The aim of the study is to development of an algorithm for managing pregnancy and childbirth by studying the functional state of the mother-placenta-fetus system in pregnant women who have undergone COVID-19 in different trimesters of pregnancy.
The object of the study was 105 pregnant women who, were treated at the Samarkand Regional Perinatal Center and a specialized maternity center for pregnant women with COVID-19
Тhe scientific novelty of the research consists of the followings: for the first time in pregnant women infected with COVID-19, a relationship was established between the course of pregnancy, childbirth, the postpartum period and the development of complications depending on the trimester and severity of the disease; a direct correlation has been established between the state of the vessels of the mother-placenta-fetus system (resistance and pulsation indices, Endothelin-1 indicators), disorders in the hemostasis system (D-dimer, platelet aggregation) and the clinical course of the disease in pregnant women who underwent COVID-19; it has been established for the first time that the developed scale for assessing risk factors for non-developing pregnancy in women infected with COVID-19 (age, BMI, obstetric history, gestation period, hemostasis system status, endothelial function and severity of the disease) can serve as a prognostic marker of the degree of risk of pregnancy complications; it was proved for the first time that the choice of effective therapy for restoring hemodynamics in the mother-placenta-fetus system, in women who underwent COVID-19 at different stages of pregnancy, leads to a decrease in the number of thrombophilic complications.
Implementation of the research results. The results of the scientific research were introduced into the practical activities of the Samarkand Regional Perinatal Center by Order No. 128/1 of 01.09.2022 and the Samarkand City Maternity Complex No. 1 by order No. 58/1 of 03.10.2022. In pregnant women who underwent COVID-19 at different periods of pregnancy, changes in the mother-placenta-fetus system were determined using simple and effective research methods, such as ultrasound and Dopplerography, and this saved 53,000 soums; obstetricians and gynecologists, as well as neonatologists and therapists, are needed to diagnose signs of complications in the echocartin, that is, it has been proven that there is no need for other highly qualified specialists for this, due to the lack of need to train new personnel, state budget funds have been saved. With early detection of disorders in the hemostasis system in pregnant women with COVID-19: the period of stay of patients in the hospital was reduced from 10.5 days to 7.5 days and the number of hospital bed days was reduced; due to the reduction of the period of stay in the hospital for several days, the number of necessary drugs was reduced (on average, drugs are used for 1 day in the amount of 130,000 soums). Examination of pregnant women infected with viral diseases using simple and effective research methods such as ultrasound and Dopplerography served to save 85,000 soums: in the early stages up to 16 (10-11 weeks. - fetometry), 19-21, 32-34, 38-40 weeks of pregnancy; due to the absence of the need to use other research methods, it was possible to reduce costs by 23.5%; early detection of changes in the hemostasis system and endothelial dysfunction using fast, budgetary and effective research methods, contributed to the prevention of possible pregnancy complications, as well as the absence of the need to use long-term and expensive research methods, and this saved 106 000 soums: the coagulogram was checked in 105 (100%) patients, time was saved and efficiency was increased; endothelin-1 was also determined in 105 (100%) patients, efficiency was increased by 78.6%.
Improving the functionality of blood circulation in the uteroplacental and fetal-placental systems, a comprehensive analysis of possible complications during pregnancy and childbirth in women who have had viral infections, improving diagnostic, preventive and prognostic measures for managing pregnancy and childbirth contributed to the birth of live, full-term and healthy newborns in women who experienced COVID-19 during pregnancy, as well as a decrease in maternal mortality and perinatal mortality, 43% of women underwent rehabilitation in the postpartum period, 23.8% of women who underwent severe COVID-19 improved their quality of life.
To introduce scientific novelty on the topic “The impact of COVID-19 on the state of hemodynamics in the mother-placenta-fetus system in pregnant women”, a letter was sent to the Ministry of Health from Samarkand State Medical University on November 9, 2022 under No. 4295 (Conclusion of the Ministry of Health No. 8 n-z / 679 of December 15, 2022).
The structure and volume of the dissertation. The content of the dissertation consists of an introduction, five chapters, conclusion, list of used references. The volume of the dissertation consists of 113 pages.
Pregnancy at an advanced maternal age presents unique challenges and considerations for both mothers and their infants. This study offers a comprehensive assessment of maternal and perinatal outcomes in the context of advanced maternal age, examining various factors that may influence the health and well-being of expectant mothers and their newborns. Through a multi-dimensional analysis, we explore the implications of delayed childbearing on maternal health, obstetric complications, neonatal outcomes, and the broader socio-cultural aspects that shape this experience. Our findings shed light on the complexities of pregnancy at an advanced age, informing healthcare providers and policymakers for improved care and support for older mothers.
This research encompasses a diverse cohort of women aged 35 and above who underwent prenatal care and delivery in various healthcare settings. Data analysis includes a wide array of factors, including maternal health, gestational complications, fetal development, and neonatal outcomes. Additionally, psychosocial and emotional aspects are explored to understand the emotional well-being and stressors experienced by older expectant mothers.
Initial findings suggest that advanced maternal age is associated with an increased risk of certain pregnancy complications, such as gestational diabetes, hypertension, and cesarean deliveries. However, maternal age alone does not determine the overall pregnancy experience. Factors such as pre-pregnancy health, lifestyle choices, and access to quality healthcare also play pivotal roles in maternal and perinatal outcomes. Furthermore, older mothers exhibit resilience and a strong commitment to their child's well-being, resulting in favorable psychosocial outcomes.
This holistic assessment underscores the importance of personalized and age-sensitive prenatal care. Tailored interventions that address the specific needs of older expectant mothers, including nutrition, exercise, and psychological support, can significantly enhance overall pregnancy experiences and mitigate certain associated risks. Furthermore, it is crucial to empower women with evidence-based information to make informed decisions about family planning and reproductive health.
This case study presents a rare instance of cytomegalovirus (CMV) seroconversion in a primiparous woman during her first trimester of pregnancy, accompanied by a significant increase in CMV-specific antibody avidity. The emergence of CMV seropositivity in pregnancy raises concerns due to potential vertical transmission risks. However, the intriguing aspect of this case lies in the unusually high avidity of the CMV-specific antibodies developed post-seroconversion. This phenomenon suggests a previous immune priming event or cross-reactive responses. The case underscores the complexity of CMV infections during pregnancy and the need for careful monitoring and research to comprehend the implications of heightened antibody avidity in the context of maternal-fetal health.
Ectopic pregnancy is the most common pathology in gynecological practice, which leads to a decrease and loss of reproductive function. After ectopic pregnancy surgery, about 35 percent of women had early complications, such as systemic inflammatory reaction syndrome and inflammatory process suppuration of the uterine appendages. Reproductive dysfunction was observed in 58,9% of women and the frequency of repeated ectopic pregnancy was 20,0%, which is the problem under studyindicates the relevance of.
in our country, the number of pregnant women with rhesus sensibility every year remains unchanged and does not have a downward trend. This is due to insufficient prophylaxis after the termination of pregnancy (spontaneous abortion, ectopic pregnancy, the birth of a rhesus-positive fetus) with the use of immunoglobulin against antiretroviruses. Previously effective methods of treatment, such as desensitization of antigens, plasmapheresis, hemosorption and intravenous administration of immunoglobulins, have only historical significance.
Objective: to study and analyze the literature data of foreign and local authors on the diagnosis of hemolytic disease of the fetus, the use of non-invasive methods of Prevention of Rh-immunization.
Search strategy: the search for information contained information such as regulatory documents, diagnostic protocols, and the conduct of RH-controversial pregnancy. Also in the databases Google Scholar, the Cochrane Library, PubMed, Library full-text scientific articles were used.
Inclusion criteria: randomized, cohort study data, systematic reviews, diagnostic protocols, and Rh-conflict pregnancy.
Exception criteria: practice, report, newspaper publications, articles describing theses.
Results: studies have shown that the prophylactic purpose and administration of anti-D-immunoglobulin, which is used during 28-30 weeks of pregnancy, significantly reduces the development of immunization after childbirth. Conclusion: due to the wide application of anti-D-immunoglobulin in pregnant women and family planning, it will be possible to reduce the frequency of immunization, but the goal will be achieved only if a clear сomplex prevention of Rh-immunization is developed, in which the appearance of hemolytic disease of the fetus occurs. Nevertheless, the diagnosis and treatment of hemolytic disease remains an urgent problem and requires the use of new possibilities of modern medicine in the field of genetics, ultrasound diagnostics, invasive and non-invasive methods.
The results of a comparative study of the oral cavity of pregnant women with hypertrophic gingivitis and without inflammatory diseases of the oral cavity (ESD) were studied on the example of the Samarkand region as a risk factor for the development of hypertrophic gingivitis in pregnant women. It has been shown that during pregnancy, the negative influence of local factors of hypertrophic gingivitis significantly increases. Keywords: hypertrophic gingivitis, pregnancy, dental indicators, risk factors Despite numerous studies, the etiology of inflammatory periodontal diseases in pregnant women has not been sufficiently studied. Thus, the prevention, diagnosis and treatment of gingivitis in pregnant women remains insufficiently effective. In addition, many medications and effects cannot be used during pregnancy (or perhaps, but there is only a risk comparable to the health of a mother with gingivitis).The fruit depends on the means used). On the other hand, hypertrophic gingivitis negatively affects the course of pregnancy and increases the likelihood of perinatal complications [1,2]. In particular, periodontitis often contributes to premature birth and intrauterine infection of the fetus, since it complicates the course of pregnancy and is a focus of infection in the mother's body.[3] Many inflammatory diseases have regional peculiarities of development, course and treatment related to its iodine state, the state of ecology, the epidemiological situation and the organization of medicine, as well as the genetic characteristics of the population of this territory [4,5]. It is reasonable to assume the presence of such signs in hypertrophic gingivitis. However, at the moment there are no special publications dedicated to this disease in the Samarkand region.
Toxicosis is one of the most common and urgent problems of modern obstetrics. Toxicosis leads to significant deterioration in the quality of life of the patient, often reducing or disabling. This pathology occurs in 50-90% of pregnant women. In addition, toxicosis can cause a threat, termination of pregnancy, and even miscarriage.