The use of Arabin pessary compbined with progesterone reduces the rate of infectious complications and bleeding during pregnancy and the postpartum period.
Due to the high estimated prevalence of magnesium deficiency, there is a need for a rapid, non-invasive assessment tool that could be used by patients and clinicians to confirm suspected hypomagnesemia and substantiate laboratory testing. This study analyzed data from four large observational studies of hypomagnesemia in pregnant women and women with hormone-related conditions across Russia. Hypomagnesemia was assessed using a 62-item magnesium deficiency questionnaire (MDQ-62) and a serum test. The diagnostic utility (sensitivity/specificity) of MDQ-62 was analyzed using area under the receiver operating characteristic curve (AUROC). A logistic regression model was applied to develop a shorter, optimized version of MDQ-62. A total of 765 pregnant women and 8836 women with hormone-related conditions were included in the analysis. The diagnostic performance of MDQ-62 was “fair” (AUROC = 0.7−0.8) for women with hormone-related conditions and “poor” for pregnant women (AUROC = 0.6−0.7). The optimized MDQ-23 (23 questions) and MDQ-10 (10 questions) had similar AUROC values; for all versions of the questionnaire, there was a significant negative correlation between score and changes in total serum magnesium levels (p < 0.0001 for all comparisons; correlation coefficients ranged from −0.1667 to −0.2716). This analysis confirmed the value of MDQ in identifying women at risk of hypomagnesemia.
Профилактические меры по предотвращению дефицита магния как на этапе подготовки к беременности, так и во время гестации, начиная с самых ранних ее сроков, позволит оптимизировать течение беременности, избежать некоторых осложнений и улучшить исходы для плода и новорожденного.
Цель исследования-определить значение многофазной комбинированной оральной контрацепции (КОК) с укороченным безгормональным интервалом на основе натурального эстрогена в сохранении здоровья женщин старшего возраста. Материал и методы. Проведен анализ статистических материалов, публикаций базы Кохрейна, клинических исследований, опубликованных в открытом доступе. Результаты. Репродуктивное поведение женщин старше 40 лет характеризуется низкими показателями рождаемости, недостаточными темпами снижения абортов по сравнению с другими возрастными группами и неудовлетворительной структурой используемых методов контрацепции. Применение КОК, содержащего эстрадиола валерат и диеногест (Э 2 В/ДНГ) в режиме 26/2, является не только средством профилактики нежеланной беременности, но и оказывает лечебное действие при нарушении менструального цикла, наличии вегетососудистых проявлений, протективное действие в отношении ВЗОМТ, рака различных локализаций. Недавнее исследование безопасности гормональных контрацептивов показало, что относительный риск тромбозов в группе Э 2 В/ДНГ ниже по сравнению с другими КОК и составляет 0,4 (95% ДИ 0,2-1,0) и с КОК, содержащим этинилэстрадиол и левоноргестрел-0,5 (95% ДИ 0,2-1,5). Выводы. Многофазный режим КОК на основе натурального эстрогена имеет высокий протективный потенциал и приемлемый профиль безопасности в отношении рисков тромбозов у женщин старше 40 лет. Ключевые слова: старший репродуктивный возраст, пременопауза, комбинированные оральные контрацептивы, эстрадиола валерат, тромбоз.
This study was aimed to assess the effectiveness of magnesium (Mg)-vitamin B 6 replenishment and its correlation with clinical status in pregnant women (PW), and quality of life in women with hormone-related conditions (HRCW) and hypomagnesemia (HME). Data collected in four observational studies were pooled and analysed. All women received Mg supplementation for 4 weeks. The proportion of women with normalized Mg level, and the correlation between serum Mg dynamics and number of symptoms/complaints (PW) or changes in World Health Organization quality of life questionnaire scores (WHOQOL; HRCW) were evaluated. 869 PW and 957 HRCW were included in the study. Normalization of serum Mg level to ≥ 0.66 mmol/L occurred in 92.1% of PW and 78.4% of HRCW, and to ≥ 0.8 mmol/L in 73.8% and 58.9%, respectively. Mg normalization was accompanied by a median decrease of 1 symptom and 1 complaint in PW. Serum Mg level increase by 0.1 mmol/L was associated to significant changes in the WHOQOL scores in HRCW. Treatment of HME with the Mg for approximately 4 weeks provided a high response rate of Mg serum level, was associated with an improvement in symptom severity and complaints in PW, and WHOQOL score in HRCW. A 0.8 mmol/L cut-off appeared to be more relevant in terms of patient-reported outcomes.
The review tells about inadequate frequency of use (less than 1%) and low awareness (58--59%) among Russian women of emergency contraception, novel recommended medications and their effectiveness (52--100%) and safety according to recent clinical trials. Enhancing awareness of doctors and potential consumers of high efficacy and safety of emergency contraception would increase its use whenever necessary.
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