DISEASES OF THE GASTROINTESTINAL TRACT IN PREGNANT WOMEN. CLINICAL SIGNIFICANCE
DOI:
https://doi.org/10.11603/24116-4944.2023.2.14261Keywords:
gastritis, constipation, dyskinesia of the colon, pregnancyAbstract
The aim of the study – to determine the features of the clinical course of pregnancy at different stages of gestation in women with various diseases of the gastrointestinal tract and the algorithm for managing a pregnant woman.
Materials and Methods. 130 pregnant women of reproductive age at different stages of gestation were examined.
Results and Discussion. The duration of diseases of the gastrointestinal tract increased over the years from 1 year to more than 2 years. In the anamnesis, 64.6 % of people had chronic gastritis in the remission stage of various types (hypo-, hyperacidic, normoacidic) for more than 2 years, chronic constipation – 41.5 %, colonic dyskinesia syndrome – 44.6 %. The main symptoms were pain in the epigastric area, right hypochondrium, in the navel area, nausea, vomiting, lethargy, headaches. Chronic constipation was clinically manifested in the 1st trimester in 38.5 % of pregnant women, in the 2nd trimester – 47.7 %, in the 3rd trimester – 49.2 %. The frequency of colonic dyskinesia syndrome increased from 44.5 % in the first trimester to 56.9 % in the third. With exacerbation of chronic gastritis, chronic constipation, with colon hypokinesia syndrome, the threat of early miscarriage, early gestosis, the threat of late miscarriage, and the threat of premature birth amounted to 100 %. The diagnosis of anemia was confirmed in pregnant women. Low hemoglobin is consistent with low ferritin. The indicators of the coagulogram had a tendency to increase according to the term of pregnancy. In the 3rd semester, the content of ferritin, iron, folic acid, cyanocobalamin, vitamin D was found to be reduced and at the level of the lower limit of normal. The determination of total antibodies (IgG, IgA, IgM) to Helicobacter pylori antigens showed the presence of high titers (the positivity coefficient was from 6 .45 to 14.57) іn women burdened by chronic gastritis in the III trimester.
Conclusions. The course of pregnancy in women with chronic diseases of the gastrointestinal tract has many identical symptoms with pathological manifestations of gestational complications. Verification of the diagnosis requires the timely use of additional diagnostic tools. It is important to prepare for pregnancy, clarify the existing pathology, prevent exacerbations, and progress.
References
Bellini, M., Gambaccini, D., Salvadori, S., Tosetti, C., Urbano, M.T., Costa, F., … Marchi, S. (2014). Management of chronic constipation in general practice. Tech. Coloproctol., 18(6), 543-549. DOI: 10.1007/s10151-013-1093-9. Epub 2013 Nov 22. DOI: https://doi.org/10.1007/s10151-013-1093-9
Body, C., & Christie, J.A. (2016). Gastrointestinal Diseases in Pregnancy: Nausea, Vomiting, Hyperemesis Gravidarum, Gastroesophageal Reflux Disease, Constipation, and Diarrhea. Gastroenterol. Clin. North. Am., 45(2), 267-83. DOI: 10.1016/j.gtc.2016.02.005. DOI: https://doi.org/10.1016/j.gtc.2016.02.005
Cardaropoli, S., Piazzese, A., Piccoli, E., & Rolfo, A. (2013). Is Helicobacter pylori infection a risk factor for miscarriage? Placenta., 34(9), A37-A38. DOI: 10.1016/j.placenta.2013.06.112. DOI: https://doi.org/10.1016/j.placenta.2013.06.112
Cardaropoli, S., Giuffrida, D., Piazzese, A., & Todros, T. (2015). Helicobacter pylori seropositivity and pregnancy-related diseases: a prospective cohort study. J. Reprod. Immunol., 109, 41-47. DOI: 10.1016/j.jri.2015.02.004. Epub 2015 Mar 9. DOI: https://doi.org/10.1016/j.jri.2015.02.004
Eswaran, S., Muir, J., & Chey, W.D. (2013). Fiber and functional gastrointestinal disorders. Am. J. Gastroenterol., 08(5), 718-727. DOI: 10.1038/ajg.2013.63. Epub 2013 Apr 2. DOI: https://doi.org/10.1038/ajg.2013.63
Gharehbaghi, K., Gharehbaghi, D.R., Wierrani, F., Sliutz, F. (2016). Treatment of Chronic Functional Constipation during Pregnancy and Lactation. Z. Geburtshilfe Neonatol., 220(1), 9-15. DOI: 10.1055/s-0035-1554626. Epub 2016 Feb 11. DOI: https://doi.org/10.1055/s-0035-1554626
Hooi, J.K.Y., Lai, W.Y., Ng, W.K., Suen, M.M.Y., Underwood, F.E., Tanyingoh, F.E., Malfertheiner, P., … Siew C., Ng, S.C. (2017). Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology, 153(2), 420-429. DOI: 10.1053/j.gastro.2017.04.022. Epub 2017 Apr 27. DOI: https://doi.org/10.1053/j.gastro.2017.04.022
Jadallah, K.A., Kullab, S., M., & Sanders, D.S. (2014). Constipation-predominant irritable bowel syndrome: A review of current and emerging drug therapies. World Journal of Gastroenterology, 20(27), 8898-8909. DOI: 10.3748/wjg.v20.i27.8898.
Kitay, A.M., Ferst, F.S., Link, A., John Peter Geibel, J.P. (2019). Induction of Secretagogue Independent Gastric Acid Secretion via a Novel Aspirin-Activated Pathway. Sec. Gastrointestinal. Sciences, 10. DOI: 10.3389/fphys.2019.01264/. DOI: https://doi.org/10.3389/fphys.2019.01264
Lakhno, O. (2018). Sindrom razdrazhennogo kishechnika pri beremennosti. Osobennosti techeniya, diagnostiki i lecheniya [Irritable bowel syndrome during pregnancy. Features of the course, diagnosis and treatment]. Z turbotoyu pro zhínku – With care for the woman, 7(91), 22-24 [in Russian].
Li, J., Fan, M., Ma. F., Zhang, S., & Li, Q. (2021). The effects of Helicobacter pylori infection on pregnancy-related diseases and fetal development in diabetes in pregnancy. Ann. Transl. Med., 9(8), 686. DOI: 10.21037/atm-21-1209. DOI: https://doi.org/10.21037/atm-21-1209
London, V., Grube, S., Sherer, D.M., & Abulafia, O. (2017). Hyperemesis Gravidarum: A Review of Recent Literature. Pharmacology, 100(3-4), 161-171. DOI: 10.1159/000477853. Epub 2017 Jun 23. DOI: https://doi.org/10.1159/000477853
Azami, M., Nasirkandy, M.P., Mansouri, A., & Darvish, Z. (2017). Global Prevalence of Helicobacter Pylori Infection in Pregnant Women: A Systematic Review and Meta-Analysis Study. International Journal of Women s Health and Reproduction Sciences, 5(1). DOI: 10.15296/ijwhr.2017.06. DOI: https://doi.org/10.15296/ijwhr.2017.06
Suman, P., Gandhi, S., Kumar, P., & Garg, K. (2017). Prospects of electrochemical immunosensors for early diagnosis of preeclampsia. Am. J. Reprod. Immunol., 77(1). DOI: 10.1111/aji.12584. Epub 2016 Sep 25. DOI: https://doi.org/10.1111/aji.12584
Davydovа, Yu.V., Ohorodnyk, A.O., & Lymanska, A.Yu. (2020). Polipshennya yakosti zhyttya zhinok pid chas vahitnosti i v pislyapolohovomu periodi: zmenshennya chastoty proyaviv hemoroyu ta yoho uskladnen [Improving the quality of life of women during pregnancy and in the postpartum period: reducing the frequency of hemorrhoids and its complications]. Ukrayinskyy zhurnal Perynatolohiya i Pediatriya – Ukrainian Journal of Perinatology and Pediatrics, 3(83), 22-25 [In Ukrainian]. DOI: https://doi.org/10.15574/PP.2020.83.22
Rafii, F., Fatemi, N.S., & Danielson, E. (2014). Compliance to treatment in patients with chronic illness: A concept exploration. Iran J. Nurs. Midwifery Res., 19, 2, 159-167. PMid:24834085 PMCid:PMC4020025
Rocha de Matos, A.S. (2014). Constipation in pregnancy – а systematic review: Dissertaзаo para obtenзаo do Grau de Mestre em Medicina. Covilhв, 30.
Shin, G.H., Toto, E.L., & Schey, R. (2015). Pregnancy and postpartum bowel changes: Constipation and fecal incontinence. The American Journal of Gastroenterology, 110, 521-529. DOI: 10.1038/ajg.2015.76. DOI: https://doi.org/10.1038/ajg.2015.76
Xiang, L., Wei, Z., & Cao, Y. (2014). Symptoms of an intrauterine hematoma associated with pregnancy complications: a systematic review. PLoS One, 9(11). DOI: https://doi.org/10.1371/journal.pone.0111676
Zherebak, N., & Gnatko, O. (2020). Perebih zahrozy pereryvannya vahitnosti pry riznykh typakh khronichnykh hastrytiv [The course of the threat of abortion in different types of chronic gastritis]. Ukrayinskyy naukovo-medychnyy molodizhnyy zhurnal (UNMMZH) – Ukrainian Scientific and Medical Youth Journal (USMYZH), 1(115), 53-62. DOI: 10.32345/ [In Ukrainian]. DOI: https://doi.org/10.32345/USMYJ.1(115).2020.53-62
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Actual Problems of Pediatrics, Obstetrics and Gynecology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in this journal agree to the following terms:
1. The authors reserve the right to authorship of the work and pass the journal right of first publication of this work is licensed under a Creative Commons Attribution License, which allows others to freely distribute the work published with reference to the authors of the original work and the first publication of this magazine.
2. Authors are entitled to enter into a separate agreement on additional non-exclusive distribution of work in the form in which it was published in the magazine (eg work place in the electronic repository institution or publish monographs in part), provided that the reference to the first publication of this magazine.
3. Policy magazine allows and encourages authors placement on the Internet (eg, in storage facilities or on personal websites) manuscript of how to submit the manuscript to the editor and during his editorial processing, since it contributes to productive scientific discussion and positive impact on the efficiency and dynamics of citing published work (see. The Effect of Open Access).
