Кафедра акушерства, гінекології та дитячої гінекології

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Browsing Кафедра акушерства, гінекології та дитячої гінекології by Author "Blagoveshchensky, Roman"

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    Administration of octaplex in comprehensive treatment of patients with profuse obstetrical hemorrhage
    (2016) Osovskiy, I.; Blagoveshchensky, Roman; Grebenyuk, L.
    Actuality. In spite of the advances in up-to-date medicine the treatment of postpartum hemorrhage remains a serious challenge for obstetricians. The incidence of such bleedings comprises up to 9-11% of the total number of deliveries. It is hemorrhage that conditions the fourth part of the causes of maternal mortality, of which over 70% result from disorders of hemostatic system, i.e. it can be considered a manifestation of DIC-syndrome. The incidence of profuse obstetric hemorrhage is 0.5 - 4.5% of the total number of bleedings. The aim was to analyze the effectiveness of administration of therapeutic agent Octaplex in the treatment of profuse obstetric hemorrhage. Materials and methods: the Department of Obstetrics, Gynecology and Children Gynecology assessed feasibility of administration and effectiveness of the therapy with this drug according to the instructions for the employment of medical immunobiological drug Octaplex 500 IU approved by the order issued by the Ministry of Health of Ukraine No.197 from 05.03.2010 Results of the study: The treatment of women with profuse blood loss was aimed both at surgical arrest of bleeding and at urgent replenishment of circulating blood volume. This method is not possible without infusion therapy and administration of drugs, activating hemostasis and preventing the development of coagulopathy. Development of hemorrhagic shock followed by a severe disruption of blood coagulation system is the most severe and life-threatening complication of blood and plasma loss. The action of this drug is aimed at the correction of coagulopathy. It contains several coagulation factors in high concentration: factor II - 220-760 IU, Factor VII - 180-480 IU, Factor IX - 500 IU, Factor X - 360-600 IU, protein S - 140-640 IU, protein C - 140-620 IU, heparin - 100-250 IU. Given the amount of clotting factors it can be said that one bottle of Octaplex 500 IU is equivalent to 1000-1500 ml of fresh frozen plasma. The average amount of blood loss was 950 mL (mean intraoperative blood loss - 620 ml), which corresponds to an average value of 21% of CBV, 1.53% of body weight. Indices of blood clotting before administration of Octaplex 500 IU (INR - 0.78, Quick’s prothrombin - 52.5%, blood clotting time - 5 minutes 41 seconds). Indices of blood clotting after administration of Octaplex 500 IU (INR-1.12, Quick’s prothrombin - 86.3%, blood clotting time - 7 minutes 23 seconds). Conclusion: Octaplex is an effective agent for the treatment of profuse postpartum hemorrhage and corrects coagulopathy.
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    Herpes virus infection influence on intrauterine state of the fetus
    (2016) Blagoveshchensky, Roman; Reznik, Marina; Rakytyanskyi, Igor; Rubinskaya, A.
    Actuality: Intrauterine herpes virus infections are among the most common infections. Numerous studies have shown that by the age of 18 years more than 90% of the world population gets infected with one or more of the currently known strains of herpes viruses. The presence of class Ig G maternal antibodies was shown to have little effect on the developing fetus. Infected mothers more frequently give birth to a healthy child while the greatest threat in terms of perinatal loss is presented by a primary infection during pregnancy. Numerous studies suggest the possibility of transplacental infection of fetus with herpes virus infections. The aim: To analyze the effect of herpes virus infections on the state of the fetus and course of labor. Materials and methods: The course of pregnancy and delivery was assessed in 20 women with herpes virus infection who underwent follow-up treatment at Kharkiv Maternity Hospital No.1. The study also involved determination of the functional state of fetoplacental complex and the course of labor. These pregnant women were found to have Ig M, A to herpes virus infections. Somatic, obstetric and gynecological status was assessed in all the patients by conventional methods of examination. The condition of the fetus and changes in the placenta were mainly identified by biometrics of the fetus, thickness and structure of the placenta, the quantity of amniotic fluid and cardiotocography. Blood flow in vessels of mother-placenta-fetus system was determined by Doppler study. Results: The study showed that intrauterine growth retardation was diagnosed in 15% of pregnant women. Signs of intrauterine viral infection included oligohydramnios in 58% and placental hypoplasia in 46% of cases. Cardiotocography demonstrated episodes of deceleration, reduction in frequency and amplitude of oscillation, indicating chronic fetal hypoxia. Biophysical profile of fetus according to Vintzeleos et al. was estimated at 6-7 points in 16% and 5 points or below in 4% of pregnant women. Disruption of fetoplacental blood flow at compensatory stage was detected in 37.4% of pregnant women, in 10.7% at subcompensatory stage and in 3% at decompensatory stage. Decompensated disruption of fetoplacental blood flow was the indication for operative delivery. Cesarean section was performed in 7 (35%) of the examined pregnant women. Delivery in the remaining patients was characterized by premature discharge of amniotic fluid in 25%, meconium-tinged amniotic fluid in 10% and uterine inertia in 22%. Conclusions: Thus, it can be concluded that herpes virus infections adversely affect the condition of the fetus and disrupt normal course of delivery.
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    Pathogenesis of endothelial dysfunction in pregnant women with preeclampsia
    (KhNMU, 2017-05-24) Eylazova, Ainur; Blagoveshchensky, Roman; Melnik, Ksenia; Reznik, Marina; Rakytyanskyi, Igor
    Preeclampsia occupies an important place among numerous types of obstetric pathology, being one of the most serious complications of pregnancy and childbirth. Pregnant women with preeclampsia were found to have endothelial damage, which caused its dysfunction.