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Reproductive Endocrinology     Open Access   (Followers: 2)
Journal Cover Reproductive Endocrinology
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   ISSN (Print) 2309-4117 - ISSN (Online) 2411-1295
   Published by Trilist Publishing Homepage  [1 journal]
  • “Sea anemone” symptom in diagnosis of fallopian tubes function

    • Authors: В. В. Дощечкин
      Pages: 14 - 18
      Abstract: The article presents the method of ultrasonographic diagnosis of fallopian tubes function by the “Sea Anemone Symptom”.Objective: to study the function of patent uterine tubes in women among the couples with unexplained subfertility.Design: prospective cross-sectional study.Patients, Methods, Settings: 43 subfertile women were included into the study group. Non-contrast transvaginal sonography was carried out in all patients by the technique of mobile hydro-acoustic window (TVS+MHAW). The new “Sea Anemone Symptom” test (SAS-test) was performed for the ultrasonographic assessment of the function of fallopian tubes. In all women uterine tubes patency was confirmed by laparoscopic chromoperfusion, retro- and prospectively. The study was conducted in the Odesa center for reproductive medicine “Remedi” in the period from July 16 to December 16, 2016.Results and discussion: 4 main sonographic phenotypes of fallopian tube funnels and associated various difficult-to-visualized pathological pelvic subjects were identified. SAS-test positive sonographic assessment confirming the functionality of one or both uterine tubes’ funnel was obtained in 30 (69.75%) of 43 women. In 10 (23.25%) negative results of SAStest served as a ground for suspicion of altered fimbriae of fallopian tubes. In 3 (7.0%) cases test results appeared doubtful. Diagnostic accuracy of SAS-test was evaluated based on the laparoscopic findings. Pathology of fallopian tubes was confirmed laparoscopically in 8 women with positive, 9 with negative and 2 women with questionable results of SAS-test.Conclusion: the SAS-test can be used in the management of couples with unexplained infertility, when deciding on the advisability of laparoscopy. The TVS+MHAW method with its advantages in accuracy, non-invasiveness and safety profile, can serve as the first-line diagnostics of hard-to-see pelvic subjects associated with fimbriae of fallopian tube in subfertile female.
      PubDate: 2017-10-30
  • Clinical efficacy of pregravid preparation in induced pregnancy on a
           background of thyroid gland pathology

    • Authors: Т. Г. Романенко, О. І. Чайка
      Pages: 19 - 25
      Abstract: The aim of study. To increase the efficiency of reproductive function restoration in women with infertility on the background of thyroid gland pathology, prevent miscarriage, reduce the incidence of gestational complications, improve perinatal outcomes and reduce neonatal morbidity.Study design. 221 women with infertility on the background of thyroid pathology were examined. Patients were divided into two clinical groups. The group I consisted of 92 women with induced pregnancies (IB) who received pregravid preparation: oral Ogestan® micronutrient complex (potassium iodide in a daily dose of 150 μg, folic acid 400 mg, vitamin D 5 μg, omega-3 fatty acids 200 mg docosahexaenoic acid, vitamin E 12 mg), micronized progesterone (Utrogestan®) 200 mg in the II phase of the menstrual cycle was intravaginal. Group II (129 women) with IB did not receive pregravid preparation.Results. In the group I 56 women (60.9%) became pregnant after induction of pregnancy, in the group II – 62 women (48.1%). The level of hormones in the serum showed the clinical effectiveness of pregravid preparation according to the method proposed by the authors. Thus, in pregnant women of group I low normal levels of TSH and high normal levels of free T4 were noted, which is a prognostically favorable index for the induction of ovulation. On the levels of progesterone and estradiol in pregnant women of group II, the stress of functioning of the mother-placenta-fetus system was noted, which led to a significantly high frequency of obstetric and perinatal complications. Analysis of the flow of pregnancy and childbirth in the group I showed a significantly lower frequency of a number of complications, which led to a significantly lower frequency of abdominal delivery (64.0%) and neonatal morbidity in the early neonatal period (14.8%).Conclusion. The inclusion of the Ogestan® complex in the schemes of pregravid preparation of women with infertility on the background of pathology of the thyroid gland is an effective way to replace the deficiency of the most important micronutrients and can be recommended for practical use.
      PubDate: 2017-10-30
  • Expression of the mRNA of the inflammatory component of the immune
           response in the period of the expected window of implantation in women
           with recurrent pregnancy loss in the programs of assisted reproductive

    • Authors: К. П. Головатюк, В. Г. Дубініна, О. М. Носенко, Е. Т. Макшаєва, І. Л. Головатюк-Юзефпольська
      Pages: 26 - 30
      Abstract: The aim of study. To reveal the peculiarities of mRNA expression of the inflammatory component genes of the immune response in the expected window of the implantation in women with RPL in ART programs.Material and methods. 240 patients with RPL in ART programs and 100 conditionally healthy fertile women in the control group with the presence in history of at least one childbirth in time and the absence of episodes of miscarriage were examined. The average age of the examined women of the main group was 29.80 ± 0.30 years, the control group – 30.09 ± 0.32 (p >0.05). The average number of cases of involuntary termination of pregnancy after conduction of ART in main group was 3.24 ± 0.11, the average term of termination of pregnancy was 8.15 ± 0.65 weeks.All women had a paipel-biopsy of the endometrium during the expected implantation window. Samples were frozen at t = -70 °C. until the study. Reverse transcription -polymerase chain reaction was used to study mRNA expression of IL-1β, IL-2, IL-10, Foxp3, TLR9, IL-2Rα cytokine genes in endometrial biopsy obtained on the day of the implantation window.Results. It was found that the relative level of mRNA expression of IL-1β, IL-2, Foxp3, TLR9, IL-2Rα genes did not differ significantly in patients with RPL in the cycles of VRT and control group. A statistically significant decrease in mRNA expression of the IL-10 gene was noted.Conclusion. RPL in the treatment of infertile women in ART programs is associated with changes in the transcription profile of the endometrium during the intended implantation window and with a decrease in the expression level of the IL-10 gene mRNA.
      PubDate: 2017-10-30
  • Strategy of effectiveness in the modern concept of reproductive health

    • Authors: V. V. Bobrytska
      Pages: 31 - 33
      Abstract: The modern concept of reproductive health is based not only on the search for optimal methods of treatment of diseases, preservation of planned pregnancy, prevention of maternal and child morbidity and mortality, but, first of all, on preventive correction of pathological conditions. These problems were examined on the 17th World Congress of the International Academy of Human Reproduction which took place on March 15–18, 2017 in Rome. In particular, the section “Current Problems in Reproductive Surgery” examined the problems of diagnosing pathological conditions before surgery, as well as issues of effective prevention of the disease recurrence. Within the framework of the section the associate professor of the Department of Perinatology, Obstetrics and Gynecology of the Kharkov Medical Academy of Postgraduate Education V.V. Bobritskaya presented the report “Management of patients after surgical treatment for ovarian neoplasia.”The report described the results of data-analysis of the management of 140 patients after surgical treatment for benign ovarian tumors. A retrospective study of these results was presented: using combined oral contraceptives (COCs), combination of COCs and the metabolic oncoprotect drug Epigalin, as well as the results of the isolated use of Epigalin in the rehabilitation period (6–12 months). The aim of the study was to optimize the methods of preventing relapses of neoplastic processes in operated women of reproductive age.Among the observed patients, the best results were reported in the group receiving co-therapy COCs + Epigaline – no recurrence of ovarian neoplasia. In group I (COCs only) 1 case of the endometrioid cyst recurrence was observed, in group III (Epigalin only) – 1 case of the cyst of the yellow body recurrence. The expected maximum number of relapses (6) was observed in a group of women who did not take the recommended drugs during the rehabilitation period for various reasons.According to conclusion of the study authors, a combination of COCs with a low dose of 20 μg ethinyl estradiol and 150 μg desogestrel with 90 mg epigallocatechin-3-gallate and 400 mg indole-3-carbinol (Epigalin) can be considered as one of the optimal methods for preventing of ovarian neoplasia recurrence, and therapy of dyshormonal conditions. Preventative treatment must be performed in the postoperative period.
      PubDate: 2017-10-30
  • ESHRE guideline: management of women with premature ovarian insufficiency

    • Authors: L. Webber, М. Davies, Р. Anderso
      Pages: 41 - 48
      Abstract: Study question. What is the optimal management of women with premature ovarian insufficiency (POI) based on the best available evidence in the literature'Study design, size, duration. This guideline was produced by a multidisciplinary group of experts in the field using the methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to September 2014 and consensus within the guideline group on all recommendations.The GDG included a patient representative with POI. After finalization of the draft, the European Society for Human Reproduction and Embryology (ESHRE) members and professional organizations were asked to review the guideline.Main results и the role of chance. The guideline development group (GDG) formulated 99 recommendations answering 31 key questions on the diagnosis and treatment of women with POI. The guideline provides 17 recommendations on diagnosis и assessment of POI and 46 recommendations on the different sequelae of POI and their consequences for monitoring и treatment. Furthermore, 24 recommendations were formulated on hormone replacement therapy in women with POI, and two on alternative и complementary treatment. A chapter on puberty induction resulted in five recommendations.Limitations, reasons for caution. The main limitation of the guideline is that, due to the lack of data, many of the recommendations are based on expert opinion or indirect evidence from studies on post-menopausal women or women with Turner Syndrome.Wider implications of the findings. Despite the limitations, the guideline group is confident that this document will be able to guide health care professionals in providing the best practice for managing women with POI given current evidence. Furthermore, the guideline group has formulated research recommendations on the gaps in knowledge identified in the literature searches, in an attempt to stimulate research on the key issues in POI.
      PubDate: 2017-10-30
  • Š¢reatment of uterine cervical dysplasia on the background of hyper
           proliferative disease of the corpus uteri in women of reproductive age

    • Authors: В. К. Кондратюк, Н. Є. Горбань, Н. П. Дзісь, А. І. Нарольська
      Pages: 52 - 57
      Abstract: The work is devoted to increasing the effectiveness of treatment the dysplastic lesions of the cervical epithelium (DLCE) on the background of hyper proliferative diseases of the uterine body (HDUB) in women of reproductive age by developing a complex of diagnostic and therapeutic measures based on the study of clinical, cytological, colposcopy, microbiological, virological, morphological and immune histochemical features of the cervical epithelium.The results of treatment of 90 women of reproductive age with DLCE on the background of HDUB were analyzed. Criteria for inclusion of patients in the study: CIN I, CIN II, CIN III, uterine leiomyoma, endometriosis of the uterus, papillomaviruses. Women of the main group (45 patients) received the developed diagnostic and treatment complex. The comparison group consisted of 45 patients, whose treatment was performed in accordance with regulatory documents.Subject to confirmation of the inflammatory process of the pelvic organs, the participants of the study performed complex anti-inflammatory therapy (antibacterial, antiviral) taking into account the antibioticogram on the background of the immunomodulator, as well as antifungal, desensitizing, hepatoprotective and enzyme therapy. In particular, the immunomodulator tilorone and local anti-inflammatory treatment were used. Four weeks after the end of the conservative treatment, the elimination of pathogens and normalization of the microbiocenosis in 77.8% of the patients of the main group and in 64.4% of the women of the comparison group was confirmed.In 33.3% of the women of the main group and 31.1% patients of the comparison group radio wave conization of the cervix was performed. For the prevention and treatment of intra- and postoperative bleedings during the surgical treatment of DLCE an anti-fibrinolytic drug was used. To improve the regenerative properties and prevent recurrence of DLCE in the postoperative period rehabilitative treatment with vaginal suppositories containing 100 mg of dexpanthenol and 16 mg of chlorhexidine bigluconate was used.As the authors of the study noted, the use of complex of diagnostic and therapeutic measures in women of reproductive age with DLCE on the background of HDUB contributed to increase of the effectiveness of DLCE surgical treatment in 1.2 times, which allowed to safely use hormonal treatment of hyper proliferative pathology of the uterus body.
      PubDate: 2017-10-30
  • The role of endothelial dysfunction in the development of clinical
           manifestations of climacteric syndrome in premenopausal women

    • Authors: О. В. Занько, Л. В. Болгова, Н. В. Коваленко, Т. Ф. Татарчук, Н. В. Яроцька
      Pages: 58 - 64
      Abstract: The aim of the study was to determine the state of vascular microcirculation in women with clinical manifestations of climacteric syndrome (CS) and to study the efficacy of using oral forms of L-arginine in its treatment.Materials and methods. 62 patients aged 40–50 years were examined: 30 patients with clinical manifestations of CS and 32 patients without signs of CS. The severity of CS was assessed using the menopausal rating scale (MRS). The study of hormonal homeostasis consisted in determining the levels of estradiol, FSH, LH, TSH and prolactin. The evaluation of the state of the vessels of the microcirculatory bed was carried out with the help of a test with «reactive hyperemia» and laser doppler fluorometry (LDF) with occlusion test. All patients with signs of endothelial dysfunction were prescribed an oral form of L-arginine –Valargin in a dose of 1 tablet per day during 1 month, after which a repeated examination of the state of the vascular endothelium was carried out.Results. When comparing the hormonal status, a decrease in the average level of estradiol and an increase in the average FSH indices in the main group were found in comparison with the control group. Based on the results of the test with «reactive hyperemia», a significantly higher level of pathological response to occlusion was revealed in comparison with the control group.In addition, a significant direct correlation was found between the level of estrogens and the index reflecting the activity of endotheliocytes. 1 month after Valargin application the degree of CS on the MRS scale decreased from 14.7 ± 1.5 to 8.6 ± 1.3 points.Conclusion. In patients with clinical manifestations of CS endothelial dysfunction is more reliably detected. This requires additional testing and the use of preventive measures aimed at preventing cardiovascular pathology. The efficacy of oral forms of L-arginine in adequately high doses, in particular Valargin, in the treatment of endothelial dysfunction and the positive effect of this therapy in patients with CS is proved.
      PubDate: 2017-10-30
  • Evaluation of efficiency of correction climacteric syndrome in women of
           perimenopausal period with reproductive disturbances in anamnesis

    • Authors: С. О. Шурпяк, В. І. Пирогова, М. Й. Малачинська
      Pages: 65 - 68
      Abstract: The article deals with the issues of application of menopausal hormone therapy (MHT) in women of perimenopausal age with menopausal syndrome and reproductive disorders in the anamnesis.46 women with moderate or severe degree of climacteric syndrome and reproductive disorders in the anamnesis (the main group) who received the drug Climonorm on a three-week schedule with a seven-day break were examined. The comparison group consisted of 19 patients of the same age who had contraindications to the use of MHT.In a reproductive history in patients marked loss of pregnancy at different gestational age; PID; operative interventions for benign ovarian tumors, ectopic pregnancy, genital endometriosis, infertility; abnormal uterine bleeding, not associated with pregnancy or the presence of uterine fibroids. During the period of inclusion in the study, 38.5% of women were regular menstrual circle (MC), 15.4% reported intermenstrual bleeding, 18.5% had hyperpolymenorrhea, and 27.6% had acyclical uterine bleeding of varying intensity. Patients showed complaints of hot flashes, night sweats, sleep disturbances, headache, dizziness, emotional lability, depression, fatigue, muscle and joint pain. Before the beginning of therapy, the severity of menopausal syndrome according to MMI was 47.0 ± 6.1 in the main group, in the comparison group – 45.3 ± 6.9.In the case of MC disorders, a pendulum biopsy of the endometrium or hysteroscopy with separate diagnostic scraping of the walls of the cavity and cervix of the uterus was performed.Morphological examination in 67.9% of cases verified endometrium in the stage of proliferation, in 32.1% – simple non-atypical endometrial hyperplasia.After 6 months of treatment, the patients of the main group had a pronounced positive dynamics of climacteric complaints, the average value of MMI after treatment decreased from 47.0 ± 6.1 to 10.2 ± 1.4 points (p <0.001). In a dynamic US examination, the negative dynamics of M-echo indices was not recorded, 86.3% of women with MC disorders before the start of treatment noted regular menstrual bleeding in the interval between the Climonorm doses.MHT with the use of the Climonorm allows to effectively reduce the severity of manifestations of the climacteric syndrome by 80–60%, ensures the regularity and stability of the MC.The appointment of a cyclic combination of MHT with a strong progestogen component (levonorgestrel) has advantages in women with non-atypical hyperplastic processes in the perimenopause, since it prevents recurrence of uterine bleeding with a reduction or complete reduction of menopausal symptoms and no adverse effect on the endometrium.
      PubDate: 2017-10-30
  • Treatment of disorders in menopausal women with hyperproliferative
           processes of reproductive system

    • Authors: Л. І. Бутіна
      Pages: 70 - 74
      Abstract: Objective. Evaluate the effectiveness of treatment of disorders in menopausal women with hyperproliferative processes of reproductive system (HPPRS).Materials and methods. The treatment was performed in 36 women after hormone prevention (HP) of neurovegetative and psycho-emotional disorders in menopause (NVPDM) and in 31 women after naturally menopause aged 48 to 60 with the signs of HPPRS according to the data of ultrasound uterine and the results of histology investigations of mucosal scrapings from the uterus. The control group consisted of 35 healthy women of the same age category. The treatment was carried out by the appointment of elaborated complex of preparation, which included a combined homeopathic preparation, a preparation from the microalgae Spirulina platensis, pectin and an anxiolytic agent with the active substance mebicar. To assess the effectiveness of therapy, hormonal homeostasis was studied before and after treatment.Results of the study. In 31 women with menopausal HPPRS after naturally menopause the increase of FSH was observed in 1.4 times, estradiol – in 1.4 times, compared with healthy women. After HP use in 36 women the level of FSH decreased in 2.2 times, but the level of estrogens increased in 1.9 times, progesterone level increased in 1.4 times compared with healthy women. After treatment in women with naturally menopause the levels of FSH increased on 36%, estradiol – on 29%. In women after HP and treatment the level of estrogens decreased in 3.2 times, the level of FSH increased in 1.4 times but it level decreased on 35% compared with healthy women. But most of the symptoms of NVPDM in women of both subgroups disappeared.Conclusions: In women with HPPRS was observed a greater level of sex hormones than healthy ones, which is provided by the increased production of gonadotropic hormone and is accompanied by the development of NVPDM. The use of HP and treatment reduces the intensity of NVPDM on account of gonadotropins level reduction compared with healthy women.
      PubDate: 2017-10-30
  • Melatonin: influence on life quality and personality profile of women of
           late reproductive and pre-menopausal age with endometrial pathology

    • Authors: С. М. Корниенко, Ю. В. Давыдова
      Pages: 75 - 77
      Abstract: The aim of the work. To investigate the relationship of melatonin with the quality of life and the profile of the personality of women of late reproductive and premenopausal age with the pathology of the endometrium.Materials and methods. 45 women aged 36–55 years with endometrial diseases were examined. All patients underwent hysteroscopy. The personality profile was assessed using the FPI test. To study the quality of life, the SF-36 questionnaire was used. The data was processed using the Spearman rank correlation.Results. As a result of the correlation analysis of data on melatonin concentration and SF-36 scales, our study found that the value of melatonin did not affect the quality of life associated with health. However, if we evaluate trends, then the highest of the reduced correlation coefficients is of some interest. It’s about role physical functioning. The correlation coefficients of the melatonin index and the scales of the FPI questionnaire looked as follows: all significant correlation coefficients had a negative sign, that is, the personality properties corresponding to these coefficients were associated with a low concentration of melatonin. The ordering of the FPI scales by decreasing the significance of the correlation coefficients helped to identify the personal profile of hypomelatoninemia in the examined women. First of all, it was characterized by high levels of depressiveness and emotional lability.Conclusions. In the psychopathological structure of the personality of women of late reproductive and pre-menopausal age with endometrial pathology burdened with hypomelatoninemia, depressive and emotional lability is predominate. Reducing the secretion of melatonin is also associated with increased spontaneous aggressiveness, neuroticism and irritability.
      PubDate: 2017-10-30
  • Vitex agnus-castus dry extract BNO 1095 (CyclodynonĀ®) inhibits uterine
           hyper-contractions and inflammation in experimental models for primary

    • Authors: J. Röhrl, O. Werz, A. Ammendola, G. Künstle
      Pages: 78 - 88
      Abstract: Background. For many women, the monthly suffering induced by menstrual “cramps” is severe enough to profoundly disrupt their quality of life. In the case of primary dysmenorrhea, a condition related to premenstrual syndrome (PMS), intense uterine contractions are thought to trigger moderate to intense pain despite the absence of an underlying infection or other medically-identifiable disease states. The associated uterine hyper-contractility is reminiscent of labor, and associated pain is likely to be mediated by the release of prostaglandins, leukotrienes and the infiltration of leukocytes that normally accompany the breakdown of the endometrial lining.Standardized extracts of Vitex agnus-castus berries (VAC extracts of chaste tree, or chaste berries) are clinically effective in treating the symptoms of PMS, yet the mechanisms of how the chemically complex mixture acts are largely unknown.Methods. Using an in vivo dysmenorrhea model rats were treated with 10 mg/kg estradiol-benzoate i.p. once daily for 12 days and with 2.1, 10.3 or 20.7 mg/kg VAC dry extract p.o. once daily for 7 days prior to induction of convulsions. Uterine contractions where induced with 2 IU/kg oxytocin i.p., followed by monitoring of abdominal convulsions and signs of pain on the last day of the experiment. Moreover, in vitro methods were applied that are described in the methods section.Results. Here, we show that the VAC herbal dry extract BNO 1095 (commercially available as Cyclodynon®) targets the uterine myometrial tissue and inflammatory signaling molecules of associated migratory/inflammatory cells. Specifically, BNO 1095 dose-dependently inhibited oxytocin-induced uterine contractions in a rat dysmenorrhea model in vivo and drug-induced contractions in isolated human and rat uterine tissue in vitro. Furthermore, BNO 1095 showed a promising anti-inflammatory capacity by potently inhibiting 5-lipoxygenase activity and leukotriene production and by reducing the production of reactive oxygen species and inflammatory cytokines in vitro.Conclusion. These results provide evidence that BNO 1095 effectively treats menstruation-related complaints including primary dysmenorrhea.
      PubDate: 2017-10-30
  • Differences in circulating non-transferrin-bound iron after oral
           administration of ferrous sulfate, sodium iron EDTA, or iron polymaltose
           in women with marginal iron stores

    • Authors: K. Schümann, N. W. Solomons, M. Orozco, M. E. Romero-Abal, G. Weiss
      Pages: 89 - 96
      Abstract: Background. The adverse interactions between iron supplements and malaria have driven the assessment of new therapeutic options for anemia prophylaxis in areas holoendemic for falciparum malaria.Objective. To determine the responses of circulating non-transferrin-bound iron (NTBI) and plasma iron to three different oral iron compounds – ferrous sulfate, sodium iron ethylenediaminetetraacetate (NaFeEDTA), and iron polymaltose (IPM) – in women with marginal iron stores.Methods. Serum samples from 10 Guatemalan women with marginal iron stores were collected every 90 minutes over a period of 270 minutes, after the individually randomized administration of 100 mg of iron from each of the three studied iron compounds or water alone. Serum iron concentration was quantified by the ferrozine method, and circulating NTBI concentration was determined with a fluorometric competitive binding assay. Kinetic responses and maximal cumulative changes in serum concentrations of iron and NTBI were compared between the four treatments. Comparison was made with data from the same protocol in iron-adequate men.Conclusions. The administration of the two “slow-release” iron compounds, NaFeEDTA and IPM, resulted in a highly significant suppression of the appearance of NTBI in the circulation in the postsupplement period. These two bioavailable forms of iron supplement could represent a safe option for supplementation in malarial areas. The slope of the iron – NTBI relationship is steeper in men than in women.
      PubDate: 2017-10-30
  • Laboratory diagnostics and management of gestational diabetes at the
           current stage

    • Authors: Л. А. Луценко
      Pages: 97 - 100
      Abstract: Gestational diabetes is a violation of carbohydrates tolerance of any severity that detected for the first time during pregnancy. The need for timely and accurate diagnosis of gestational diabetes is caused by a high frequency of pregnancy complications and neonatal morbidity.The oral glucose tolerance test is recommended to use for the gestational diabetes diagnostics. This test is considered positive (the diagnosis of gestational diabetes installed), if at least one of the glucose indicators exceeds normal levels. The optimal duration of oral glucose tolerance test is 24–28 weeks of pregnancy; in exceptional cases is up to 32 weeks (at high risk for gestational diabetes, ultrasonic symptoms of diabetic fetopathy).Glycated hemoglobin (HbA1c) evaluations can a useful as a test to assess the state of carbohydrate metabolism during pregnancy. HbA1c provides an integrated view of the level of blood glucose over a long period of time, can be used in the detection and monitoring of carbohydrate metabolism disorders during pregnancy. Many studies have confirmed the assosiation of glycated hemoglobin and blood glucose level. Determination of glycated hemoglobin has several advantages: the test result on HbA1c is independent of food intake (possible evaluation is not an empty stomach, which is important for toxicosis in pregnant), patient’s psycho-emotional state, blood samples can be carried out at any time (stable over a wide temperature interval and time).If diagnosis of “gestational diabetes” confirmed it is recommended diet with restriction of carbohydrate and fat, dosed physical activity and glycemic control. Criteria for gestational diabetes compensate on the diet background: fasting glucose level < 5.0 mmol/l, in 1 hour after ingestion < 7.5 mmol/l. Inability to achieve glycemic targets within 2 weeks of self-control or the presence of ultrasonic signs of diabetic fetopathy are indications for insulin therapy.
      PubDate: 2017-10-30
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