Перегляд за Автор "Dobrovolska, L. М."

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    Changes of psychoemotional state in the infertile pregnant females due to the anamnesis and IVF
    (Wydawnictwo Aluna, 2023-08) Lykhachov, V. К.; Shymanska, Ya. V.; Savelyeva, Yu. S.; Vashchenko, V. L.; Dobrovolska, L. М.; Ліхачов, Володимир Костянтинович; Шиманська, Яніна Вікторівна; Савельєва, Оксана Володимирівна; Ващенко, Вікторія Леонідівна; Добровольська, Людмила Миколаївна
    Introduction: During pregnancy in the body of a healthy woman there are physiological and psychological changes that contribute to the bearing a child and prepare the female for future labour and motherhood. In women who experience failure at the stage of fertilization or during pregnancy, as a result of prolonged negative emotional states, psycho-emotional stress develops. The aim of the research was to study the psycho-emotional state of women with infertility in history, whose pregnancy resulted from extracorporal fertilization (IVF), and to develop methods for reducing their anxiety. Materials and methods: At the first stage, the initial psycho-emotional state of 60 women in the second trimester, whose pregnancy resulted from IVF (Group I), was studied; the control group consisted of 20 healthy women with a physiological course of pregnancy (Group II). At the second stage, 10 art therapy exercises with a requestioning of pregnant women from Group I were conducted for improving their psycho-emotional state. Results: Women of Group I had a high level of both situational anxiety (SA) and the personal one (PA).The prevalent type of the psychological component of gestational dominant was anxiety and euphoric types (58.3%). In one third of women with burdened gynecological history examined mild or masked depression was diagnosed. 43 pregnant women from Group I used a method of psychocorrection – art therapy, which included colouring “antistress” pictures of perinatal topic, making flowers from paper andcreating a collage of dreams. Conclusions: After the art therapy course, a high level of SA (from 46.5% to 7.0%) and OA (from 48.8% to 32.6%) decreased, the index of the optimal type of the psychological component of gestational dominant increased from 25.6% to 53.5%.The number of women without depression increased from 62.8% to 93%.
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    Possibility for non-invasive diagnosis of chronic endometrinis in women at risk during pregnavid preparation
    (Aluna Publishing, 2024-11) Taranovska, O. О.; Likhachov, V. К.; Dobrovolska, L. М.; Makarov, O. G.; Shymanska, Ya. V.; Тарановська, Олена Олексіївна; Ліхачов, Володимир Костянтинович; Добровольська, Людмила Миколаївна; Макаров, Олег Геннадійович; Шиманська, Яніна Вікторівна
    Introduction: Detection and treatment o f chronic endometritis (CE) is clinically significant, though involves intrauterine intervention to collect endometrium. The aim : To estimate the possibility to use fertility a2-m icroglobulin (FAMG) as the marker of the high risk for CE. Materials and m ethods: 70 women with CE who were planning pregnancy were tested for FAMG in menstrual blood. 40 of them received treatment of CE. The other 30 women refused from the proposed treatment. The control group involved 30 women who had neither CE nor luteal phase deficiency (LPD). Additional group (20 women) had LPD without CE. Results: The decrease of FAMG by 2.4 times was noted in women with CE (16.3 ± 3.9 |jg/ml against 39.8 ± 8.3 |jg/ml in the controls). In LPD the index was 5.6 times lower. After treatment the level of FAMG was increasing. Conclusions: The decrease o f the amount o f FAMG in menstrual blood is specific for women both with CE and LPD. Detection of abnorm ally low rates o f FAMG in all women with CE enables, with the exception of absolute hypoprogesteronemia and LPD, using it as a sim ple method of estimation of the functional state o f endometrium . Its application can be very useful both for non-invasive diagnosis of CE and subsequent evaluation of treatment of this pathology.
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    Зміни гормонально-імунологічної регуляції як предиктор невиношування вагітності у жінок з гіперандрогенією
    (Полтавський державний медичний університет, 2015) Семенюк, Людмила Миколаївна; Яроцький, Микола Євгенович; Ліхачов, Володимир Костянтинович; Добровольська, Людмила Миколаївна; Semeniuk, L. М.; Yarotskyi, М. Е.; Lihachov, V. K.; Dobrovolska, L. М.
    Для нормального перебігу вагітності окрім гормонального забезпечення надзвичайно важливим є імунологічна толерантність материнського організму до антигенів плоду. Науковий і практичний інтерес представляє вивчення в динаміці окремих параметрів системного імунітету та їх вкладу в становлення гестаційного процесу, а також розробка ранніх методів прогнозування та профілактики ранніх втрат вагітності на тлі гіперандрогенії, спрямованих на безпечне завершення вагітності. The organism of pregnant woman must maintain a state of immunological balance between full immune competency against alien microorganisms and immunologic tolerance to the developing foetus. Disorder of tolerance formation processes leads to pathological conditions characterized by activation of cellular and humoral links of the immune system with the development of clinical manifestations of ovum rejection of varying severity that is considered as the starting point of reproductive losses. Therefore, the aim of the research was to study the imbalance of sex hormones and disorders of systemic and local immunity in patients with recurrent miscarriage on the background of hyperandrogenism (HA) to predict the development of the next pregnancy. The indicators of reproductive hormones and content of populations and subpopulations of peripheral blood lymphocytes were studied in 45 patients with adrenal hyperandrogenism (AHA) and early reproductive losses in the anamnesis (the main group) and 20 women with normal reproductive function (control group); local cellular immunity in endocervical bioptates of 15 healthy non-pregnant women and 25 pregnant women of the main group was studied. A tendency of synthesis progesterone decrease toward the median of the control group was observed in women with adrenal hyperandrogenism (AHA); this phenomenon of progesterone relative deficiency should be considered as a biochemical marker of the luteal phase inferiority of the cycle in conditions of androgen excess, that leads to the secondary function inhibition of the ovaries granular cells. Estradiol level did not differ from the mean normal values for women of reproductive age. Subpopulation analysis of peripheral blood lymphocytes in patients of the main group stated that the number of T-helpers (CD4) before the pregnancy is significantly decreased, the number of natural killer cells (CD16), the activation marker interleukin-2 (CD25), the number of dendrite cells (HLA-DR) and cells that are ready to apoptosis (CD95) are increasing. The presence of luteal phase insufficiency in women leads to the unavailability of the endometrium to embryo implantation. In women of risk group with miscarriage, T-supressor immunity decreases, natural killer cells, which are capable to commit aggression against the fetus, while passing through placenta are activated upon the occurrence of pregnancy. The increase of functional activity of lymphocytes can be used to predict the development of pregnancy in the first trimester. Considering the general mechanisms of cell activity regulation, it can be assumed that the decrease in function and possible loss of cytotrophoblast are caused by the high cytotoxic activity of natural killers, which is one of the pathogenetic links of pregnancy miscarriage. The tendency towards the increase of the number CD19 lymphocytes during the pregnancy, which probably stated the activation of autosensibilization and also predetermines an unfavorable outcome of pregnancy is noteworthy. The following predictive immunological risk markers of miscarriage of the next pregnancy in women with hyperandrogenism can be proposed: reduction of immunoregulatory index (CD4/CD8); increased level of natural killer cells (CD16); the increase in the number of activated cells (CD25; CD95); high level of HLA-DR Conservative correction of hyperandrogenism dysfunction on preconception stage will facilitate normalization of the main parameters of hormonal and immunological mechanisms and restore mother’s organism ability to ensure full implantation and normal development of pregnancy on early stages