinal tract (16.7%
and 20% in the groups, respectively) is also noteworthy.
In addition, we found that in both groups, chronic
extragenital pathology was present in several organs:
for example, the ratio of the frequency of pathology to
the number of patients with chronic pathology in the
group was 1.69 and 1.54. In patients with extragenital
diseases of different localization, the combination of
two was often noted (22.2 and 25% in groups of 4 and 5
women, respectively), less often - the combination of 3
or 4 extragenital chronic diseases (16.77% and 20%,
respectively) observed.
Thus, approximately one-third of women in each group
had a combined extragenital pathology, a similar
percentage of patients did not have a severe somatic
background, and a slightly larger part had monoorgan
pathology. Statistical intergroup analysis of the
structure of extragenital pathology in pregnant
women did not reveal significant differences between
groups (p>0.05).
The age of menarche was almost the same in the
groups and was on average 13.1 ± 1.2 years. In most
women, menarche was on time (11 - 61.1% in group 1 and
13 - 65% in group 2), 7 women in groups (38.9% and 35%),
respectively, had a late onset of menstruation,
between groups no statistically significant differences
were found.
Complicated pregnancies with a complicated obstetric
and gynecological history and multiple pregnancies
had a higher rate of reproductive losses. A high
frequency of medical abortion was found, which was
27.8% in group 1 and 20% in group 2, in addition, 33.3%
and 35% in the non-developing pregnancy groups, and
Volume 03 Issue 04-2023
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International Journal of Medical Sciences And Clinical Research
(ISSN
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VOLUME
03
ISSUE
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P
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SJIF
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FACTOR
(2021:
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(2022:
5.
893
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(2023:
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OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
the frequency of spontaneous abortion was 16.7 and
20%, respectively. . Among the complications that
occurred during previous pregnancies, there was often
a threat of abortion in the early period of pregnancy: 12
- 66.7% in group 1 and 60% in group 2, as well as chronic
YY - 8 (44.4%) and 9 (45%) women , respectively by
group, p>0.05. Also, cases of premature birth in group
1 - 5 (27.8%), in group 2 - 4 (20.0%) and uterine infection
- in 3 women by group, 16.7% and 15%, respectively
determined, p>0.05.
It should be noted that women in both groups were
statistically compatible when compared in terms of
general clinical characteristics, key anthropometric
data, extragenital diseases, and reproductive history.
The most common complications of labor were
premature infusion of amniotic fluid (4 in group 1 - 22.2%
and 5-25% in group 2) and acute fetal hypoxia (3-16.7%
and 3-15%).
The use of ozone therapy in the complex treatment of
YY in pregnant women of group 1 led to a significant
increase in the level of hemoglobin, the number of
erythrocytes, platelets, and a decrease in the number
of leukocytes in peripheral blood, in contrast to
pregnant women of group 2, who were treated with
traditional methods. At the same time, patients in both
groups received iron preparations for anemia, but the
duration of therapy in group 1 was 14 days, and in group
2 it was 21 days.
Initially, patients in both groups had decreased serum
protein levels (59.3 and 60.4 g/l in the groups,
respectively), but none of the patients had clinical
manifestations of hypoproteinemia. In pregnant
women of group 1, the protein level did not change
clinically and was 62.8 g/l after 3 weeks of ozone
therapy sessions, p<0.001. In group 2, the amount of
total protein in the blood plasma did not change
significantly and was 61.2 g / l.
The average level of bilirubin, urea and creatinine
decreased significantly after efferent methods of
therapy. Biochemical blood analysis before and after
treatment showed a slight increase in the total protein
content, as well as a decrease in the level of liver
enzymes and an improvement in the functioning of the
div's natural detoxification systems, expressed by a
significant decrease in the level of endogenous
intoxication.
CONCLUSIONS
The indicators of maternal-fetal blood circulation,
fetoplacental blood circulation in the group of women
treated with ozone therapy were positive compared to
group 2, and the degree of adaptability of the fetus to
hypoxia was higher.
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Servi
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5.
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