Method of predicting uterine inertia
SUBSTANCE: invention relates to field of medicine, namely to obstetrics. Cardiointervalography (CIG) is performed. Analysis of heart rate variability (HRV) is carried out. Value of the following indices is estimated: standard deviation, pRR50, coefficient of variation, total power of HRV (TP), power of slow LF-waves, mode amplitude, index of adequacy of regulation processes (IARP), voltage index (VI), value of maximal R-R interval, mean-square difference between duration of neighbouring cardiointervals (RMSSD), normalised power of slow LF-waves, normalised power of fast HF-waves, vegetative index of rhythm (VIR). On the basis of obtained data each of the above mentioned indices is given points from 0 to 2. Also evaluated is value of systolic and diastolic arterial pressure with assigning points. Degree of cervix "maturity" is determined by Bishop scale with giving points. Obtained points are summed up. If sum of points equals 7 or more woman is related to group of risk in of uterine inertia development.
EFFECT: method makes it possible to carry out prediction of uterine inertia before beginning of urgent delivery, which gives possibility to take measures for prevention of initial uterine inertia, in addition, method is non-invasive and safe for parturient woman and newborn baby.
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The proposed development relates to the field of medicine, in particular to obstetrics.
The necessity is justified by the fact that the forecasting, prevention and correction of complications in childbirth remains a topical problem of modern obstetrics. There are various ways to predict anomalies generic activities, including the weakness of labor (PL), discoordinating generic activities (DFA). A significant number of diagnostic and prognostic tests used for predicting the course of childbirth (clinical, anamnestic, gastrografin, hormonal, genetic, anthropometric, and others), uninformative and allow us to determine only the degree of risk for anomalies labor (DGS), and in relation to the individual characteristics of women do not provide the realization of the forecast ARD. The weakness of labor (PL) is one of the most common obstetric complications, which occurs in 5-10% of pregnant women , which is associated with the absence of effective methods of prevention and correction. It also suggests that all previously proposed methods for predicting the course of childbirth has not led to a significant reduction in the incidence of RDS. Therefore, we need new ways of prediction anomalies generic activities, including PSAs. Known the Yong way of predicting the weakness of patrimonial activity, based on the assessment of cardio-respiratory synchronism . Its essence lies in the fact that the test is determined by the artificially increased respiratory rate, at which it coincides with the frequency of heart contractions, i.e. occurs cardio-respiratory synchronism. With this purpose, the test should breathe in time with the flashes of photostimulator with a frequency commensurate with the initial heart rate. At a certain breathing frequency (in time with the flashes of photostimulator) cardio-respiratory synchronism, i.e. the contraction of the heart occurs in response to each respiratory cycle. OK synchronism occurs in a certain frequency range, in which the breathing rate change leads to a simultaneous change in heart rate. The definition of this range is carried out using "System to determine cardio-respiratory synchronism with the man". The essence of the method for predicting the weakness of labor (PL) is that the risk of developing PSAs are those pregnant women, who on the eve of the birth of the synchronization range is equal to zero, i.e. synchronization occurs only at a single point, i.e. at a certain frequency of breathing, and the synchronization range is missing.
The disadvantages of the method: the sample is not physiological, as studied have to develop is Okipnoi, i.e. to make 80-90 cycles "inhale-exhale" in 1 minute, which can lead to severe hypocapnia in the mother and fetus and to the disturbance of acid-base balance; the test requires a special device "System to determine cardio-respiratory synchronism with the man", which is used only in limited cases; the authors have not proven the effectiveness of this method for predicting the development of PSAs.
The way to prepare for childbirth pregnant women with high-risk primary weakness of labor activity . Diagnostic signs that indicate a high probability of developing primary SDM in gestation 38 weeks, according to the claimed method are 1) the decrease in the content of phospholipids in the cells of the vaginal epithelium less than 2.0% Astaldi; 2) low concentration of cortisol in plasma (less than 400 nmol/l); 3) lack of dynamics changes in skin resistance at acupuncture point epiphysis MP-31; 4) high content of coproporphyrin and lead in urine; 5) high content of buccal cells with micronuclei; 6) reduction of the concentration of SH groups in buccal cells; 7) increased concentration of malondialdehyde in the saliva (4.0 nmol/ml); 8) reduced catalase activity in saliva (less than 12-15 nmol/ml).
The disadvantages of the method: the great complexity of the method, it is very useful and the need for long-term study as it requires the definition of different ways at the same time 8 indicators; no clear criteria - i.e. the presence of at least one characteristic of the above, or set of features.
A method for predicting anomalies labor (ARD) prior to delivery, based on the results of ultrasound echography the body of the uterus on the border with the lower segment. When identifying hyperechoic line on the background hypoechoic myometrium predict ARD . The disadvantages of the method: subjective evaluation of the high probability of errors (30%); the method does not differentiate between DDS and discoordinating RD that does not allow specific prevention PSAs.
A method for predicting types of anomalies labor activity . The essence of the invention lies in the fact that determine osmoresistens erythrocytes in the presence of beta-blocker - 1-(1-isopropylamino)-3-(1-naphthalenyl-oxy)-2-propanolol hydrochloride, and when the value of osmoresistens less than 65 srvc. units predict the development of hypotonic dysfunction of the uterus on the stage of the preliminary period and the first period of delivery and, if the value of 80 s. units and more hypertensive disorders of the uterus in the form of pathological preliminary period, dystocia cervix and discoordinating labor.
The disadvantages of the method: the method is invasive; for Yoda characteristic nespecificnomu, because the change of adrenalectomy erythrocytes, determined by the nature of the osmotic resistance of erythrocytes in the presence of propranolol, observed in various conditions such as the presence of preeclampsia, the method is not very accurate because it is based on a method of estimating beta adrenoreceptor proposed Stryuk RI and Dlussky I.G. , which is characterized by a large enough margin of error.
A method for predicting violations of contractile activity of the uterus and formation of violations of dystocia cervix of the uterus in childbirth on the basis of determining ultrasonic degree of "maturity" of the cervix before birth . For 1-5 days before delivery spend transvaginal ultrasound study using three-dimensional Doppler mode. When the index vascularization less than 2% of diagnosed immature cervix and predict disorders of contractile activity of the uterus and the formation of dystocia of the cervix in the upcoming childbirth. The method allows to reduce the degree of subjectivity of estimating the parameters of "maturity" of the cervix, giving the possibility of multiple dynamic studies of "maturity" of the cervix and has a high prognostic value.
Disadvantages of the method: subjective evaluation of the high probability of errors; lack of data about technoscapes; the method does not differentiate between DDS and discoordinating RD that does not allow specific prevention PSAs.
A method for predicting the development of abnormalities of labor in women with preeclampsia . The method allows a timely manner before the onset of labour to predict the development of abnormalities of labor in pregnant women with preeclampsia. Conducting a study of peripheral venous blood of women at 38-39 weeks of gestation to determine the index of the functional reserve of neutrophils (IFRS). When the values IFRN equal to or smaller than 0.7 and forecasted anomalies of labor.
The disadvantages of the method: the method is invasive; the method does not allow to differentiate between DDS and discoordinating RD that does not allow specific prevention PSAs.
There is a method of predicting discoordination labor activity by determining the blood from the cervix activity adenozindezaminazy and increase the norm predict discoordination labor activity .
The disadvantages of the method: the activity adenozindezaminazy has a pronounced age-related dynamics and depends on immunodeficiency, extragenital pathology, polyhydramnion, etc.; this complicates interpretation of the results of determination of enzyme activity; carrying out the reaction, t is Eboue mandatory production control to determine non-specific phosphatase, which pregnant is initially modified level; the application of the method can contribute to the development of inflammatory complications; invasive way; the way is traumatic; the lack of data on the accuracy of the method; the method is non-specific, as the increased activity of adenozindezaminazy observed in tumor conditions.
The method of determining in a sample of the amniotic fluid, the amount of malondialdehyde (MDA) after induction of lipid peroxidation in the reaction with thiobarbituric acid and the amount of MDA formed more than 3.0 mmol/l predict a normal family activities . The disadvantages of the method: the invasiveness of the method (the removal of amniotic fluid when the whole fetal bladder) and, consequently, a higher risk of developing inflammatory diseases of the mother and fetus; nespecificnomu of this method, as a change of production of MDA was observed under the influence of external factors, high concentrations of MDA observed in patients with any inflammatory diseases, including reproductive health, in the development of perinatal damage of the Central nervous system of the fetus, miscarriage; the method allows to predict the development of normal birth and the presence of DGS, but does not allow accurate prediction of the development of PSAs; most versions of this technique does not allow will reveal the all products lipid peroxidation, reactive thiobarbiturate acid; a large registration error results due to the development of nonspecific staining; large variability of results depending on the methodology sampling the sample and add detergent.
Way to predict the nature of descent according to the degree of "maturity" of the cervix, which is determined according to the vaginal research before birth. To do this, use the scoring for Bishop (1964) modified Eaharuny (1999), and with the degree of maturity of the cervix to 4 points make a conclusion about the possibility of anomalies labor activity . The disadvantages of the method: subjective evaluation of all parameters of this method; the lack of accuracy of the method in determining the extent of readiness of the woman's body for childbirth.
A method for predicting a generic activity-based assessment of autonomic tests , which provides for the examined wedge - and orthostatic tests, analysis of the phenomenon of Dagnini-Achnera in combination with the study of the temperature and bioelectric gradients on the surface of the skin at acupuncture points of the uterus (R-12) and ovarian (VM-46), as well as with the assessment of the reactivity of the vascular walls of the skin using a metered electrophoresis 0.1% solution of adrenaline and 1% solution of carbacholine injected intradermally, followed interpreter which it received the data. A necessary condition to ensure the accuracy of the prediction is the implementation of the above studies in pregnant and parturient women in dynamics, at least two times.
The disadvantages of the method: samples are not physiological; invasive method; the method does not differentiate between DDS and discoordinating RD that does not allow differentiated prevention PSAs; the complexity of the research; the need for multiple repeat tests in the same patient; long total time of implementation of the method; the subjectivity of the results due to the specific characteristics of the vegetative system of every woman.
Closest to the proposed development is a method for predicting discoordination labor in pregnant women risk group . A method for predicting discoordination labor in pregnant women risk group based on the definition on the term 37-40 weeks of gestation according to the spectral analysis of heart rate indices, reflecting the change in RR interval in the low frequencies (LF norm, or the normalized power of slow waves, or LF-waves, i.e. oscillations of RR interval in frequency from 0.04 to 0.15 Hz) and high frequency (HF norm, or the normalized power of fast waves, or HF-waves, i.e. oscillations of RR interval in the frequency range from 0.15 to 0.40 is C), expressed as a percentage of the total spectral area of the oscillations of RR interval, and when the values LFnorm, equal 53.9% and less, and HFnorm equal to 46.1 per cent and more, forecast discoordinating generic activities with an accuracy of 87.8%.
The disadvantages of the method are that the prediction discoordinating labor activity is carried out in only two indicators of heart rate variability, which reduces the reliability of the forecast; does not allow to predict the development of PSAs.
The essence of the proposed development: at the present time to assess the adaptation of the maternal organism to generic stress and activity of the autonomic nervous system (ANS), part of which is the adaptation of the widely used method of mathematical analysis of heart rate characterizing heart rate variability or HRV), which is estimated according to kardiointervalografii (CIG). Cardiointervalography is to register not less than 200-500 cardiocycle using electrocardiography. The higher the degree of variability of the RR interval, i.e. the duration of the cardiac cycle, the higher the probability of high parasympathetic activity of the ANS or the higher the probability of low activity of the sympathetic division of the ANS. Cardiointervalography has no age restrictions, safe and non-invasive. In scientific research the studies it has already been used in pregnant women to assess their state of adaptation. This method us and offered to be used for forecasting the weakness of labor (PL) before term birth and early latent phase I period urgent delivery.
The novelty of the proposed method.
According to kardiointervalografii (TG, 500 cardiocycle), conducted with the help of the medical diagnostic system of the company "Neurosoft" women in the position of lying on its side before term labor, i.e. 5-1 day before delivery and/or early latent phase of first stage of labor, a mathematical analysis of HRV and provides an assessment on the state of activity of the sympathetic division of the ANS during these periods. Simultaneously with HRV assessed the state of the cervix in the score Bishop and blood pressure. Each characteristic is assigned 1 or 2 points. Based on these values, presented in the scale, total score is calculated forecast Wed. If the score is equal to or more than 7 points, the woman is at risk for the development of PSAs.
About the likelihood of the development of the DDS indicates the presence of the following characteristics:
1) before the birth is low, the activity of SP, as evidenced by the values of the eight parameters of HRV, presented at a scale of 1, and such activity persists or becomes even lower in the latent phase of first stage of labor (scale 2);
2), the likelihood of PSA increases significantly when the service is provided just before birth and in the latent phase of first stage of labor has "immature" type cervical (0-6 score of Bishop) and/or have low values of systolic (not more than 110 mm RT. Art.) and diastolic (not more than 70 mm RT. Art.) pressure.
|Indices of HRV registered 5-1 the days before the development of spontaneous labor at 39-40 weeks of gestation|
|No.||indices of HRV||normal family activities||points||the weakness of labor activity||points|
|1||the standard deviation, MS2||no more than 50||0||51 and above||1|
|2||pRR50 (number of RR-intervals that differ from the next by more than 50 MS)%||no more 7||0||7.1 and above||1|
|3||the coefficient of variation, %||not more than 7,5||0||7.6 and above||1|
|4||the total power of the HRV spectrum, or TR, MS2||no more than 4000||0||4010 and above||1|
|5||the power of slow waves (LF), MS2||not more than 850||0||860 and above||1|
|6||the mode amplitude, %||40 and above||0||below 40||1|
|7||the adequacy of regulatory processes (PAPR), usl. units||60 and above||0||below 60||1|
|8||the tension index (ti), usl. units||130 and above||0||below 130||1|
|9||systolic blood pressure, mm RT. Art.||111-120||0||below 110||2|
|10||diastolic blood pressure, mm RT. Art.||71-80||0||below 70||2|
|11||the degree of "maturity" of the cervix, the score Bishop||7 and above||0||6 and below||2|
|Indices of HRV, registered in the latent phase of the first period term labor|
|No.||indicators||normal family activities||points||the weakness of labor activity||points|
|1||the maximum value of RR, MS||950 and below||0||951 and above||1|
|2||the standard deviation, MS2||55 and below||0||56 and above||1|
|3||root-mean-square difference between the duration of neighboring cardiac intervals (RMSSD), MS||40 and below||0||41 and above||1|
|4||the power of slow waves (LF), MS2||250 and below||0||251 and above||1|
|5||the normalized power of slow waves (LF-waves), %||60 and below||0||61 and above||1|
|6||the normalized power of fast waves (HF-waves), %||48 and above||0||47 and below||1|
|7||the adequacy of regulatory processes (PAPR), usl. units||50 and above||0||49 and below||1|
|8||vegetative indicator rhythm (CDF), usl. units||5.0 and above||0||4.9 and below||1|
|9||systolic blood pressure, mm RT. Art.||110-120||0||below 110||2|
|10||diastolic blood pressure, mm RT. Art.||70-80||0||below 70||2|
|11||the degree of "maturity" of the cervix, the score Bishop||7 and above||0||6 and below||2|
Before the birth (39-40 weeks) or in the latent phase I period term labor with diagnostic system "Neuron-spectrum" (Neurosoft, Ivanovo) is cardiointervalography (within 5 minutes when placed women in the position lying on the side") and by standard indicators of mathematical analysis evaluated heart rate variability. We also evaluate the condition of the cervix (on a scale of Bishop) and blood pressure measured. The presence of high activity of the parasympathetic division of the ANS on the eve of the birth and/or in the latent phase, as evidenced by the corresponding values of some indices of HRV (for pregnant women, the standard deviation, or RMS; pRR50, i.e. the number of RR-intervals that differ from the next by more than 50 MS; coefficient of variation; the total power of the HRV spectrum, or TR; absolute power of slow waves, or LF-waves; amplitude fashion; the adequacy regulation, or PAPR, tension index, or IN ie 8 indicators; for women - maximum value RR; RMS deviation, or RMS; RMS difference between the duration of adjacent R-R-interval, or RMSSD; absolute power of fast waves, or HF-waves; absolute and normalized power of slow waves, or LF-waves; the adequacy regulation, or PAPER; vegetative index rate, or the CDF; only 8 indicators) and low values of HELL, and "immaturity" of the cervix indicate high veroyatnostei DDS. Each characteristic is assigned 1 or 2 points. Based on these values, presented in the scale, total score is calculated forecast Wed. If the score is equal to or more than 7 points, pregnant or a pregnant woman is referred to the group risk or at high risk for the development of PSAs and carry out the appropriate measures of preventive character.
This method allows the assessment of the prognosis of PSA in women admitted in the obstetric hospital before the beginning of term labor at 39-40 weeks of gestation. In this case, the assessment is carried out before the delivery. If a woman gets a high score on the scale of the forecast Wed (7 and above), it is a complex of measures for the prevention of RDS. In the latent phase of labor, research and repeat with high scores on the scale of the forecast Wed (7 and above), there will be additional preventive measures. In the presence of low points prior to delivery and/or in the latent phase of labor is a delaying tactic. If a woman was admitted to hospital in the latent phase of the first stage, we conducted a single investigation and if there is a high risk of developing RDS (rating on a scale of forecast Wed 7 points and above) is a complex of measures aimed at prevention PSAs.
The essence of the proposed development is illustrated by examples.
Example . Pregnant O., 37 years. Pregnancy I. he Entered the chamber of the pathology diagnosis: Pregnancy 39 weeks. Harbingers of birth. "Immature" type cervical (3 points on a scale of Bishop). Blood pressure 100/70-100/60 mm RT. Art. With diagnostic system "Neuron-spectrum" was held cardiointervalography (CIG): standard deviation of 56 MS2, pRR50 (number of RR-intervals that differ from the next by more than 50 MS) of 14.5%, the coefficient of variation of 5.6%, the total power of the HRV spectrum, or TR, 4125 MS2capacity slow (LF) waves 606 MS2the mode amplitude 31.4%, adequacy regulation (PAPR) 32,6 $ index voltage 62 USD survey Data by the present method: the assessment of HRV - 12 score of 1, i.e. the identified risk to the weakness of labor activity. Within 4 days was spent preparing the cervix for childbirth (antispasmodics), developed after spontaneous labor activity. In the latent phase of first stage of labor conducted TG: the maximum value of RR 1247 MS, standard deviation 74 MS2, root-mean-square difference between the duration of adjacent R-R-interval (RMSSD) 93 MS, the slow power (LF) waves 260 MS2normalized power slow (LF) waves 55 MS2normalized power fast (HF) waves 55 MS2the measure adequately the different regulatory processes (PAPR) 15,6 c.u., vegetative indicator rhythm (CDF) of 1.6 cu Systolic blood pressure of 100 mm RT. Art., diastolic blood pressure of 70 mm RT. Art., the degree of "maturity" of the cervix on a scale of Bishop 6 points. In the evaluation of heart rate variability on the scale of 2 received 12 points, i.e. the risk of developing RDS. Prevention PSAs were not carried out. In childbirth developed PSAs were conducted stimulation of labor activity oxytocin, but without effect. Produced by emergency caesarean section, gave birth to a boy 3300 g, 52 cm with estimation on Apgar scale 7-8 points. The forecast for the claimed method was confirmed.
Example 2. Pregnant B., 22 years. Pregnancy II, the first ended in spontaneous abortion in a small time period. He entered the chamber of the pathology diagnosis: Pregnancy 39 weeks. Harbingers of birth. Hydrops. "Immature" type cervical (4 points on the scale of Bishop). Blood pressure 100/60-100/60 mm RT. Art. With diagnostic system "Neuron-spectrum" was held cardiointervalography (CIG): standard deviation 70 MS2, pRR50 7.0%coefficient of variation of 12%, the total power of the HRV spectrum, or TR, 8343 MS2capacity slow (LF) waves 505 MS2the mode amplitude of 38.7%, the adequacy of regulatory processes (PAPR) 54,5 c.u., tension index (ti) 120 USD survey Data by the present method when assessing variabe is a major heart rhythm - 11 points on a scale of 1, i.e. the identified risk of developing RDS. Within 5 days was conducted to prepare the cervix for childbirth by antispasmodics, developed after spontaneous labor activity. In childbirth developed PSAs were conducted stimulation of labor activity oxytocin, without effect. Produced by emergency caesarean section, gave birth to a boy 3820 g, 54 cm with estimation on Apgar scale 7-8 points. The forecast for the claimed method was confirmed.
Example 3. Pregnant With., 27 years. Pregnancy I. Entered the maternity ward in the latent phase I period term labor. Blood pressure 90/60 - 100/70 mm RT. Art. With diagnostic system "Neuron-spectrum" was held TG: the maximum value of RR 955 MS, standard deviation 59 MS2, root-mean-square difference between the duration of adjacent R-R-interval (RMSSD) 39 MS, the slow power (LF)waves 300 MS2normalized power slow (LF) waves 30%, the normalized power fast (HF) waves 40%, the adequacy of regulatory processes (PAPR) $ 41, vegetative indicator rhythm (CDF) of 4.8 cu Degree of "maturity" of the cervix on a scale of Bishop 4 points. Survey data by the present method: the assessment of HRV - 11 score of 2, i.e. the identified risk of developing RDS. In childbirth developed PSAs were conducted stimulation of labor activity oxytocin is m, childbirth is over vaginal delivery. The boy was born 3560 g, 52 cm with estimation on Apgar scale 7-8 points. The forecast for the claimed method was confirmed.
Example 4. Pregnant D., 27 years. Pregnancy I. he Entered the chamber of the pathology diagnosis: Pregnancy 39 weeks. Harbingers of birth.
"Mature" type of the cervix (8 points on a scale of Bishop). Blood pressure 120/80-120/70 mm RT. Art. With diagnostic system "Neuron-spectrum" was held cardiointervalography (CIG): standard deviation 38 MS2, pRR50 of 6.0%, the coefficient of variation of 7.1%, the total power of the HRV spectrum, or TR, 2500 MS2capacity slow (LF) waves of 600 MS, the amplitude of fashion 54%, the adequacy of regulatory processes (PAPR) $ 74, the tension index 150 USD survey Data by the present method: the estimate of the HRV - 1 score of 1, i.e. no identified risk of developing RDS. After 4 days developed spontaneous labor activity. In the latent phase of first stage of labor conducted TG: the maximum value of RR 900 MS, the standard deviation 42 MS2, root-mean-square difference between the duration of adjacent R-R-interval (RMSSD) 25 MS, the slow power (LF) waves 255 MS2normalized power slow (LF) waves 50 MS2normalized power fast (HF) waves 60 MS2indicator of adequ is the surrounding area of regulatory processes (PAPR) $ 64, vegetative indicator rhythm (CDF) of 7.0 cu Systolic blood pressure 120 mm RT. Art., diastolic blood pressure of 80 mm RT. Art., the degree of "maturity" of the cervix on a scale of Bishop 8 points. In the evaluation of heart rate variability on the scale of 2 received 1 point, i.e. there is no risk of developing RDS. It was all over vaginal delivery, a baby boy was born 3600 g, 52 cm with estimation on Apgar scale 7-8 points. The forecast for the claimed method was confirmed.
The advantages of the proposed method:
1. The possibility of holding events with the purpose of prevention and correction of primary weakness of labor activity.
2. The method is simple in execution.
3. It has high precision.
4. Method nivation, safe.
5. Method objective.
6. The duration of the methodology and calculation of the indicators is 15 minutes.
The sensitivity of the method - 93,4%, specificity of the method is to 96.8%.
1. L.V. Adamyan, Smolenova T.U., Dlussky I.G., Braginsky YEAR, Stryuk R.I., Mohsin SV estimation Method adrenalectomy organism (β-AWS) in pregnant women for prediction of birth // problems of reproduction. - 2006. No. 1. S-97. Patent No. 2296993 from 10.04.2007.
2. Belikova ME Bowl T.V., Tikhomirova NR, Panov, I., Moiseeva L.V. Way of predicting discoordination labor in pregnant women risk group SI "Ivanovo scientific biolofy research center is the first Institute of motherhood and childhood to them. Vnegorodov". Russian Federation patent RU 2235499, 2002.09.19 - prototype.
3. Glushko A.A., Fedorov, M.V., Cats SHE, Tumanyan EA a Method for predicting anomalies labor before the birth. // Newsletter. Of the invention. - 1999. - No. 22. part 2. - P.390-394. // Patent No. 2134418.
4. Rosilina, G.S. non-pharmacological prevention primary weakness of labor activity // abstract. Dis... KMN - Rostov-on-don, 2009. S.
5. Hot A.F., Youssef AA, Fofanov, S. a Method for predicting a generic activity-based assessment of autonomic tests // Obstetrics and gynecology. - 1985. No. 8. - P.5-7.
6. Crescina NV, Panov, I., Sotnikova POSTGRADUATE, Tikhomirova E.G. a method for predicting the development of abnormalities of labor in women with preeclampsia. Patent No. 2001119714/14, 2001.
7. Orlov V., Pogorelov T.N., Drucker N.A., Jurowski S.L., a Method for predicting discoordination labor. // Official Bulletin "Discoveries. Invention" - 1991. - No. 18. - p.17. // A.S. No. 1648346.
8. Pokrovsky V.M., Abushkevich VG Test cardio-respiratory synchronism - method assessment of the regulatory-adaptive status in the clinic // Kuban scientific medical journal. - 2005. No. 7-8 (80-81). - P.98-103.
9. Sidorov, I.S. Physiology and pathology of labor activity. - M.: Medpress, 2006. - 318 S.
10. Stryuk R.I., Dlussky I.G. the cardiac adrenergic reactivity and cardiovascular system. - M.: Medicine, 2003. - 160 S.
1. Chernukha E.A., Murylev VA, Wysokosc AI, Komissarova, L.M., Y.A. Hassan, Galustyan A.A. Way of predicting normal labor. // ABOUT "Opening. The invention". 1989. No. 12. - S.
12. Chernukha E.A. Generic unit. - M.: Triada-X, 1999. - 533 S.
13. Annaev N.E., Chehonatzkaya M. a Method for predicting violations of contractile activity of the uterus and formation of violations of dystocia cervix of the uterus in childbirth on the basis of determining ultrasonic degree of "maturity" of the cervix before birth. Patent No. 2008109463/14, 2008.
A method for predicting the weakness of labor activity (SDR), including registration of kardiointervalografii (CIG), mathematical analysis of heart rate variability (HRV), characterized in that simultaneously with the registration of the CIG, a mathematical analysis of HRV, while the figures recorded for 5-1 the days before the development of spontaneous labor, when the standard deviation is not more than 50 MS2assigned 0 points, at 51 MS2and above - 1 point; if PR50(the number of RR-intervals that differ from the next by more than 50 MS) not more than 7% - 0 points, 7.1% and above - 1 point; coefficient of variation of not more than 7,5% - 0 points, 7.6 and above - 1 point; total power of the HRV spectrum (TR) is not greater than 4000 MS2- 0 points, 4010 MS2and above - 1 point; power slow LF waves is not b is the larger 850 MS 2- 0 points, at 860 and above - 1 point; the mode amplitude of 40% and above 0 points, below 40% - 1 point; the adequacy of regulatory processes (PAPR) 60 services. units and above 0 points below 60 srvc. unit - 1 point; the tension index (ti) 130 srvc. units and above 0 points, below 130 srvc. unit - 1 point; indices of HRV, registered in the latent phase of first stage of labor: when the value of the maximum values of R-R interval 950 MS and below assigned 0 points, 951 MS and above - 1 point; standard deviation 55 MS2and below 0 points, 56 MS2and above - 1 point; the RMS differences between the duration of adjacent R-R-interval (RMSSD) 40 MS and below - 0 points, 41 MS and above - 1 point; power slow LF-wave 250 MS2and below 0 points, 251 MS2and above - 1 point; normalized power slow LF waves 60% and below 0 points, 61% and above - 1 point; normalized power fast HF-waves 48% and above 0 points, 47%and below - 1 point; the adequacy of regulatory processes (PAPR) 50 services. units and above 0 points, 49 srvc. units and below - 1 point; vegetative indicator rhythm (CDF) 5.0 services. units and above 0 points, 4.9 and below the usl. units and below - 1 point, while systolic blood pressure 111-120 mm Hg - 0 points, below 110 mm Hg - 2 points; diastolic blood pressure 71-80 mm Hg - 0 score below 70 mm Hg - 2 points; the maturity of the cervix on a scale of Bishop 7 points and above - 0 ball is s, 6 points and below - 2 points; if the woman is at risk for the development of SDR, the sum of scores equal to or greater than 7 points.
SUBSTANCE: duration, amplitude and form of each continuous brain signal wave are matched with parameters of each sensory signal. Recording each continuous brain signal wave, forming a matched sensory signal and exposing a patient to this signal are consistent and immediate. During the procedure, the patient is suggested to pay attention that the sensory signals perceived reflect brain work.
EFFECT: method enables more efficient process normalising psychophysiological state following stress load, psychoemotional and mental strain, and while treating functional disorders of central nervous system, psychosomatic diseases and consequences of organic cerebral affections.
SUBSTANCE: invention relates to psychology, medicine, namely to symptomatic psychotherapy of diseases associated with disturbances of person's psychoemotional state. Estimation of patient's psychoemotional state is carried out by performing clinical-psychological examination with formulation of diagnosis. After that in accordance with psychotherapeutical aims, musical background is created, carrying and modulating frequency of sound vibrations are added for rhythm impact in spectrum of frequencies of natural electroencephalographic processes, and in colour images determined are predominating colour gamut, succession and frequency of colour image change for rhythm impact in spectrum of frequencies of natural electroencephalographic processes. Selected material is presented in form of videofilm, taking into account obtained patient's diagnostic data, after which it is shown to the patient.
EFFECT: method increases efficiency of impact on person's psychoemotional state, which takes into account presence in etiopathogenesis of biological, psychological and social factors, each of which needs correcting impacts, corresponding to its nature.
13 cl, 4 tbl, 4 dwg
SUBSTANCE: method involves successively electromiographic (EMG) training of ischiocavernosus muscles on initial electromiographic signals of biological feedback (BF), causing alternating contraction of 5 seconds long and relaxation of 10 seconds long of perineum muscles during 15 minutes. Then follows an alternating contraction to 30% of maximal EMG level of 10 seconds long and relaxation of 10 seconds long during 15 minutes. After that electric stimulation of ischiocavernosus muscles and between segments of spinal cord S2-S4 and S4-S5-C1 of spine is performed, laser irradiation of segments S2-S4 of spinal cord, spine segments S4-S5-C1 and upper surface of penis body is performed. Laser exposure is performed with low-intensive infra-red waves with amplitude-frequency modulation with frequency to 3 Hz and modulation depth to 30 per cent, energy to 50 joule, wavelength 960 nm. Electric stimulation of ischiocavernosus muscles is performed bipolarly by pulse current with their weak titanic contraction, duration of burst and pause being 2 seconds with frequency of burst filling 3000 Hz, and bipolar electric stimulation between segmentsS2-S4 of spinal cord and S4-S5-C1 of spine with infra-low electric waves with frequency to 3 Hz and amplitude to 100 mcA is performed. Time of laser exposure on each region is 5 minutes, time of exposure to pulse current is 30 minutes, time of exposure to infra-low current is 24 hours, course of treatment is 15 days.
EFFECT: extended arsenal of means for treatment of erectile dysfunction.
FIELD: medicine; physiology and therapy.
SUBSTANCE: patient's cardiointervalograms are registered and analysed in real time mode. Respiratory movements are synchronised with own heart rate. Command information to man on inspiration-expiration is generated by microcontroller on basis of analysis of ongoing cardiointervalogram, and inspiration command is generated by microcontroller upon registration of cardiointervalogram's maximum and provided the time interval of analysis lockout is completed, when microcontroller's commands are pending even at extremum. Expiration command is generated upon registration of cardiointervalogram's minimum and the time interval of analysis lockout starts at expiration command with duration of three cardio cycles, or at inspiration command with duration of one cardio cycle.
EFFECT: method increases efficacy of systems of diagnostics and correction of human functional condition.
FIELD: medicine, neuroophthalmology.
SUBSTANCE: it is necessary to register electroencephalogram (EEG) and at disorganized low-amplitude EEG, when amplitude of alpha-rhythm is below 30 mcV or is not detected at all it is necessary to prescribe nystenon per os per 1 tablet twice/d daily for 2 wk. In case of high-amplitude hypersynchronous EEG at amplitude of alpha-rhythm being 100 mcV and more one should prescribe glycin per 1 tablet 100 mg sublingually twice/d daily for 2 wk. Then comes video-training with the help of "Amblyocor-01" device for 2 wk along with simultaneous intake of earlier prescribed preparations. In case of disorganized low-amplitude EEG one should fulfill training in the mode of "relaxation", in case of high-amplitude hypersynchronous EEG - in the mode of "activation". The innovation enables to affect central departments of optic analyzer.
EFFECT: higher efficiency of correction.
FIELD: medical engineering.
SUBSTANCE: device has means for acting upon object under study, means for recording responses having transducers connected to computer via signal input/output unit, photorecorder unit having programmed control mechanism and frame marker unit having in series connected control desk, frame marker, superposed responses photorecorder, programming unit and switchboard connected to control desk, means for acting upon object, means for recording responses and computer. Photorecorder programming unit has cam mechanism, the switchboard has relay circuits, the frame marker unit has means for recording treatment protocol and means for recording current events being tape drive with transparent tape coupled with tape drive with exposed film. The means for recording responses have magnetic tape recorder connected to control desk and transducers via switchboard. Tape recorder signal input is connected to microphone for recording vocal data describing current experiment condition and testee data.
EFFECT: enhanced effectiveness in recording biopotentials and creating feedback links among testees; wide range of functional applications.
2 cl, 6 dwg
SUBSTANCE: method involves carrying out clinical and diagnostic examination and additionally measuring latent period of III peak on invoked potential curve from acoustic invoked stem potentials. Cerebral stem injuries are determined from neuromuscular electrodiagnostic data. Latent period III peak value being above or below a norm and injured medial cerebral stem region allover the stem thickness or totally injured lateral and caudal stem regions or all said regions injury taking place, high intraoperation trigeminocardial reflex risk degree is diagnosed in patients suffering from vestibular neuroschwannoma. Latent period III peak value being above or below a norm and no injuries of cerebral stem or latent period III peak value corresponding to norm and totally injured lateral and caudal stem regions at the same time or only medial cerebral stem regions taking place, moderate risk degree is diagnosed. Normal latent period III peak value and no injuries of cerebral stem being the case, low risk degree is to be diagnosed.
EFFECT: high accuracy of diagnosis.
SUBSTANCE: invention refers to medicine, particularly cardiology. Passive orthostatic test involves measuring: mean arterial pressure by the end of the 1st minute of orthostasis, mm Hg, APm._1; a reaction of total peripheral vascular resistance (TPVR) by the end of the 1st minute of orthostasis as related to the prone value, %, %TPVR; a reaction of basic thoracic impedance by the end of the 1st minute of orthostasis as related to the prone value, %, %BI; a reaction of standard power of rhythmogram spectrum low frequency by the end of the 1st minute of orthostasis as related to the prone value, %, %LFn. An integral 'orthostatic stability' (IOS) is determined: IOS=3.83APm._1+0.98(%TPVR)+14.4(%BI)+0.954(%LFn) wherein 3.83APm._1 is a pressure index; 0.98(%TPVR) is a vasoconstriction index; 14.4(%BI) is a blood redistribution index; 0.954(%LFn) is a vegetative control index. The derived values of IOS, the pressure index, the vasoconstriction index, the blood redistribution index and the vegetative control index are used to choose the optimal therapeutic method.
EFFECT: method enables selecting the optimal therapy for the patients taking into account the pathogenetic aspects.
1 tbl, 2 ex
SUBSTANCE: invention concerns medicine, specifically psychophysiology and psychology. A biological control session is preceded by diagnosing the character properties. The character findings are used to predict the biological control effectiveness of the heart rate parameters. The individuals with high ergicity, plasticity, rate and moderate emotionality exercise stable gain of total power distribution of heart rate variability accompanying the biological feedback training.
EFFECT: method enables correcting the functional state of various groups of populations, ensuring the effective biological control of the heart rate parameters over a short period of time.
3 ex, 3 dwg
SUBSTANCE: invention relates to medicine, namely to clinical diagnostics, and can be used as express-method of detecting impairment of blood aggregate state. For this purpose echcardiographic and electrocardiographic examinations are performed, systolic arterial pressure and body temperature are measured. Obtained data are processed and obtained characteristic is used to carry out comparison with control characteristic, preliminarily obtained after processing of data of echcardiographic and electrocardiographic examinations, measurement of systolic pressure, temperature in healthy blood donors. Results of comparison are used to judge about degree of impairment of blood aggregate state, as control characteristic used is digital characteristic of degree of hemoaggregation interaction in blood flow (HAWR), which is calculated by formula where Wng is potential energy of blood gravitation field Wng = -γ M; Wne is potential energy of blood electric field Wne = LMT-3 Y-1; Wnc is potential energy of coagulation chemical interaction Wnc = Σ (ni×Eci); Wk is kinetic energy of blood flow Wk = MV2/2, M is weight of circulating blood volume; G is gravitational potential of earth, L is length of arterial section of blood flow; Y is current intensity in volume conductor; ni is number of bonds of molecules of blood cells; Eci is average value of bond energies; V is rate of blood flow in output part of left ventricle; P is systolic arterial pressure; T is absolute temperature. If HAWR>9.82, degree of impairment of aggregation potential is determined as hypercoagulation. If HAWR<9.64, impairment is determined as hypocoagulation. If HAWR is 9.64-9.82, it is determined as normal aggregate blood state.
EFFECT: method makes it possible to determine degree of impairment of blood aggregate state in efficient non-invasive way.
1 tbl, 4 ex
SUBSTANCE: invention relates to medicine, namely to therapy and endoscopic methods of examination, and can be used in carrying out bronchoscopic examination. For this purpose immediately before bronchoscopy, electrocardiogram is registered and within 10-16 minutes in real time mode determined are: heart rate, arterial pressure, saturation with oxygen. Directly during fibrobronchoscopy current monitoring of heart rate, arterial pressure and saturation with oxygen, as well as of electrocardiogram in one of main leads is continued. After that, during 10-15 minutes after finishing fibrobroncoscopymonitoring of heart rate, arterial pressure, saturation with oxygen is performed until their normalisation. 15-20 minutes after carrying out fibrobronchoscopy electrocardiogram is re-registered. 5-6 hours after carrying out fibrobronchoscopy electrocardiogram is re-registered again.
EFFECT: method makes it possible to prevent possibility of development of different complications during and after performing fibrobronchoscopy, including painless form of ischemia or myocardium infarction, due to providing control over the most essential vital functions of organism in patients with somatic pathology in specified time intervals.
SUBSTANCE: invention relates to medicine, namely to cardiology and cardiac surgery. Non-invasive transesophageal electric stimulation is performed. Parameters are selected in such a way that at the base frequency time of atrioventricular conduction, namely interval St1-R1 does not exceed 180 ms. Time of atrioventricular conduction after the first extra stimulus - interval St2-R2 is higher than interval St1-R1, but does not exceed 250 ms.
EFFECT: method makes it possible to detect presence of double ways of atrioventricular conduction and induce paroxysmal atrioventricular node reciprocating tachycardia in children in case if other methods of atrial electrical stimulation prove to be inefficient.
1 ex, 5 dwg
SUBSTANCE: cardiac ultrasonography is used to measure left ventricle and left ventricular ejection fraction; daily electrocardiographic monitoring involves determining a number of single and double auricular extrasystoles; then with respect to the patient's age, a total risk is calculated by presented formula. If the total risk is equal to zero or exceeds zero, a high risk of transformation of paroxysmal atrial fibrillation into its permanent form for the following three years is predicted; if it is below zero, a low risk of transformation of paroxysmal atrial fibrillation into its permanent form for the following three years is predicted.
EFFECT: method enables evaluating a risk of transformation of paroxysmal atrial fibrillation into its permanent form in the patients with ischemic heart disease of all age groups.
1 tbl, 3 ex
SUBSTANCE: invention relates to medicine, in particular to cardiology. ECG monitoring is performed to patient. Ratio of each RR interval to previous RR interval is determined. In case if, at least, four following each other ratios, whose values are more than 1.15 and/or less than 0.85, paroxysmal atrial fibrillation (PAF) is diagnosed.
EFFECT: method makes it possible to increase specificity of PAF with preservation of high sensitivity due to distinguishing PAF from sinus rhythm and from sinus rhythm with extrasystole.
3 ex, 4 tbl
SUBSTANCE: method comprises the stages involving formation of a learning sample in the form of a set (k-1)*m of n-size reference data vectors, construction of decision rules and learning of k*L (L is lead number) neuron networks for analysis of each cardiac k-states in each lead. Then patient's electric cardiac signal is recorded, pre-processed and presented in the form of the n-size vector. The neural network analysis is enabled by comparing the n-size vector to the number (k-1)*m of n-size reference data vectors. The neural network analysis data are used to sample the cardiac k-state with maximum number of signs.
EFFECT: improved algorithm of the neural network analysis of the electric cardiac signal.
4 cl, 11 dwg
SUBSTANCE: invention relates to medicine, namely to pediatrics. In children of pre-school age with tuberculosis of intrathotacic lymph nodes indices of heart rhythm variability are determined: rhythmograms - interinterval differences RMSSD (ms), coefficient of variability CV (%), spectrograms - total spectrum power TR (ms2), very low frequency waves of spectrum VLF (ms2), low frequency waves of spectrum LF (ms2), high frequency waves of spectrum HF (ms2). If their values equal: interinterval differences RMSSD - 76.8±3.92, coefficient of variability CV - 9.9±0.50, total spectrum power TR - 3437±175.3, very low frequency waves of spectrum VLF - 1067±54.4, low frequency waves of spectrum LF - 1003±51.2, high frequency waves of spectrum HF - 1900.2±96,9 vegetative dysfunction is diagnosed.
EFFECT: method increases reliability of diagnostics of impairment of vegetative regulation in children with tuberculosis.
1 tbl, 1 ex
SUBSTANCE: invention relates to medical equipment, namely to devices for remote monitoring of physiological parameters of human organism. System contains sensor of heart activity control, sensor of respiratory activity control, sensor of hemodynamics control, unit of data introduction and central computer. Additionally system contains microprocessor, GSM mobile connection net, which supports transmission of GPRS data packet, and function of location determination in PRCF radiosystem, data of motor activity control, two GPRS modems and multi-channel microcontroller. System also includes display, two telephones of mobile connection, database containing anamnesis, passport data, as well as contact information with patient's confidant.
EFFECT: realisation of invention makes it possible to perform mobile control of physiological state of organism of people, who are in helpless state.
5 cl, 2 dwg
SUBSTANCE: method involves carrying out pulsating Doppler echocardiographic examination. Mean pressure is determined in pulmonary artery. Mean pressure in pulmonary artery being less than 13 mm of mercury column, no cardiac rhythm disorders risk is considered to take place. The value being greater than 13 mm of mercury column, complex cardiac rhythm disorder occurrence risk is considered to be the case.
EFFECT: accelerated noninvasive method.