Медицинские науки/ 1. Акушерство и гинекология

Medical sciences / 1. Obstetrics and Gynecology

PhD of Medical Science, A.P., Syusyuka V.G.

State Medical University of Zaporozhye

Department of Obstetrics and Gynecology

Estimation of effect of sanatorium

rehabilitation on delivery index of women with extragenital pathology

Indices of death among mothers and babies are the indicator of social and economic welfare and their decrease is included into the main goals of development during the century which were specified by United Nations Organization [5]. Policy of World Health Organization, United Nations Children's Fund, International Pediatric Association in the following decade of XXI century is oriented towards unification of efforts for decrease of mother’s and baby’s death with general distribution of technologies of family planning and child protection programs [1].

Special perinatal pathologies characterized by diseases of mother very often occur in extragenital pathology (EGP) clinical picture [3]. Increase of number of pregnant women with associated EGP and available complications which are stipulated by EGP, on the one part, requires necessary complex treatment and, on the other part, it raises risk of polypragmasy. That is why use of medical, physical factors for pregnant women permits to limit quantity of therapeutic substances without decrease of the clinical effect and to reduce possibility of unfavorable influence of pharmacological drugs on fetus.

Object of the work – is to estimate state of newborns and course of their early neonatal period, state of mothers who had a stage of sanatorium health improvement because of available extragenital pathology.

Group оf examined persons and methods of investigation

There were examined 127 pregnant women with gestation term of 12-35 weeks who had undergone sanatorium health improvement. Sanatorium health improvement was carried out in conditions of special department for pregnant women in Velikiy Lug sanatorium (Chief doctor is Shapran N.F.), Zaporizhzhia city, according to standards of sanatorium treatment (alimentary therapy, therapeutic exercises, climatotherapy, balneotherapy and other kinds of hydrotherapy, oxygenotheraphy, physiotherapeutic methods of treatment, chromotherapy, psychorelaxation and physiological and psychological preparation for labour) [2, 4]. The main group comprised 97 pregnant women with EGP. Criterion for selection was hard somatic diseases. Control group consisted of 30 somatically healthy pregnant women. Average age of examined women in the main and control groups statistically (р < 0.05) was not different and made 28.7 ± 0.76 and 27.3 ± 1.54 years, correspondingly.

Results of investigation and their discussion

While characterizing the rate of EGP there was found that in 81.6% of cases it had combined nature and the leading place belonged to pathology of cardiovascular system. Analysis of features of the pregnancy process allowed to determine most part of percentage of complications of gestation both in the main (82.5%) and control (73.3%) examined groups. However it is necessary to note that most part of pregnancy complications occurred before sanatorium health improvement. While characterizing the labour course there was determined that rate of obstetric and perinatal complications was almost equal in comparison in the examined groups. However during analysis of complications structure there was found that in the main group the rate of poor labour process (9.3 %) and fetus distress (10.3 %) was almost 3 times higher than correspondent indicators of the control group. Rate of poor labour process and fetus distress in the control group was the same and made 3.3 %. Increase of percentage of perinatal complications in the control group was stipulated by higher rate of neonatal biliousness (16.7%) comparing to the main group (5.2 %). Asphyxia in labour occurred in 5 (5.2 %) cases during labour process of women from the main group and in some extend exceeded the correspondent indicator of the control – 1 (3.3 %). Rate of retardation of growth of fetus (RGF) during calculation under weight-growth parameters made 24.7 % in the main group that exceeded the correspondent indicator of the control group in 1.8 times (13.3 %).

Conclusions

1. Analysis of features during pregnancy course permitted to determine considerable percentage of complications of gestation both in the main (82.5 %) and control (73.3%) examined groups. However it should be noted that most part of pregnancy complications occurred before sanatorium health improvement.

2. Performed investigation didn’t confirm fact of the higher rate of general indicator of complications which had women with extragenital pathology during labour (46.4 %) comparing to somatically healthy women (46.7 %). However while analyzing of complications stracture there was found that in the main group rate of poor labour activity (9.3 %) and fetus distress (10.3 %) was almost 3 times higher than the correspondent indicators of the control group and also of asphyxia during labour which was detected in 5.2% and 3.3% of cases correspondingly.

3. Based on performed investigation there was stated that increase of percentage of perinatal complications in the control group was stipulated by higher rate of neonatal biliousness (16.7%) comparing to the main group (5.2 %).

4. Results of investigation show that during antropomorphic investigations of newborns the proved difference (р > 0.05) between the main indicators (weight and growth) was not determined but rate of retardation of growth of fetus during calculation under weight-growth parameters in the main group made 24.7 % that is 1.8 times higher than the correspondent indicator of the control group (13.3 %).

Literature

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2. Malkina-Pyh I.G. Psihosomatika (2010). Moscow: Jeksm, 1024р.

3. Medved' V.I. Extragenital pathology of pregnancy: maternal and perinatal problems (2010). Zhіnochij lіkar, №4, 5-10р.

4. Rajgorodskij D.Ja. Practical psychodiagnosis (2002). Samara: «Bahrah-M», 672р.

5. Znamenskaja T.K. Priority directions of development of perinatal services in Ukraine (2011). Neonatologіja, hіrurgіja ta perinatal'na medicina, №2, 6-11р.