Method a retrospective (post-partum) rapid diagnosis of placental insufficiency in the delivery room
(57) Abstract:The invention relates to the field of medicine. The newborn is separated from the placenta, crossing the umbilical cord, some distance of 25-30 cm from the umbilical ring. In this case, the length of the umbilical residue that is attached to the placenta, will be 26-28 see the Placenta immediately after birth looks, osupivaja, defined pathological areas and seals. Then the placenta weighed without preparing entirely with further calculation of the placental-fetal coefficient according to the formula K=(a-b)/C, where K - placental-fetal coefficient; And is the mass of the placenta with shells and the remnant of the umbilical cord; weight unpleasantry shells and stump equal to 103 grams; is the mass of the fetus at birth. For values of K=of 0.13 to 0.19 in the case of children born in the period of gestation 38-40 weeks and coefficient values To=from 0.2 to 0.23 in the case of premature births in the period 32-37 weeks of the placenta are compensated without macroscopically detectable in their pathological changes. When larger or smaller values in the specified period of gestation is diagnosed chronic secondary (developed in II and III trimesters of pregnancy) placental insufficiency important to identify e allows you to enhance, to extend the diagnostic capabilities, to objectively diagnose placental insufficiency immediately after the birth of the placenta. table 1. The invention relates to medicine and can be used in practical obstetrics and neonatology, pathology.Proposed many methods to determine the degree of compensation of the placenta during pregnancy and retrospectively.There is a method of evaluation of the uterine-placental blood flow during pregnancy when the radioisotope placentocentesis. This method is based on the visualization of the body, receiving its shielded areas of the dynamic characteristics of the receipt and distribution of radiopharmaceuticals (protein, labeled with radioactive technetium, indium), injected into the peripheral blood. The disadvantages of this method are its high cost, the introduction of radioactive blood protein, the necessity of special sophisticated equipment, the availability of radioisotope laboratories. Possible radiation exposure to the fetus (Saveliev, M. and other Placental insufficiency - M.: Medicine, 1991, S. 158-163).In clinical practice the method of ultrasonic diagnosti to evaluate quantitatively and qualitatively the uterine-placental blood flow, the blood vessels in the umbilical cord and great vessels of the fetus and to determine the amount of the placenta and its thickness, the period of gestation in size of the fruit. Advantages: highly informative, non-invasive, relatively simple, the safety for the fetus and the mother, the ability to use throughout pregnancy. Disadvantages of the method: the impossibility of rendering the placenta is located on the rear wall of the uterus, the need for highly qualified staff and the availability of expensive devices with high resolution (Savelyeva, M and other Placental insufficiency. - M.: Medicine 1991, S. 163-169.).Methods a retrospective assessment of fetoplacental circulation, i.e. after childbirth. The data obtained can be used for prognosis of early neonatal period and status of the newborn. For example, a method Crans, which is based on the perfusion of maternal and fruit parts placental glucose solution and the chemical composition of flowing and flowing solution. It is possible to measure the dynamic parameters of blood circulation. Disadvantages of the method: requires chemical laboratory, special equipment.Method Savelieva, M with co - stor is: at the moment of the eruption of the occipital tubercles of the head of the fetus to the mother is injected with 5 IU of oxytocin with glucose solution and after birth immediately separate the placenta external methods kateteriziruyut vessels of the placenta and washed them isotonic sodium chloride with heparin at the rate of 5000 IU/l, followed by her brandy 1% silver nitrate solution for Ranvier. Then the placenta is fixed in formalin and examined microscopically with morphometrics terminal of fetoplacental vessels (Saveliev, M. and other Placental insufficiency. - M.: Medicine, 1991, S. 169-170).A significant drawback of the method is that it can only be applied at physiological childbirth in the head previa. Childbirth by caesarean section or under development in childbirth complications, this method is inapplicable. The method requires special skills of medical personnel (catheterization of blood vessels of the placenta, infusion solutions, brandy), solutions and medicines. Morphometry of placentas takes a lot of time.Closest to the proposed method long practical use was proposed method a retrospective evaluation of blood supply to the fetus by calculating the placental-fetal coefficient (ACC) as the ratio of the weight of the placenta (the children's place without membranes and umbilical cord) to the weight of the fetus. It is known that CPD at term pregnancy varies from 0.13 to 0.19. It decreases when uvely - 0,22-0,23; 36 weeks - 0,19-0,1. In the event of the birth of premature babies CPD, as a rule, more of 0.2. Increase or decrease the values of CPD evidence of hyperplasia or hypoplasia of the placenta and consequently chronic placental insufficiency. Adverse prognostic sign in the case of premature birth is the value of CPD more 0,3 (Sulkevich Yu, Makkaveev M, Nikiforov B. Pathology of the placenta of man and its effect on the fetus. - Minsk: Belarus, 1968, S. 34-37; zemkova H. P., topchieva O. I. Clinical and morphological diagnosis of placental insufficiency. - L.: Medicine, 1973, S. 74 and 75).A significant drawback of this method is the necessity of the preparation of the placenta (separation from the placenta unpleasantry shells and the remainder of the umbilical cord) in a specially designed space in the hospital. Problems arise marking, recording and delivery of prepared placenta in the anatomic hospital for subsequent histological examination. In view of these disadvantages of the use of this method in the delivery room immediately after birth, the placenta is difficult. This method has found wide application in the anatomic compartments p what about the studies of the placenta conclusion is transferred to the maternity ward on the fifth-sixth working day and may not be used or lost, if there is no continuity between the pathological anatomical service, service, obstetric and pediatric advice. In this regard, the importance of the method is reduced.With the aim of obtaining reliable placental-fetal coefficient, standardized and simplified man-made processing of the placenta in the delivery room immediately after birth of the placenta, the maximum low cost method of determining the CPD was studied 270 placentae in cases of children born alive. We determined the size of the placenta, its thickness in the Central division, weight without membranes and umbilical cord, the weight of the shells and the remainder of the umbilical cord was measured length of the stump Considering that the length of the umbilical cord in normal full-term fetus 50-60 cm, the newborn was separated from the placenta, crossing the umbilical cord, some distance of 25-30 cm from the umbilical ring. Calculated placental-fetal ratio. Statistically obtained data is processed in the program Microsoft Excel. Placental histology was studied By morphological picture (Kalashnikov, E. P. Clinical and morphological aspects of placental insufficiency. Archives of pathology. So 50. - 1988, No. 5, S. 99-105; Milovanov, A. P. Pathology of the system mother - placenta - fetus: guidelines for physicians. Medicine, 1999, S. 279-309) all of the placenta in the article is; ) subcompensated placental insufficiency (second degree); 3) asthma placental insufficiency(third degree); 4) placenta without pathology (control group).In the control group, the weight of the shells and the stump was 103,677,5 g, stump length of 26.3±1,03 cm, mask placenta 510,922,84, fruit Weight 3406,9111,25, CPD 0,1501. Significant differences in the mass of the membranes and umbilical cord in 1-, 2-, 3-St group compared to the control was not detected (see table). In placentae 1-, 2-, 3-th groups identified macroscopically singular and plural white infarcts (seals in the placenta gray or white in color, determined macroscopically and with the feeling of the placenta), which are signs of chronic placental insufficiency. In groups of placentas with secondary (developed in II and III trimesters of pregnancy) chronic compensated and subcompensated placental insufficiency significant differences of the values of the placental-fetal coefficient compared with that of the control group (see table). Morphologically 30% of placentas with varying degrees of chronic placental insufficiency was detected signs of infection.ACC=(weight of placenta - 103 g)/ weight of the fruit.The proposed method is retrospective (post-partum) rapid diagnosis of secondary chronic placental insufficiency (developed in II and III trimesters of pregnancy) ensures the achievement of the technical result consists in raising awareness and expanding diagnostic capabilities.In addition, compared with the prototype method retrospective rapid diagnosis of placental insufficiency does not require preparation of the placenta, therefore, can be applied directly in the delivery room immediately after birth of the placenta. The method does not require additional financial costs, special skills and qualifications of medical personnel. To conduct this diagnostic method takes a minimum amount of working time is 1-2 minutesFurther clarification of the degree of compensation of the placenta does not preclude its subsequent morphological study.The proposed method is rapid diagnosis of secondary chronic placental insufficiency (razbivsheysya in the II-III trimesters of pregnancy) is as follows.After the birth of the placenta, while looking through the cold factor suggested above formula.Example 1. Newborn, was born in the gestation of 40 weeks. Birth weight 3660 g, body length 56 cm, score on a scale of Apgar at birth 6 points in 5 min - 8 points. The weight of the placenta 573, Macroscopically in the placenta diagnosed in three slices white heart attacks that are based on the maternal surface. Calculated placental-fetal ratio: ACC=(573-103)/3660=0,13. In this case, there are macroscopic signs of chronic placental insufficiency, the value of CPD corresponds to the lower limit of normal. The newborn clinically diagnosed hypoxia moderate severity. Conducted intensive therapy. On the third day with an increase of respiratory disorders of the newborn dies, despite ongoing therapy. Postmortem conclusion: the underlying disease. Telematicheskie form of pneumopathy (Code ICD-10 - P22.0). Background. Viral and mycoplasmal placenta. Etnicheskie placental insufficiency second degree.Example 2. Newborn P., gestation 39-40 weeks. Birth weight 3200 g, body length 54 cm, score on a scale of Algar 7 points after 5 min - 8 points. The weight of the placenta 440 g, placenta looked juicy, pathological changes macroscopically not found.
FIELD: medicine, psychiatry.
SUBSTANCE: one should isolate DNA out of lymphocytes of peripheral venous blood, then due to the method of polymerase chain reaction of DNA synthesis one should amplify the fragments of hSERT locus of serotonin carrier gene and at detecting genotype 12/10 one should predict the risk for the development of hallucino-delirious forms of psychoses of cerebro-atherosclerotic genesis.
EFFECT: more objective prediction of disease development.
FIELD: medicine, urology.
SUBSTANCE: one should conduct subcutaneous prevocational tuberculin test and, additionally, both before the test and 48 h later it is necessary to perform the mapping of prostatic vessels and at decreased values of hemodynamics one should diagnose tuberculosis. The information obtained should be documented due to printing dopplerograms.
EFFECT: more reliable and objective information.
1 ex, 1 tbl
FIELD: molecular biology.
SUBSTANCE: the suggested innovation deals with the fact that nucleic acids should be isolated directly out of the sample without pipetting stage but with the help of interconnected reservoirs being prepared beforehand. The above-mentioned vessels should be applied either separately or being interconnected according to standard microtitrating format. The sample should be mixed with a lyzing buffer and nucleic acids are bound with matrix in closed system including, at least, two interconnected reservoirs. Forced movement of sample's mixture and buffer back and forth from one reservoir into another one for several times through narrow passage provides their thorough intermixing. The method provides quick and safe isolation of nucleic acids.
EFFECT: higher efficiency.
44 cl, 4 dwg, 1 ex
FIELD: medicine, phthisiology, microbiology.
SUBSTANCE: diagnostic material is poured preliminary with chlorohexidine bigluconium solution, homogenized, kept at room temperature for 10-12 h and centrifuged. Precipitate is poured with Shkolnikova's liquid medium, incubated at 37oC for 3 days, supernatant part of Shkolnokova's medium is removed, fresh Shkolnikova's medium is added, and precipitate is stirred and inoculated on the dense cellular egg media. Sensitivity of the strain is determined in 3 weeks by the presence of growth in the control tube only. Invention provides enhancing precision and reducing time for assay. Invention can be used in assay for medicinal sensitivity of tuberculosis mycobacterium.
EFFECT: improved assay method.
FIELD: medicine, biotechnology, pharmacy.
SUBSTANCE: invention relates to agents used for treatment of pathological states associated with disorder of synthesis of neuromediating substances. Method involves the development of pharmaceutical composition and a method for it preparing. Pharmaceutical composition represents subcellular synaptosomal fractions: synaptic membranes, "light" synaptosomes and "heavy" synaptosomes prepared from gray matter of cerebral hemispheres from experimental animals based on the goal-seeking modification of humoral mediators of nerve endings transformed to synaptosomes in development and regression of malignant processes. The composition provides inhibiting the growth of tumor cells, to elevate span-life of patients with ascite Ehrlich's sarcoma, breast adenocarcinoma Ca-755, Wolker's carcinosarcoma-256.
EFFECT: valuable medicinal and anti-tumor properties of composition.
12 cl, 3 tbl, 3 ex
SUBSTANCE: method involves carrying out microscopic examination of blood serum samples taken from femoral vein and cubital vein. Femoral vein sample is taken on injured side. The examination is carried out before and after treatment. The blood serum samples are placed on fat-free glass slide in the amount of 0.01-0.02 ml as drops, dried at 18-30°C for 18-24 h. The set of pathological symptoms becoming larger or not changed after the treatment in comparison to sample taken before treatment, and morphological picture of samples under comparison taken from the cubital vein showing no changes or being changed to worse, the treatment is considered to be effective.
EFFECT: enabled medicamentous treatment evaluation in course of treatment to allow the treatment mode to be changed in due time; avoided surgical intervention (amputation); retained active life-style of aged patients.
FIELD: medicine, clinical toxicology.
SUBSTANCE: at patient's hospitalization one should gather the data of clinical and laboratory values: on the type of chemical substance, patient's age, data of clinical survey and laboratory values: body temperature, the presence or absence of dysphonia, oliguria being below 30 ml/h, hemoglobinuria, erythrocytic hemolysis, exotoxic shock, glucose level in blood, fibrinogen and creatinine concentration in blood serum, general bilirubin, prothrombin index (PTI), Ph-plasma, the state of blood clotting system. The state of every sign should be evaluated in points to be then summed up and at exceeding the sum of points being above "+20" one should predict unfavorable result. At the sum of "-13" prediction should be stated upon as favorable and at "-13" up to "+20" - prediction is considered to be doubtful.
EFFECT: higher accuracy of prediction.
2 ex, 3 tbl
FIELD: medicine, juvenile clinical nephrology.
SUBSTANCE: disease duration in case of obstructive pyelonephritis should be detected by two ways: either by detecting the value of NADPH-diaphorase activity, as the marker of nitroxide synthase activity in different renal department and comparing it to established norm, or by detecting clinico-laboratory values, such as: hemoglobin, leukocytes, eosinophils, urea, beta-lipoproteides, lymphocytes, neutrophils, the level of glomerular filtration, that of canalicular reabsorption, urinary specific weight, daily excretion of oxalates, arterial pressure, and estimating their deviation against average statistical values by taking into account a child's age.
EFFECT: higher efficiency of detection.
7 dwg, 1 ex, 6 tbl
FIELD: medicine, urology.
SUBSTANCE: the present innovation deals with differential diagnostics of prostatic cancer and other prostatic diseases at the stage of primary inspection. The method includes the detection of PCA and calculation of probability coefficient for prostatic cancer (PCC) by the following formula: where e - the foundation of natural logarithm (e=2.718…), PCA - the level of total blood PCA in ng/ml, V - patient's age in years. At PCC value being above 0.2 one should diagnose prostatic cancer and to establish final diagnosis one should perform polyfocal prostatic biopsy. The method enables to increase accuracy of diagnostics at decreased number of unjustified prostatic biopsies.
EFFECT: higher efficiency of diagnostics.
FIELD: medicine, biology.
SUBSTANCE: invention relates to nutrient medium used for accumulation of cells for the following cytological and/or immunocytochemical analysis carrying out. Invention relates to medium containing salts NaCl, KCl, anhydrous CaCl2, MgSO4 x 6 H2O, MgCl2 x 6 H2O, Na2HPO4 x 2 H2O, KHPO4, NaHCO3, and also glucose and Henx's solution, 10% albumin solution and polyglucin taken in the ratio 1:1:1. Invention provides enhancing the preservation of cells.
EFFECT: improved an valuable properties of nutrient medium.