Method for prediction of embryopathy in pregnant women suffering hypotheriosis and obesity

FIELD: medicine.

SUBSTANCE: pregnant woman suffering hypotheriosis and obesity on their 2-12 weeks of gestation are examined for a fT4 level. If the fT4 values are less than 10 pmol/l, macrosomic delivery is predicted.

EFFECT: use of the method enables high-accuracy prediction of macrosomic delivery.

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The invention relates to medicine, namely to obstetrics and gynecology, and allows to predict the development of fetopathy the child in early pregnancy in women with hypothyroidism, and obesity.

The urgency of the invention is defined by the relatively high frequency of occurrence (up to 1.86%) hypothyroidism among pregnant women. These women are significantly more likely to develop such pregnancy complications like hypertension, pre-eclampsia, placental abruption, intrauterine death, fetal defects, postpartum hemorrhage, which affects the health of not only women but also children (Fadeev V.V., Perminova YEAR, Nazarenko, T.A. Diseases of the thyroid and reproductive function in women: a manual for physicians. - M: IIA-PRINT. - 2009. - p.52).

One of these complications gestational process is the development of fetopathy often found in endocrine pathology in pregnant women.

The proposed method for predicting the development of fetopathy in pregnant women with obesity and hypothyroidism is based on the determination of free thyroxine (fT4) in serum for up to 12 weeks of gestation. Previously free thyroxine was used to diagnose hypothyroidism outside and during pregnancy.

A known method for predicting the birth of large fruit, characterized in that in order to increase the accuracy of the forecast zdorovyh women in the serum in the first stage of labor was determined by the number of total lipids and cholesterol in their content of 9.5 g/l or more and 9.0 mmol/l and above, respectively predict childbirth large fruit (patent No. 1415190. Stepankowsky G.K., Karpenko A.N., Pushkareva TI a Method for predicting the birth of large fruit. // The Bulletin " Discoveries. The invention". - 1988. No. 29. - s).

The above authors conduct the study in the first stage of labor in women that is not sufficiently timely for the early prevention of fetopathy type of large fruit, as has already happened pathogenetic changes leading to this disease, do not indicate the accuracy of the method and the possibility of using this method for the early prediction of childbirth large fruit, conduct lab tests on 2 indicators: the number of total lipids and cholesterol, this method is not specific, as these rates vary for many diseases.

The technical result of the proposed method lies in the fact that in peripheral blood serum of pregnant women diagnosed with hypothyroidism and obesity varying severity in 2-12 weeks of gestation to determine the level of fT4 and when the values of this index less than 10 pmol/l, predicted the birth of large fruit with an accuracy of 75%.

The method is as follows: in peripheral blood serum of pregnant women diagnosed with hypothyroidism and obesity varying severity in 2-12 weeks of gestation to determine the level of fT4 by the standard method.

p> First level fT4 defined in the first trimester of pregnancy used to predict the birth of a large fetus in women with obesity and hypothyroidism.

Established prognostic parameter content fT4 in serum of pregnant women in 2-12 weeks of gestation diagnosed with hypothyroidism and obesity, a value which is less than 10 pmol/l predicted the birth of large fruit.

Clinical example 1.

Pregnant N., 30. This second pregnancy. The body mass index of 41.5 kg/m2. The thickness of the placenta in 12 weeks was 11 mm, the Volume of the thyroid gland was 25.4 cm3. During the period of pregnancy arrived in weight 9 kg In the study of fT4 at 34 weeks of pregnancy it was 0.7 pmol/L. the Initial dose of L-thyroxine was 100 mg, for every 2 weeks dose of L-thyroxine was increased by 25 mg Outcome: the birth of a healthy child weight 3,9 kg

Conclusion: low fT4 and the presence of obesity - the birth of large fruit. The forecast for the claimed method was confirmed.

Clinical example 2.

Pregnant Meters, 29 years. This first pregnancy. The body mass index 32,8 kg/m2. During pregnancy noted palpitations, edema of the lower extremities. In the study of fT4 in 2 weeks he was 4 pmol/l, and the level of thyroid stimulating hormone (TSH) - 47,6 mIU/L. Pregnancy replayable, treatment in the form of L-thyroxine was not received. The volume of the thyroid gland was 23 cm3. Outcome: produced medical abortion on the grounds.

Conclusion: high levels of TSH produced medical abortion.

In this way were examined 28 women, of whom a positive result by the present method were obtained in 21 patients, which amounts to 75%.

The effect of the proposed method is to determine the level of fT4 in serum of pregnant women in 2-12 weeks of pregnancy, which allows early prediction of major birth of the fetus, fetal development, subsequently implementing a set of preventive measures to reduce the risk of birth disorders; the possibility of screening pregnant women in the first trimester for the prediction of the birth of large fruit; and is simple and easy to perform techniques.

A method for predicting fetopathy in pregnant women with hypothyroidism and obesity by examining pregnant, characterized in that in the peripheral blood serum of pregnant women diagnosed with hypothyroidism and obesity varying severity in 2-12 weeks of gestation to determine the level of fT4 and values less than 10 pmol/l predicted the birth of large fruit.



 

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FIELD: medicine.

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2 tbl, 2 ex

FIELD: medicine.

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1 tbl, 2 ex

FIELD: medicine.

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2 ex, 1 tbl

FIELD: medicine; gynaecology.

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2 ex

FIELD: medicine.

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3 ex

FIELD: medicine.

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9 dwg, 2 ex

FIELD: medicine.

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9 dwg, 2 ex

FIELD: medicine.

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4 ex, 1 tbl

FIELD: medicine, endocrinology.

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3 ex

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3 ex

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3 tbl, 3 ex, 3 dwg

FIELD: medicine.

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3 ex

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1 ex, 2 tbl

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2 ex

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4 ex, 2 tbl

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5 ex, 1 tbl

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2 ex, 1 tbl

FIELD: medicine.

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2 ex, 2 tbl

FIELD: medicine.

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1 tbl, 1 ex

FIELD: medicine.

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EFFECT: improved assay method.

2 ex

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