Complex applying physical therapy and preformed physical factors in pregnant women with chronic pyelonephritis

Authors

DOI:

https://doi.org/10.14739/2409-2932.2023.1.269150

Keywords:

pregnancy, chronic pyelonephritis, prevention of obstetric and perinatal complications, physical therapy, preformed physical factors, intermittent normobaric hypoxytherapy, hemodynamics

Abstract

The aim of the work is to evaluate the impact of physical therapy and preformed physical factors in pregnant women with chronic pyelonephritis on central hemodynamic indicators.

Materials and methods. The dynamics of 134 pregnant women with chronic pyelonephritis (CP) in the remission stage, who underwent a complex sanatorium rehabilitation program, were examined. The main study group consisted of 79 pregnant women with chronic pyelonephritis. In this contingent of women, the sanatorium rehabilitation complex additionally included a course of intermittent normobaric hypoxytherapy (INH). The comparison group consisted of 55 pregnant women with CP, for whom the sanatorium rehabilitation complex did not include an INH course. The control group is represented by 37 somatically healthy women with a physiological course of pregnancy. All pregnant women were examined for central hemodynamic (CH) indicators using the computer diagnostic complex REOKOM (Kharkiv).

Results. Pregnancy periods of 20–30 and 31–30 weeks in women with CP are characterized by a pathological load on central hemodynamics. At the same time, the application for the INH course in the sanatorium rehabilitation complex (the main group) allows for an increase in the compensatory capabilities of the pregnant woman with CH. Thus, in the period of pregnancy of 22–30 weeks in the main group, indicators of diastolic blood pressure and heart rate were probably lower than the control values (P < 0.001), which in this group is determined by values of peripheral resistance of blood vessels close to those of the control group (P > 0.05), regardless of the timing of the study.

The study of CH and the comparison of different periods of gestation and between research groups indicate an inverse relationship between indicators that reflect the intensity of cardiohemodynamics and indicators of vascular resistance, as one of the final mechanisms of maintaining blood pressure at a physiological level, or its pathological increase in chronic pyelonephritis and preeclampsia

Taking into account that the ratio of cardiac index indicators and total peripheral vascular resistance in all study groups was stable and directly dependent on the level of blood pressure, it is advisable to recommend for practical application in order to assess the state of CH of pregnant women with CP indicators of stroke or cardiac indices, which characterize the intensity cardiohemodynamics and do not depend on the anthropometric data of the pregnant woman.

Conclusions. The application of physical therapy and preformed physical factors, namely, intermittent normobaric hypoxytherapy in pregnant women with chronic pyelonephritis in a complex program of sanatorium rehabilitation increases the compensatory capabilities of the cardiovascular system, which is confirmed by a significant decrease in the values of the total peripheral resistance against the background of an increase in the cardiac index.

 

Author Biographies

М. І. Pavliuchenko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assosiate Professor of the Department of Obstetrics and Gynecology

V. H. Siusiuka, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Assosiate Professor of the Department of Obstetrics and Gynecology

N. V. Haidai, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assosiate Professor of the Department of Obstetrics and Gynecology

M. Yu. Serhiienko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assistant of the Department of Obstetrics and Gynecology

O. V. Deinichenko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assistant of the Department of Obstetrics and Gynecology

References

Ansaldi, Y., & Martinez de Tejada Weber, B. (2022). Urinary tract infections in pregnancy. Clinical microbiology and infection, S1198-743X(22)00431-1. Advance online publication. https://doi.org/10.1016/j.cmi.2022.08.015

Johnson, C. Y., Rocheleau, C. M., Howley, M. M., Chiu, S. K., Arnold, K. E., & Ailes, E. C. (2021). Characteristics of Women with Urinary Tract Infection in Pregnancy. Journal of women's health (2002), 30(11), 1556-1564. https://doi.org/10.1089/jwh.2020.8946

Kalinderi, K., Delkos, D., Kalinderis, M., Athanasiadis, A., & Kalogiannidis, I. (2018). Urinary tract infection during pregnancy: current concepts on a common multifaceted problem. Journal of obstetrics and gynaecology, 38(4), 448-453. https://doi.org/10.1080/01443615.2017.1370579

Szweda, H., & Jóźwik, M. (2016). Urinary tract infections during pregnancy - an updated overview. Developmental period medicine, 20(4), 263-272.

Zanatta, D. A. L., Rossini, M. M., & Trapani Júnior, A. (2017). Pyelonephritis in Pregnancy: Clinical and Laboratorial Aspects and Perinatal Results. Pielonefrite na gestação: aspectos clínicos e laboratoriais e resultados perinatais. Revista brasileira de ginecologia e obstetricia, 39(12), 653-658. https://doi.org/10.1055/s-0037-1608627

Rao, S., & Jim, B. (2018). Acute Kidney Injury in Pregnancy: The Changing Landscape for the 21st Century. Kidney international reports, 3(2), 247-257. https://doi.org/10.1016/j.ekir.2018.01.011

Turbeville, H. R., & Sasser, J. M. (2020). Preeclampsia beyond pregnancy: long-term consequences for mother and child. American journal of physiology. Renal physiology, 318(6), F1315-F1326. https://doi.org/10.1152/ajprenal.00071.2020

Stevens, W., Shih, T., Incerti, D., Ton, T. G. N., Lee, H. C., Peneva, D., Macones, G. A., Sibai, B. M., & Jena, A. B. (2017). Short-term costs of preeclampsia to the United States health care system. American journal of obstetrics and gynecology, 217(3), 237-248.e16. https://doi.org/10.1016/j.ajog.2017.04.032

WHO. (2018). WHO recommendations: policy of interventionist versus expectant management of severe pre-eclampsia before term. https://www.who.int/publications/i/item/9789241550444

Gyselaers, W., & Thilaganathan, B. (2019). Preeclampsia: a gestational cardiorenal syndrome. The Journal of physiology, 597(18), 4695-4714. https://doi.org/10.1113/JP274893

Ma'ayeh, M., & Costantine, M. M. (2020). Prevention of preeclampsia. Seminars in fetal & neonatal medicine, 25(5), 101123. https://doi.org/10.1016/j.siny.2020.101123

Thilaganathan, B., & Kalafat, E. (2019). Cardiovascular System in Preeclampsia and Beyond. Hypertension, 73(3), 522-531. https://doi.org/10.1161/HYPERTENSIONAHA.118.11191

Yagel, S., Cohen, S. M., & Goldman-Wohl, D. (2022). An integrated model of preeclampsia: a multifaceted syndrome of the maternal cardiovascular-placental-fetal array. American journal of obstetrics and gynecology, 226(2S), S963-S972. https://doi.org/10.1016/j.ajog.2020.10.023

Zharkikh, A. V., Ponomarenko, V. I., Mamedov, A. M., Shapran, N. F., & Pavlyuchenko, M. I. (2004). Sanatornoe ozdorovlenie beremennykh [Sanatorium rehabilitation of pregnant women]. Zaporozhye. [in Russian].

Moors, S., Bullens, L. M., van Runnard Heimel, P. J., Dieleman, J. P., Kulik, W., Bakkeren, D. L., van den Heuvel, E. R., van der Hout-van der Jagt, M. B., & Oei, S. G. (2020). The effect of intrauterine resuscitation by maternal hyperoxygenation on perinatal and maternal outcome: a randomized controlled trial. American journal of obstetrics & gynecology MFM, 2(2), 100102. https://doi.org/10.1016/j.ajogmf.2020.100102

Raghuraman, N., Temming, L. A., Doering, M. M., Stoll, C. R., Palanisamy, A., Stout, M. J., Colditz, G. A., Cahill, A. G., & Tuuli, M. G. (2021). Maternal Oxygen Supplementation Compared With Room Air for Intrauterine Resuscitation: A Systematic Review and Meta-analysis. JAMA pediatrics, 175(4), 368-376. https://doi.org/10.1001/jamapediatrics.2020.5351

Guerby, P., Tasta, O., Swiader, A., Pont, F., Bujold, E., Parant, O., Vayssiere, C., Salvayre, R., & Negre-Salvayre, A. (2021). Role of oxidative stress in the dysfunction of the placental endothelial nitric oxide synthase in preeclampsia. Redox biology, 40, 101861. https://doi.org/10.1016/j.redox.2021.101861

Määttä, J., Sissala, N., Dimova, E. Y., Serpi, R., Moore, L. G., & Koivunen, P. (2018). Hypoxia causes reductions in birth weight by altering maternal glucose and lipid metabolism. Scientific reports, 8(1), 13583. https://doi.org/10.1038/s41598-018-31908-2

Martin, A., Millet, G., Osredkar, D., Mramor, M., Faes, C., Gouraud, E., Debevec, T., & Pialoux, V. (2020). Effect of pre-term birth on oxidative stress responses to normoxic and hypoxic exercise. Redox biology, 32, 101497. https://doi.org/10.1016/j.redox.2020.101497

Loboda, M. V., Babov, K. D., Zolotarova, T. A., & Hriniaieva, L. Ya. (Eds.). (2008). Standarty (klinichni protokoly) sanatorno-kurortnoho likuvannia [Standards (clinical protocols) of sanatorium-resort treatment]. Kyiv: KIM. [in Ukrainian].

Published

2023-03-10

How to Cite

1.
Pavliuchenko МІ, Siusiuka VH, Haidai NV, Serhiienko MY, Deinichenko OV. Complex applying physical therapy and preformed physical factors in pregnant women with chronic pyelonephritis. Current issues in pharmacy and medicine: science and practice [Internet]. 2023Mar.10 [cited 2024Apr.14];16(1):53-9. Available from: http://pharmed.zsmu.edu.ua/article/view/269150

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Original research