PROGNOSIS AND PREVENTION OF UTERUS BLEEDINGS IN EARLY POSTPARTUM PERIOD FOR WOMEN WITH IDIOPATHIC ARTERIAL HYPOTENSION

Objective: The aim: To establish the effectiveness of thromboelastography (TEG) and tranexamic acid (TXA) for prognosis and prevention of early postpartum period bleedings (PPB) for postpartum women with idiopathic arterial hypotension (IAH).

Patients and methods: Materials and methods: Coagulogical research was conducted (coaugologram screening, dynamic function of platelets under the influence of adenosine diphosphate (ADP) (visual assessment), measurement of soluble fibrin-monomer complexes (FMC) and TEG of 36 in parturient women during the I chilbirth period with arterial hypotension. 14 parturient women with normal fibrinolysis were included into the first observation group; The second group includes 22 parturient women with TEG results which show signs of hyperfibrinolysis. Further, in cases when stronger fibrinolysis was detected during the late pushing phase of childbirth period, the TXA by amount of 1,0 g IV (bolus) was injected due to bleeding prevention. TEG was repeated during early postpartum period.

Results: Results: the inhibition of platelet aggregation activity with ADP was observed in every parturient woman with IAH in the first partum period. In 61,1% cases with TEG hyperfibrinolysis were shown, which was accompanied by significant increase in FMC levels in blood. The use of TXA as PPB prevention for parturient women with IAH and hyperfibrinolysis during TEG was fully oppressing the fibrinolytic activity and was not affecting the coagulation part of hemostasis.

Conclusion: Conclusions: hemostasis testing during childbirth based on TEG gives the ability to prognose the hemorrhagic complications in parturient women with IAH and administer their prophylaxy using TXA.

Keywords: childbirth; fibrinolysis system; thrombocytopathy; thromboelastography; tranexamic acid; idiopathic arterial hypotension.

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EFFECTIVENESS OF THE MAGNESIUM APPLICATION IN OBSTETRICAL PRACTICE

ABSTRACT
The aim: Conducting an evaluation of the effectiveness and safety of the use of magnesium in pregnant women.
Materials and methods: A comprehensive examination of 60 pregnant women was conducted, of which 30 were taking a magnesium preparation in a daily dose of 2473.72 mg of magnesium citrate and 40 mg of pyridoxine hydrochloride (the main group) and 30 pregnant women who were not taking a magnesium preparation (сomparison group). The analysis of the clinical course of the first half of the pregnancy with the determination the frequency and structure of complications, blood pressure levels, indicators of ultrasound, general and biochemical blood tests, urinalysis, lipid status and carbohydrarate metabolism.
Results: The main complications of the first half of pregnancy were: threatening miscarriage, abortion in progress, early gestosis, anemia, respiratory viral infection, exacerbation of extragenital pathology, hypertension. During the analysis of carbohydrate and lipid metabolism increased atherogenic potential. Analyzing the results of ultrasound studies reliably earlier comes down the local hypertonus.
Сonclusions: The correction of chronic magnesium deficiency, performed by the drug magnesium has allowed to reduce cases of threat of abortion, the abortion that was started, the symptoms of early preeclampsia, anemia of pregnant women, symptoms of respiratory viral infection, reduces the number of bed-days in the case of hospitalization. Theuseof magnesium helpedto normalizebloodpressure, carbohydrateandlipid metabolism, reduces hypertonus of the myometrium.
KEY WORDS: magnesium deliciency, pregnancy complication, magnesium

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Efficacy of primary rehabilitation measures associated with the development of recurrent bronchial obstruction syndrome in young children with respiratory disorders in neonatal period

Respiratory pathology in the recent years remains an urgent problem in clinical pediatrics. The aim of the research was to improve primary prophylactic measures associated with the development and progression of recurrent bronchial obstruction syndrome in young children, who had suffered respiratory disorders in neonatal period. Algorithm of primary prophylactic measures implied adequate balanced nutrition, sanation of living conditions, restriction of contact with infectious agents, sanation of chronic foci of infection, systematic training and general fitness. 

The investigation included 160 young children (1 day – 3 years of age). The basic group (n=80) involved children, who had experienced respiratory disorders in neonatal period and received appropriate respiratory therapy (artificial ventilation and / or spontaneous breathing with continuous positive airway pressure and supply of free oxygen), control group – children, who did not have respiratory disorders and respiratory therapy (n=80). 

Conducted investigation throughout 12-month monitoring enabled to record the development of recurrent bronchial obstruction syndrome in 43 children (respectively, 30 – 37.50% patients of the basic group versus 13 – 16.25% of control group; p<0.05). However, the results, which would confirm the efficacy of suggested primary rehabilitation measures (р>0.05), could not be obtained. 

Conclusions: comparative analysis within groups did not show a reliable difference in the development of recurrent bronchial obstruction syndrome in children (р>0.05), which can be explained by partial following of doctor’s recommendations. There is the need in further study of the issue involving more patients for a longer period of monitoring. 

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