Acta Scientific Women's Health (ASWH)(ISSN: 2582-3205)

Research Article Volume 4 Issue 2

Correction of Cardio-hemodynamics and Endothelial Function Disorders in Pregnant Women with Connective Tissue Dysplasia

Viktoria Yuriivna Dobrianska1, Svitlana Mykolaivna Heryak2* and Mykola Ivanovych Shved3

1Department of Obstetrics and Gynaecology No.1, I. Horbachevsky Ternopil National Medical University, Ukraine
2Department of Obstetrics and Gynaecology No. 2, I. Horbachevsky Ternopil National Medical University, Ukraine
3Department of First Emergency Medical Aid and Emergency Medical Treatment I. Horbachevsky Ternopil National Medical University, Ukraine

*Corresponding Author: Svitlana Mykolaivna Heryak, Department of Obstetrics and Gynaecology No. 2, I. Horbachevsky Ternopil National Medical University, Ukraine.

Received: January 03, 2022; Published: January 27, 2022

Abstract

Objectives: The negative impact of undifferentiated connective tissue dysplasia (UCTD) in myocardial contractility and endothelial microvascular dysfunction and their frequent combination with cardiac arrhythmias suggests an unfavorable course to pregnancy and childbirth due to the formation of uteroplacental dysfunction.

The Aim of the Study: To reduce the incidence of obstetric complications in pregnants with UCTD by carnitine-arginine complex.

Materials and Methods: There were examined 58 pregnants with UCTD, including mitral valve prolaps with and without frequent extrasystoles, and 14 pregnants of control group. Metabolic support by intravenous infusion of L-arginine and L-carnitine complex.

Results: There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction and significantly more often diagnosed with obstetrics complications in pregnant women with MVP and extrasystolic arrhythmia on the background of UCTD. There was a significant reduction of arrhythmias in patients with MVP and frequent ventricular (90.6%) or mixed extrasystoles (77.8%) under the influence of complex drug treatment with L-arginine and L-carnitine.

Conclusion: There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction, which are triggers of complicated pregnancy and childbirth in pregnant women with MVP and extrasystolic arrhythmia on the background of UCTD in the initial state. The inclusion of L-arginine and L-carnitine led to a significant improvement in the parameters of central cardiohemodynamics and restoration of endothelial function of microvessels and pregnancy complications.

Keywords: Pregnancy; Undifferentiated Connective Tissue Dysplasia (UCTD); Mitral Valve Prolapse (MVP); Extrasystole; Systolic-diastolic and Endothelial Dysfunction; Arginine; Carnitine

References

  1. Faiz SA., et al. “Pregnancy and valvular heart disease”. Saudi Medical Journal10 (2016): 1098-1101.
  2. Gazazyan MG. “Features of the course of pregnancy and childbirth in patients with connective tissue dysplasia”. Obstetrics and Gynecology 1 (2017): 121-126.
  3. Jana N., et al. “Pregnancy in association with mitral valve prolapse”. Asia-Oceania Journal of Obstetrics and Gynaecology 1 (1993): 61-65.
  4. Kildiyarova RR and Uglova DF. “Dysplasia of connective tissue as a constitutional basis of congenital heart defects in women and their newborn children”. Archives of Internal Medicine 4 (2015): 38-42.
  5. Makarchuk OM., et al. “Undifferentiated connective tissue dysplasia as a factor of probable gestational complications”. Genetics | Obstetrics and Gynecology 2 (2015): 18-19.
  6. Yashchuk AG., et al. “Functioning of the hemostasis system in pregnant women against the background of undifferentiated connective tissue dysplasia”. Practice Medicine93 (2016): 37-40.
  7. Siromakha SO., et al. “Marfan syndrome and pregnancy”. Actual Problems of Pediatrics, Obstetrics and Gynecology 1 (2020): 94-101.
  8. Ben Salkha M and Repina NB. “Clinical diagnosis of undifferentiated connective tissue dysplasia”. P.Pavlov Russian Medical Biological Herald 24.4 (2016): 164-172.
  9. Pavlenko M. “Isthmic-cervical insufficiency: description, causes, treatment” (2018).
  10. Hameed A., et al. “The effect of valvular heart disease on maternal and fetal outcome of pregnancy”. Journal of the American College of Cardiology 3 (2015): 893-899.
  11. Smirnova TL., et al. “Features of the course of pregnancy and childbirth in women with the syndrome of undifferentiated connective tissue dysplasia”. Practice Medicine6 (2018): 39-44.
  12. Lukina TS., et al. “Management of pregnant women with undifferentiated connective tissue dysplasia”. 4 (2015): 2-5.
  13. Heryak SM., et al. “Electrolyte disorders as a predictor of obstetric and perinatal complications in pregnant women with mitral valve prolapse”. of Sci. Works of Obstet. Gynecol. of Ukraine. (2019): 11-19.
  14. Saryyeva OP., et al. “Pathomorphology of extra-placental membranes with their premature rupture and undifferentiated connective tissue dysplasia in women”. Archives of Pathology4 (2019): 26-32.
  15. Tetelyutina FK., et al. “Indicators of biopolymers of connective tissue dysplasia in the assessment of placental insufficiency”. Vyatka Medical Bulletin58 (2018): 27-31.
  16. Chia YT., et al. “Pregnancy outcome and mitral valve prolapse”. Asia-Oceania Journal of Obstetrics and Gynaecology 4 (1994): 383-388.
  17. Nanna M and Stergiopoulos K. “Pregnancy complicated by valvular heart disease: an update”. Journal of the American Heart Association 3 (2014): 76-80.
  18. Kazachkova EA. “Syndrome of dysplasia of the connective tissue of the heart and pregnancy”. Obstetrics and Gynecology 1 (2017): 127-132.
  19. Sitnikova OG., et al. “Free radical oxidation of lipids and antioxidant activity in pregnant women with undifferentiated connective tissue dysplasia in premature pregnancy”. Tavrida Med. Biol. Bull.69 (2015): 120-122.
  20. Kononenko IS. “Polymorphisms of the genes of the transforming growth factor β1 and matrix metalloproteinase 9 as molecular genetic predictors of the formation of isthmic-cervical insufficiency in patients with undifferentiated connective tissue dysplasia”. Bulletin VSMU3 (2020): 50-58.
  21. Dobrokhotova YuE and Borovkova YeI. “Pregravid preparation and management of pregnancy in patients with connective tissue dysplasia”. Gynecology5 (2017): 44-49.
  22. Ilina YuI and Chikisheva AA. “Features of the course of pregnancy in patients with connective tissue dysplasia”. Mother and Child 3 (2020): 182-188.
  23. Dobryanska VYu., et al. “Predictors of extrasistic arrythmia and its treatment in pregnant military valve prolapses”. Advances in Clinical and Experimental Medicine 2 (2018): 48-52.
  24. Lichodziejewska B., et al. “Clinical symptoms of mitral valve prolapse are related to hypomagnesaemia and attenuated by magnesium supplementation”. American Journal of Cardiology 6 (2017): 768-772.
  25. Artal R., et al. “Transient ischemic attack: a complication of mitral valve prolapse in pregnancy”. Obstetrics and Gynecology6 (2016): 1028-1030.
  26. Kucharczyk-Petryka E., et al. “Mitral valve prolapse at pregnancy: is it a real clinical problem?” Polish Archives of Internal Medicine 5 (2016): 1084-1088.
  27. Smolnova TYu. “Indications for the choice of drug therapy in patients with connective tissue dysplasia in obstetrics and gynecology”. Proceedings of the first All-Russian conf. Topical issues of internal pathology. Connective tissue dysplasia (2015).
  28. Kondakov IL and Yakovenko AF. “Methods of morpho-functional study of endothelial status. Methodical recommendations”. Kharkiv (2000): 18.
  29. Selyuk MM., et al. “Selection of the optimal combination of metabolic drugs for the treatment of patients with cardiovascular pathology”. Family Medicine 70 (2017): 60-64.
  30. Shved MI and Pelyo M. “Influence of cardioprotective metabolic therapy on the occurrence of rhythm and conduction disorders in patients with myocardial infarction with metabolic syndrome”. Arithmology 26 (2018): 53-55.

Citation

Citation: Svitlana Mykolaivna Heryak., et al. “Correction of Cardio-hemodynamics and Endothelial Function Disorders in Pregnant Women with Connective Tissue Dysplasia". Acta Scientific Women's Health 4.2 (2022):32-39.

Copyright

Copyright: © 2022 Svitlana Mykolaivna Heryak., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"

Contact US