Obstetric Problems Research Articles

Helicobacter Pylori Infection among Pregnant Women with Different Obstetric Problems

Helicobacter Pylori Infection among Pregnant Women with Different Obstetric Problems

Assessment of Maternal Mortality Rate and Associated Risk Factors at Tertiary Hospitals in Burundi (2020-2021): A retrospective Cohort Study

Background: Burundi continues to struggle with maternal mortality (MM). Early risk factor identification is crucial for thorough intervention measures to be developed to prevent pregnancy-related problems. Objective: To investigate maternal mortality rate (MMR) and identify its associated risk factors among women aged 15 to 49 years at four tertiary hospitals in Burundi. Methods: We collected data describing all pregnancies from January 2020 to December 2021 among women enrolled in Centre Hospital-University of Kamenge (CHUK), Military Hospital of Kamenge (MHK), Prince Regent Charles Hospital (PRCH), and Clinical Hospital Prince Louis Rwagasore (CHPLR) referral hospitals. We reported the proportion of mothers who died per pregnancy and the MMR. Multivariate regression models were used to determine the maternal, pregnancy-related, delivery, and postpartum factors that were associated with maternal death. Results: There were 31,968 deliveries in total in CHUK, MHK, PRCH, and CHPLR referral hospitals, 125 of which resulted in maternal fatalities. The total live births were 31,067, yielding an MMR of 402/100,000 live births. Our findings suggest significant associations between MMR and direct and indirect causes of maternal death, (F (8, 116) = 2.18, p < .05); haemorrhage and uterine rupture, where p was less than 0.05; community-level characteristics, (F (7, 117) = 9.91, p < .05); and type of delay, (F (3, 121) = 2.76, p < .05). Whereas, second delay was significantly associated with MMR, with p = 0.005. Conclusion: Reducing maternal fatalities in CHUK, MHK, PRCH, and CHPLR requires the implementation of ANC programs on the management of obstetric problems.

Monitoring of the intrauterine state of the fetus. Question history. New possibilities of phonocardiography

The problem of decreasing perinatal mortality is one of the pressing problems in modern obstetrics. Unfortunately, current methods of monitoring the intrauterine state of the fetus that are at the disposal of an obstetrician – gynecologist (сardiotocography, Doppler velocimetry) do not guarantee fetal wellbeing in the near-term outlook, and the number of tests is limited due to safety concerns. Consequently, there is ongoing search for alternative methods of obtaining information about the intrauterine state of the fetus (phonocardiography, electrocardiography). Using IT and mathematical data analysis has considerably enlarged the phonocardiography potential, including implementation of remote monitoring of the fetal health state.A Tomsk-based company Diagnostika + LCC developed software and hardware appliance FetalCare aimed at 24-hour monitoring of the intrauterine state of the fetus based on audio data on the fetal cardiovascular system. Cardiointervalograms (CIG) obtained by phonocardiography allow to estimate the state of the fetus based on standard assessment criteria: basal heart rate, heart rate variability, presence of accelerations and decelerations, short-term variation (STV), and long-term variation (LTV). The developed appliance is non-invasive, relatively cheap, portable, and safe both for the mother and the fetus.

Postdate Pregnancy Maternal and Fetal Outcomes among Sudanese Women

Background: Postdated pregnancy is one of the most common obstetric problems associated with increased maternal morbidity, prenatal morbidity, and mortality. Pregnancy at 37-40 weeks of gestation is called the term from the last menstrual period. If the pregnancy exceeds 40 weeks, it is called a postdated pregnancy, but when pregnancy is prolonged beyond 42 weeks, it is called post-maturity or post-term pregnancy. Objective: This study aimed to determine the adverse effects of postdate pregnancy on mothers and fetuses. Methodology: This was a descriptive, prospective, cross-sectional, hospital-based study conducted at Omdurman Maternity Hospital from January 2018 to June 2018. An interview questionnaire was used to collect data. Data were collected by trained doctors in the labor room. One hundred and thirty-eight (138) postdated pregnant women were included in this study after obtaining informed consent through a structured questionnaire. Demographic and clinical data concerning personal history, booking status, mode of delivery, maternal complications, and fetal complications were recorded. Results: During the study period, 2751 women delivered, of which 138 were postdated deliveries, with a prevalence of 5%. Most women's age range was 31-34 years 48.6%). Their education level was mostly secondary school (42%). Primigravida 65%), booked were 75.4%. Previous history of postdate pregnancy was 34.1%, normal vaginal delivery was 79 .7%, cesarean section was 14.5%, and instrumental delivery 5.8%. Cesarean section indications were cervical dystocia (14.4%), cephalopelvic disproportion (9.5%), meconium-stained liquor with fetal distress (33.3%), pathological cardiotocography (CTC) (19%), and failure to progress (23.8%). Maternal complications included post-partum hemorrhage (PPH) (7.2%), perineal tears (.7%, cervical tears (1.4%), and postpartum infections (1.4%). Fetal complications were 14.5%, Shoulder Dystocia 2.9%, asphyxia (6.5%), and meconium aspiration (5.1%). The mean APGAR score was 1.1667, less than three in only 3.6%, and > 7 in 86.9%. Neonatal death was 3%. Approximately 18 neonates were admitted to the Neonatal Intensive care unit (NICU) and only five of them were admitted for more than one week. Conclusion: Postdate pregnancy prevalence in this study was 5%, which was associated with maternal risk of cesarean section delivery, instrumental delivery, postpartum hemorrhage, and postnatal infection.

Prophylaxis of decidual CD68+/CD163+ macrophage disbalance in extracorporeal fertilized women

The demographic crisis that prevailed in Ukraine in recent years, the state of war as a result of the aggression of the Russian Federation, reproductive losses among women of childbearing age are one of the most urgent problems in modern obstetrics and gynecology. One of the most effective methods of correcting impaired reproductive function is in vitro fertilization. The purpose of this workis to develop a pharmacological complex for the prevention of imbalance of CD68+/CD163+ decidual macrophages in vitro fertilized women. Materials and methods105 pregnant women who were divided into 3 groups took part in the study. The first group included 20 women whose pregnancy occurred and is proceeding physiologically. The second group consisted of 85 women who became pregnant as a result of in vitro fertilization, including 37 pregnant women who refused prophylactic correction of the threat of premature birth, and 48 pregnant women who received prophylactic correction of the threat of premature birth: complex prescription of vitamin D3 2000 IU orally 2 times a day, micronized progesterone 200 mg 2 times a day and l-arginine aspartate 1000 mg 4 times a day, starting from 18 to 20 weeks of pregnancy. ResultsIn women who refused prophylactic correction of the threat of premature birth, a local increase in the activity of inducible NO-synthase and concentration of tumor necrosis factor-α, and a decrease in the activity of arginase and in the level of interleukin-10 were observed in the cervical mucus. They have a lower expression of CD163+ on placental decidual macrophages and an increased expression of CD68+, which indicates a shift in the polarization of macrophages from an anti-inflammatory to a pro-inflammatory phenotype. The use of prophylactic treatment brings the studied parameters closer to the results of women in whom pregnancy occurred physiologically. ConclusionsIn women who became pregnant as a result of in vitro fertilization, at 28–30 weeks of pregnancy, changes specific for pro-inflammatory phenotype of decidual macrophages were observed. Complex administration of vitamin D3, micronized progesterone and l-arginine aspartate lead to restoration of anti-inflammatory phenotype of decidual macrophages.

Estimated prevalence study of attention-deficit/hyperactivity disorder among eastern province children in the Kingdom of Saudi Arabia.

Studying mental disorders in children is significantly important due to the huge suffering of educational and psychosocial impairments in adult life. Attention-deficit/hyperactivity disorder (ADHD) is considered the most common mental disorder in children, especially in early school-aged children. It manifests in about 8%-12% of children in the world. In Saudi Arabia, it affects 4%-12% of children. The study aimed to count the number of undiagnosed ADHD cases and the associated risk factors in Eastern Province in Kingdom of Saudi Arabia (KSA). A cross-sectional study was performed among girls' and boys' children aged 6-10 years old in Eastern Province in KSA with a random selection of parents. Sample size is equal to 1658. The assessment was done by an online questionnaire filled it by parents using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria and Connor's scale of ADHD excluding any developmental or mental disorder at the beginning of the questionnaire. After excluding the participants who were diagnosed with behavioral and growth developmental disorder, the remaining 1430 have been screened for ADHD based on Connor's scale. 185 of a child out of 1430 were suggested to have ADHD, of which 10 out of them show the signs of ADHD, 76 of them have moderately severe ADHD, and 99 out of them have atypical or severe ADHD based on Connor's scale of ADHD. The study shows that there is a significant relationship between the positive screening of ADHD and gender males (71.35%), females (28.64%), family history (20.5%), nervous system diseases (4.32%), brain damage from trauma (9.72%), smoking habit of the mother (8.64%), smoking during pregnancy (3.78%), mother exposure to second-hand smoking (42.16%), child exposure to a toxic substance like lead during the early life (1.62%), and the preterm labor (15.13%). However, the study shows there is no significant relationship between the positive screening of ADHD with age, drinking alcohol, and central nervous system infection. The prevalence of undiagnosed ADHD is slightly high. Also, it has many causes of ADHD including gender, smoking, parental psychiatric disorders, and obstetric and pregnancy problems.

Modern obstetrics: science, practice, aspects of teaching

The article discusses the problems of obstetrics from different perspectives - science, practice, teaching - based on a review of modern technologies for reducing maternal and perinatal mortality, as well as current aspects of treatment of gynecological patients.The purpose of the study is to show that the use of modern scientific achievements and their application in practice and the educational process will improve the quality of education of students and interns at the departments of obstetrics and gynecology. We applied the results of scientific research of the department staff in the educational process. Modern, highly effective approaches to lectures with the introduction of discussion elements are presented. The structure of question-and-answer methods, their use in practical classes, which contribute to the emergence of professional competence of interns and significantly increase the efficiency of their perception of academic material, are described in detail.

Risk factors for placenta previa among pregnant women of Kyiv, Ukraine: a retrospective cohort study

Placenta previa is a significant obstetric problem with elevated morbidity and mortality rates for both mother and fetus. The risks associated with placenta previa underscore the necessity for comprehensive treatment and timely intervention to mitigate adverse outcomes. Purpose - to conduct a retrospective analysis of the impact of obstetric-gynecological factors on the prediction of placenta previa occurrence and its influence on perinatal outcomes. Materials and methods. A retrospective cohort study was conducted on cases of placenta previa between 2018 and 2022. The study included 22491 deliveries, of which 65 (0.29%) cases were registered as placenta previa. Data from delivery records of 374 patients without placenta previa were used for comparison. The following variables were evaluated for all patients: maternal age, characteristics of the menstrual cycle, gravidity, parity, history of cesarean sections, gestational age at delivery, method of delivery, blood loss during delivery, length of postpartum hospitalization, birth weight, gender of the newborn, Apgar scores at 1 and 5 minutes. Gynecological intervention histories, including curettage/hysteroscopy, laparoscopy, and cervical treatment, as well as obstetric pathologies, such as cesarean section, ectopic pregnancy, instrumental abortions, missed pregnancies, and assisted reproductive technologies in the last pregnancy, were examined. Results. Multifactorial analysis revealed four significant risk factors. The risk of placenta previa was found to increase with advanced maternal age (p<0.001), OR=1.14 (95% CI 1.07-1.20), and the presence of previous cesarean sections (p<0.001), OR=5.51 (95% CI 2.73-11.1), while a history of previous deliveries reduced the risk (p<0.001), OR=0.24 (95% CI 0.15-0.40). Instrumental abortions increased the risk of placenta previa (p=0.001), OR=2.14 (95% CI 1.20-3.81). Newborns in the placenta previa group had lower Apgar scores at 1 and 5 minutes and lower birth weight. Conclusions. The obtained results emphasize the importance of considering risk factors in assessing placenta previa occurrence during antenatal monitoring and can contribute to improving obstetric and perinatal care for women. However, the morphological and functional basis of placenta previa remains unknown and requires further study. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. No conflict of interests was declared by the authors.

Antenatal Care - How to ensure quality!

Antenatal Care - How to ensure quality!

High Neutrophils to Lymphocytes Ratio in Maternal Blood Serum as Risk Factor for Preterm Premature Rupture of Membrane

Introduction: Neutrophil-to-lymphocyte ratio (NLR) has been extensively studied as a prognostic factor for various diseases based on systemic inflammation. Premature rupture of membranes (PROM) is an obstetric problem that does not only occur in term pregnancies but can also occur in preterm pregnancies. One of the main etiologies for premature rupture of membranes is inflammation. Knowing the difference in the NLR between preterm prematurerupture of membranes (PPROM) and without PPROM is important to increase understanding of the crucial role of NLR in predicting the incidence of PPROM.
 Method: This analytic case-control study compared NLR values ??in maternal blood serum between PPROM and without PPROM. This research was conducted in the emergencydelivery room and obstetrics and gynecology outpatient clinic at Prof. dr. I.G.N.G. Ngoerah Hospital Denpasar from February to June 2022.
 Results: A high NLR in maternal blood serum may be a risk factor for PPROM. Patients with a high NLR had a 4.5 times greater likelihood of experiencing PPROM than those with a low NLR (OR = 4.5; 95% CI = 1.4 – 13.83; p = 0.007).
 Conclusion: A high NLR in maternal blood serum is a marker of inflammation with an increased risk of 4.5 times for the occurrence of PPROM.

Чрезмерная рвота беременных: диагностика, лечение, профилактика осложнений

The article is devoted to one of the urgent problems of modern obstetrics - early toxicosis and its especially severe form, in particular, excessive vomiting of pregnant women, and is aimed at diagnosing and treating, as well as preventing its complications.

Impact of Primary Cesarean Section on Grand Multiparous Women

Background: Grand multiparty is common obstetrical problem, in Sudan large families is desirable for cultural and religious backgrounds and higher incidence of grandmultipra is expected, the risk factors associated with adverse maternal outcomes have yet to be adequately investigated among grand multiparity need to delivered by primary cesarean section. Objective: The main objective was to determine impact of primary cesarean section on grand multiparous, it is indications and complications. Methodology: It was a descriptive prospective cross-sectional hospital-based study conducted at Omdurman Maternity Hospital during period October 2016 to March 2017. An interview questionnaire was used for data collection. Demographic and clinical data concerning personal history, parity, indications of primary cesarean section, type of Cs, maternal complication and neonatal complications were recorded. Also, multiparous less than five delivery, previous lower segment caesarean section, known medical disorders except anemia and twin pregnancy were excluded. Results: During the study period total of 113 grand multipara included, incidence of primary cesarean section in grand multipara was 10%. Indication in our study 22.1% due to malpresentation, fetl distress 15% and prolonged first stage 13.4%, prolonged second stage 12.4% and antepartum haemorrhage 11.5%. Postpartum haemorrhage developed in 9.7%, hysterectomy 1.8%, uterine tear 5.4% bladder injury fetal laceration 3.6%, spinal anesthesia headache 7%, post-partum pyrexia 5.3%, sepsis 4.4%, urinary tract infections were 2.7%. Conclusion: The finding in this study showed 10% incidence of primary cesarean section in grandmultipra. The most indications of primary cesarean section in grandmultipra malpresentation, fetal distress, prolonged first and second stage of labour. Most CS were emergency.

Coding Hotline

This month’s Coding Hotline addresses obstetric problems affecting newborns and evaluation and management with decision for hospitalization.

Association of Maternal Serum Magnesium Level with Preterm Labour

Background: Preterm labour is a major health problem in obstetrics. The cause of preterm labour is still unknown. The role of magnesium is also not clear. Recently, involvement of magnesium in physiological and pathological process of labour has been clearly demonstrated. Aims and Objectives: To see the association between maternal scrum magnesium level and preterm labour. Materials and Method: This cross-sectional comparative study was conducted in Department of Obstetrics and Gynecology, Sylhet M.A.G. Osmani Medical College Hospital, between January 2017 and December 2018. Thirty-five pregnant women with preterm labour were selected as case and 35 preterm age and gestational age matched pregnant women without having preterm labour were selected as control group. Serum magnesium concentration was measured. Results: The mean age (25.43 ± 4.62 years versus 24.40 ± 3.99 years; p=0.332) and the gestational age (31.31 ± 1.78 weeks versus 31.34 ± 1.84 weeks; p=0.974) did not differ between preterm labour group and control group. Serum magnesium level (mg/dl) was significantly lower in prelabour group compared to control group (0.90 ± 0.37 versus 1.69 ± 0.33; p<0.001). Conclusion: It is strongly suggested that maternal serum magnesium associated with preterm labor of unknown etiology

Calcium and vitamin D supplementation to pregnant women in urban maternity centre

Prevalence of vitamin D deficiency in pregnant women in India is high. There have been case reports from India of neonatal tetany and vitamin D deficiency in breast-fed infants. India initiated the calcium and vitamin D supplementation programmes for pregnant women a decade ago. There is a need to assess compliance with calcium and vitamin D supplementation and impact of supplements on vitamin D levels in pregnant women.Women attending antenatal clinic in an urban maternity centre who fulfilled the eligibility criteria and were willing to participate in the study were enrolled. They were given one month’s supply of supplements, and form for recording compliance and side effects and were followed up every month. Blood samples were drawn at enrolment and after three months of supplementation and plasma vitamin D levels were estimated.Two third of the women had vitamin D level below 20 ng/ml at enrolment There was excellent compliance with supplementation; women who were followed up consumed 94% of the tablets provided. None of the women had clinical signs suggestive of vitamin D deficiency or any major obstetric problems; their offsprings were healthy. A third of the pregnant women continued to have low vitamin D levels after three months supplementation.The current dose of supplements appears to be inadequate to correct the vitamin D levels in deficient individuals. There is a need to undertake studies to find out the optimal dose of vitamin D supplementation which corrects vitamin D deficiency as assessed by maternal vitamin D levels.

FETAL AND NEONATAL STATUS IN WOMEN WITH CEREBRO-VASCULAR DISORDERS AND RISK FACTORS FOR THEIR DEVELOPMENT

Introduction. Cerebrovascular diseases in pregnant women are one of the most important problems of modern obstetrics and perinatology due to the steady increase in maternal and neonatal morbidity. Diabetes mellitus and hypertensive disorders are two of the most common complications of pregnancy, which negatively affect both short-term and long-term outcomes for the mother, fetus and newborn.The aim of the study was to determine the state of the fetus and the newborn in pregnant women with cerebral disorders, taking into account risk factors (hypertension, diabetes mellitus).Material and methods. 92 pregnant women were examined, of which the main group (77 pregnant women) consisted of women with extragenital pathology, in particular, cerebrovascular disease - 20 (21.7%), hypertension - 23 (29.8%), diabetes mellitus - 34 (44.1%), the control group consisted of 15 pregnant women (16.3%) with physiological pregnancy and their newborns.Scientific research passed the bioethics commission, no violations were found (Protocol No. 7 of 05.04.2023).Statistical processing of the data obtained during the study was carried out using Microsoft Office Excel 2016 (Microsoft, USA) and Statistica 10.0 (StatSoft, USA). The significance of differences in the characteristics of dependent groups with signs of normal distribution was assessed by the paired Student's t-test (t-test of dependent samples).This work is a fragment of the complex research work of the Department of Obstetrics and Gynaecology №2 of Kharkiv National Medical University "Optimisation of diagnostics, treatment of diseases of the reproductive system and pregnancy complications in women with extragenital pathology", state registration number 0121U11923).Results. Cerebrovascular disease was represented by the consequences of traumatic brain injury in 8 (40%) cases, acute cerebrovascular accident (ischaemic, haemorrhagic) - in 5 (25%), epilepsy - in 5 (25%), encephalopathy in cerebral palsy - in 3 (15%), arteriovenous transformation, angiomatous cavity - in 2 (10%) cases. Among women of the hypertension group, pre-eclampsia was found in 11 (47.8%), gestational hypertension - in 8 (34.7%), and chronic hypertension - in 4 (17.4%) cases. Pre-gestational diabetes was detected in 8 (23.5%) pregnant women in the diabetic group, and gestational diabetes in 26 (76.5%).Doppler flowmetry examination of blood flow in the middle cerebral artery (MCA) revealed a significant decrease (p<0.05) in the pulsatile index in pregnant patients of the main group (1.24±0.09) compared with women with a physiological course of the gestational process (1.82±0.11). There was a difference in the systolic-diastolic ratio in the SMA between women of the main and control groups (2.4±0.2 and 3.5±0.3, respectively) (p<0.05).When analysing the acid-base status of newborns, it was noted that the pH values in the groups with extragenital pathology had a shift to the acidic side. These shifts were most pronounced in the group with placental dysfunction due to diabetes mellitus, where the pH averaged 7.18±0.05, against the background of increased PCO2 to 56.3±3.4 mm Hg (p<0.05), indicating the presence of respiratory acidosis in fetuses. A decrease in the deficit of alkaline bases in the fruits of this group to an average of -7.1±0.69 mmol/l (p<0.05) indicated the occurrence of manifestations of metabolic acidosis in them.Conclusions. Cerebrovascular disease was more common in pregnant women over 30 years of age, mostly residents of the region (80%), which may be due to high trauma, insufficient examination and treatment, housewives, due to the underlying disease, as well as with Rh-negative blood type (35%), hypertensive disorders, diabetes mellitus, placental dysfunction, and early delivery, which increases the risk of neonatal complications and perinatal morbidity. Hypertensive disorders and diabetes mellitus can be considered risk factors for the development of cerebrovascular disorders in pregnant women and perinatal complications.

INCIDENCE, INDICATIONS, RISK FACTORS, AND OUTCOMES OF EMERGENCY PERIPARTUM HYSTERECTOMY WORLDWIDE: A SYSTEMATIC REVIEW

Objective: The objective of this study is to provide a comprehensive analysis of the occurrence, indications, risk factors, outcomes, and management strategies associated with emergency peripartum hysterectomy on a global scale. Additionally, this study aims to compare the outcomes of this procedure across various income situations.
 Methods: A systematic search strategy was conducted across several electronic reference databases: PubMed, MEDLINE, EMBASE, ClinicalTrials.gov, Cochrane Library, Web of Science, and Emcare databases up to August 3, 2023. Duplicate publications, review articles, editorials, and incomplete articles were excluded.
 Results: This study presents an updated version of a previously conducted systematic review, which was originally published in 2016. The inclusion criteria for this study encompassed reports that provided data on the occurrence of emergency peripartum hysterectomy. Emergency peripartum hysterectomy was operationally defined as the surgical extraction of the uterus due to severe obstetric problems within a period of up to 6 weeks following childbirth. The process of title and abstract screening, as well as full-text review, was conducted with Endnote data management software. Out of a total of 8,775 papers that were reviewed, a subset of 26 articles published after the year 2015 were deemed eligible for inclusion. Consequently, the overall number of studies included in the analysis amounted to 154.
 Conclusion: There are significant variations in the occurrence of emergency peripartum hysterectomy across different income contexts. Women residing in lower-income settings face an elevated likelihood of experiencing emergency peripartum hysterectomy, as well as a greater burden of associated morbidity and mortality. The incidence of emergency peripartum hysterectomy is expected to rise because to the escalating prevalence of caesarean deliveries.

PREVALENCE OF DEPRESSION OR ANXIETY DURING ANTEPARTUM HOSPITALIZATIONS FOR OBSTETRIC COMPLICATIONS : A SYSTEMATIC REVIEW

Introduction: Women with pregnancy problems are more likely to develop perinatal mood disorders or relapse into underlying mood disorders. 
 Objective: This study aimed to look at the prevalence of prenatal depression and anxiety in women admitted to an antepartum ward for obstetric problems. 
 Methods: We searched Pubmed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and ClinicalTrials.gov for English-language papers published between establishing the database in July 2023. The cross-sectional, cohort, case-control, quasi-experimental, and randomized-controlled designs used in the selected studies were all related to the research goal. 
 Results: We discovered 8.799 papers and reviewed 7.918, included in the primary outcome systematic review. Using a 14-question checklist is used to assess the quality of each study. Depression was 34% (95% CI 27-41%), while anxiety was 29% (95% CI 16-43%). Significant clinical and methodologic heterogeneity between trials was expected, and it persisted even after planned a priori subgroup analysis and meta-regression. Nonetheless, the effect direction was constant across trials. There was no evidence of publication bias. 
 Conclusion: According to the current systematic review, one in every three pregnant women hospitalized for obstetric difficulties has clinical depression or anxiety symptoms, double the reported prevalence of prenatal depression or anxiety in the general obstetric population.

Coding Hotline

This month’s Coding Hotline addresses obstetric problems affecting newborns and evaluation and management with decision for hospitalization.

Comprehensive obstetric injury prevention based on the biological feedback method

Perineum injury is an important problem in obstetrics and causes dysfunction of the pelvic floor and prolapse female genital organs. The aim of the work is to reduce the incidence of obstetric injuries by integrated improved method of preparation for childbirth with biological feedback. Materials and research methods: Simple comparative controlled study case control was done in 175 pregnant women in two parallel groups. The main group consisted of 103 patients, trained to control the perineum muscle tone by innovative methodology. The comparison group is made up of 72 pregnant women who have passed standard preparation of a maternity school in a maternity clinic. Results: It was revealed that the perineal muscle tone correlated with high personal and reactive anxiety, which can cause birth injuries. The proposed method reduces the frequency and severity of perineum injuries (15.1 % versus 39.8 %) (OP = 2.6 95 % CI 1.5; 4.5). This makes it possible to recommend to include such method in the mothers school program.