No abstract

The aim: To investigate the relationship between serum bilirubin level and the presence of the APS in women with a history of spontaneous miscarriages. Materials and methods: Fifty six women aged 22-38 (median 27) years with a history of spontaneous miscarriages were divided into two groups: 33 women with the APS and 23 without. Patients were tested for the presence of lupus anticoagulant, anticardiolipin, anti-β2-glycoprotein 1, antiphospholipid antibodies and genetic thrombophilic defects. Results: Groups were comparable by age, blood pressure, BMI, co-morbidity (anemia, heart abnormality, thyroid disease, overweight). Median serum total bilirubin levels were 7,2 μmol/L (interquartile range [5,8-9,7]) in women with the APS and 10,5 μmol/L (interquartile range [7,5-15,1]) in control group, p=0.005. The chance of detecting a total bilirubin level of less than 8 μmol/L is 4.1 times higher in the APS patients than in the control group (OR 4,1; 95% CI 1,274-13,213). Logistic regression analysis found a statistically significant association between total bilirubin and the presence of the APS (odds ratio, 0.856; 95% CI, 0.734-0.997, p =0.046). Patients with the APS had elevated serum C-reactive protein (medians 2,3 vs 1,1 mg/L, p=0.01) and fibrinogen (medians 2,8 vs 2,5 g/L, p=0.006) levels compared with controls. Correlation analysis revealed a significant correlation between all types of bilirubin and inflammatory markers. Conclusions: All types of serum bilirubin (total, direct and indirect) are significantly reduced in women with APS, associated with higher inflammatory markers and lower levels of 25-hydroxyvitamin D, which may be the result of oxidative stress.

The aim: To study the epidemiological situation of ascariasis among women with pathology of the reproductive system on the basis of a literature database (PubMed, Medline, Google Scholar, PLoS, Hindawi) and to present our experience with ascariasis and pathology of reproductive system. Materials and methods: We investigated parasitic invasions in 174 women reproductive losses and 186 patients with primary infertility. Results: The results performed in women with infertility and reproductive losses have proved the role of parasitic infection in the emergence of disorders of hormonal homeostasis, endothelial-lymphocytic dysfunction, severe vaginal and intestinal dysbiosis and, as a consequence, reproduction of conditionally pathogenic flora, etiopathogenetic risk factors for the development of various forms of women’s reproductive health pathology. Conclusions: More global attention to the diagnosis and treatment of parasitic infections in the examination of women with infertility and reproductive losses is warranted. The influence of ascariasis as a source of autoinfection of the gastrointestinal tract, allowed us to consider the presence of this invasion a risk factor for the development of chronic inflammatory process of the lower genital tract.

Objectives: To study the association of second trimester uterine artery Doppler (PI) pattern with adverse maternal and fetal outcome. Methods: Prospective cohort study involving 100 singleton, uncomplicated gestations between 18-28 weeks of gestation, attending the ante-natal clinic of Department of Obstetrics and Gynaecology in Amrita Institute of Medical Sciences, Kochi, a tertiary care centre in Kerala, Southern India from July 2017 and September 2020. Approval from the Institutional Ethics committee was obtained. Patient details, complications and neonatal outcomes were obtained from the hospital's electronic medical records. Uterine artery Pulsatility index (PI), the most commonly used index was done routinely with second-trimester (anomaly) scan. It is considered to be abnormal if above the 90th centile for the gestational age. Results: Of 100 samples, 15% were subject to hypertensive disorder, 7 % fetal growth restriction (FGR) and 7% spontaneous preterm labour. Abnormal PI was found in 13 pregnancies. 69.2% of this was complicated by hypertensive disorders (p = 0.001). Sensitivity and specificity was 60% and 95.3% respectively. 23.1% had FGR (p = 0.064) with sensitivity of 44.4% and specificity of 90%. 38.5% had preterm birth (32-37 weeks) (p = 0.051). Out of the 100 neonates, 94% of the neonates had APGAR≥7. 12% of the total required immediate NICU admission for various factors. No statistically significant association between uterine artery PI and spontaneous preterm labour (p = 1.00), neonatal birth weight (p = 0.3), APGAR score at birth (p = 0.36) and NICU admission (p = 0.076). Conclusions: Uterine artery Doppler is not only an inexpensive and non-invasive modality, but also becoming quite popular in developing countries as routine practice. The findings from this study certainly have potential clinical implications with the use of second trimester uterine artery Doppler for the management of high risk pregnancies especially with hypertensive disorders, FGR and preterm birth with good sensitivity and specificity.

No abstract

Materials  and  methods : This  is  an  investigation of  49  cases  with confirmed  ascariasis and pathology of reproductive system in the Lviv City Center for Family Planning and Human Reproduction Lviv Ukraine between  January  2013  and December 2015. Purpose : The aim of the study was to investigate changes in the L-arginine / NO synthase / arginase system in women with primary infertility and recurrent pregnancy loss with ascariasis presence in Ukraine. Results : In women with recurrent pregnancy loss and women with primary infertility were observed significant activation of iNOS in lymphocyte lysates, an increase in nitrite anion production, and a decrease in L-arginine content in the blood plasma and ascariasis compared with RPL and PI patients without ascariasis.  Conclusion : Ascariasis can be factor of the development of inflammation.

No abstract

Background: Chronic endometritis (CE) is one of aggressive factor of infertility and reproductive losses. Objective: We aimed to assess the effectiveness of using platelet-rich plasma (PRP) treatment of chronic endometritis (CE) treatment in women with infertility (PI) and recurrent pregnancy losses (RPL). Material and methods: In this non-randomized clinical trial, women aged 22-45 years with CE diagnosed by positive CD 138 between February 2017 and December 2019 were included. Were investigated 65 women - 30 patients with RPL and 35 women with PI and unsuccessful attempts at IVF. PRP therapy was performed paracervical ( 6 ml) and intrauterus ( 1,5 ml) once a week for 4 -8 weeks. Control of the treatment of CE was performed by endometrial biopsy pipelines 15-20 days after the last PRP. Results: After carrying out 4 procedures of combined paracervical and intrauterine PRP, CE was cured in 70-77% of women (p <0.05); after 8 procedures - 97% (p <0.01). Conclusions: Combined intrauterine and paracervical PRP therapy is an effective treatment for CE in women with PI and RPL.