Procoagulant Status and Fibrinolytic Activity in COVID-19 Patients during Illness and Convalescence.

SARS-CoV-2 (Severe Acute Respiratory Syndrome-related CoronaVirus 2) activates the immune system, causing thrombin dysregulation and tissue damage and reduces endothelium anticoagulant function, leading to excessive thrombin formation. Hypercoagulability, which causes multiple organ failure in critically ill COVID-19 (COronaVIrus Disease 2019) patients, can be detected by viscoelastic tests like thromboelastography and rotational thromboelastometry (ROTEM). We aimed to assess the coagulation system status and fibrinolytic activity using ROTEM thromboelastometry in patients with COVID-19 and convalescents.

[Various phenotypes of postpartum atypical hemolytic uremic syndrome: the role of genetic testing in determining prognosis. Case report].

We report a case of atypical hemolytic uremic syndrome (aHUS) that occurred after childbirth in a patient with a history of numerous recurrent episodes of TMA with nephrotic proteinuria and impaired renal function. At 33 weeks of the first spontaneous pregnancy, proteinuria up to 0.8 g/l was first registered, at 38 weeks she was hospitalized with proteinuria, reaching a maximum of 13 g/l, she was delivered promptly, after which progressive thrombocytopenia was noted over the next few days (up to 44×10/l) and anemia and severe arterial hypertension, which could not be corrected by several groups of antihypertensive drugs.

Distinct gene expression patterns for CD14++ and CD16++ monocytes in preeclampsia.

Preeclampsia (PE) is a serious gestational complication affecting the life of a mother and child. The immunophenotype and gene expression profile of isolated blood monocyte subpopulations of pregnant women with PE have not been studied before. In this work, we assessed changes in CD14++ and CD16++ monocyte subpopulations in PE and physiological pregnancy (n = 33).

Expression of Estrogen Receptor α by Decidual Macrophages in Preeclampsia.

Preeclampsia is a gestation-associated hypertensive syndrome that threatens the life and health of the mother and the child. The condition is presumably caused by systemic failure with a strong involvement of innate immunity. In particular, it has been associated with flexible phenotypes of macrophages, which depend on the molecules circulating in the blood and tissue fluid, such as cytokines and hormones.

Preeclampsia: inflammatory signature of decidual cells in early manifestation of disease.

Introduction: Preeclampsia is a pregnancy-specific complication characterized by hypertension in combination with proteinuria and/or various manifestations of multiple organ failure. It is believed that etiology of preeclampsia lies in dysfunction of the placenta and disorder of the maternal-fetal interactions. In preeclampsia decidual membrane, the maternal part of the placenta which normally supports immunological tolerance of the maternal organism to the semi-allogeneic fetus, becomes a site of inflammation.

Clinical course of novel COVID-19 infection in pregnant women.

Objectives: Evaluation of clinical course of COVID-19 during pregnancy and maternal and perinatal outcomes of this pregnancy.

Methods: 66 women with polymerase chain reaction (PCR) - confirmed SARS-CoV-2 and their 42 neonates were included in the prospective observational study. Demographic, epidemiological, clinical, laboratory and instrumental data of pregnancy, delivery, postpartum period, including pharmacotherapy and neonatal outcomes were analyzed.

Risk Assessment and Management of Venous Thromboembolism in Women during Pregnancy and Puerperium (SAVE): An International, Cross-sectional Study.

The clinical burden of obstetric venous thromboembolism (VTE) risk is inadequately established. This study assessed the prevalence and management of VTE risk during pregnancy and postpartum outside the Western world. This international, noninterventional study enrolled adult women with objectively confirmed pregnancy attending prenatal care/obstetric centers across 18 countries in Africa, Eurasia, Middle-East, and South Asia.

The laboratory control of anticoagulant thromboprophylaxis during the early postpartum period after cesarean delivery.

Introduction: The incidence of venous thromboembolism (VTE) after cesarean section is up to 0.6%, and the widespread use of cesarean section draws attention to this group. The dosage and duration of low-molecular-weight heparin (LMWH) prophylaxis after delivery is estimated by anamnestic risk-scales; however, the predictive potency for an individual patient's risk can be low.

[Anaesthetic management of the infant with gastroschisis].

The review deals with an analysis of articles about a gastroschisis, its firequency and outcomes of treatment. The review discusses the mortality in patients with gastroschisis in Russia and peculiarities of anaesthesia management and surgical treatment.

[Regional anaesthesia in women with morbid obesity in obstetrics and gynecology].

The article deals with regional anaesthesia peculiarities in womnen wiith morbid obesity in obstetrics and gynecology. The articles discusses cases demonstating safety and effectiveness of low-dose comnbined spinal-epidural anaesthesia in these patients.

[Noninvasive total hemoglobin monitoring based on multiwave spectrophotometry in obstetrics and gynecology].

Results of prospective randomized comparative research of 2 total hemoglobin estimation methods are presented. There were laboratory tests and continuous noninvasive technique with multiwave spectrophotometry on the Masimo Rainbow SET. Research was carried out in two stages.

PP073. The diagnostics potential of integral rheography during the dynamic examination of body fluid sectors at puerperal women with preeclampsia.

Objectives: correction of infusion intravenous therapy to avoid body hyperhydration during the infusion therapy by estimating body's water sectors condition at puerperal women with preeclampsia, which were delivered by caesarian section and received infusion intravenous therapy.

Material And Methods: 220 women with average and severe preeclampsia were analyzed. Due to the infusion therapy composition women were divided into 2 groups: 1- the basic group (n=110) in which the infusion solution was new hydroxyethylstarch solution (Tetraspan), which consist of starch at isooncotic solution, which electrolyte structure is similar to blood plasma and contains Na, K, Cl, Mg, Ca ions, also malats and lactats.

PP059. Characteristics of body inflammatory reaction during the implementation of differentiated therapy of preeclampsia in perioperative care.

Objectives: To learn features of the electrolyte balanced starch solution of Tetraspan in comparison with standard starch solutions in therapy of preeclampsia. The advantages of Tetraspan (B Braun®) application were the composition, which is due to electrolyte composition near to blood plasma absence of negative influence on kidneys and on curtailing system of blood.

Material And Methods: 220 puerperal women with preeclampsia after cesarean section were investigated.

[Prophylaxis and treatment of severe bleeding in obstetrics (draft guidelines)].

The article represents draft guidelines on severe bleeding in obstetrics which is the major reason of maternal mortality throughout the world. Criteria of estimation the physiological, pathological and massive blood loss are given. Algorithms of conservative and surgical treatment are presented, as well as major indications for administration of anti-fibrinolythics, infusion and transfusion treatment.

[The Second All-Russian Educational Congress "Anaesthesia and Intensive Care in Obstetrics and Neonatology"].

The article highlights the most urgent issues of anaesthesia and intensive care in obstetrics presented in the reports of the leading specialists at the 2nd All-Russian Educational Congress "Anaesthesia And Intensive Care In Obstetrics And Neonatology".

[Concentration of 8-isoprostaglandin F2alpha depending on type of anesthesia in laparoscopic surgery in gynecology].

The article represents a randomized comparative study including 100 patients from 21 to 34 years old who has underwent a laparoscopic surgery in V. I. Kulakov Research Center of Obstetrics, Gynaecology, and Perinatology in 2007-2009.

[Pregnancy in the context of general adaptation syndrome].

Based on their own findings and the data available in the literature on pregnancy including that complicated by gestosis, the authors consider these conditions in the context of Selye's general adaptation syndrome. They identify its basic links (the autonomic nervous and cardiovascular systems) the function of which is affected by all the physiological and pathophysiological processes involved in its development. There is a high likelihood of baseline impaired adaption processes in these links, which may lead to an inability to accommodate (dysadaptation) by the moment of delivery.

[Risks of surgery and anesthesia and optimization of anesthesiological maintenance of abdominal delivery].

The paper deals with abdominal labor pain relief in pregnant women at high risk for impaired development of the general adaptation syndrome: significant sympathicotonia, placental ischemia-reperfusion syndrome, and systemic inflammatory response syndrome. All these syndromes are attended by either impaired oxygen transport or a high risk for the occurrence of such at surgery. The detection and correction of these impairments in development of the general adaptation syndrome in pregnancy, which are provided by the author's modified rating scale for risks of surgery and anesthesia, contribute to the development of the body's compensated metabolic reaction to surgical injury, reducing the number of maternal, fetal, and neonatal complications.

[Optimization of anesthetic service during abdominal delivery of pregnant women with gestosis].

Differential preoperative preparation of pregnant women with gestosis, by using calcium antagonists is an effective preventive measure against a circulatory hyperdynamic response to transportation to the operating suite. In pregnant women who had all hemodynamic types at baseline, the eukinetic type achieved during the preparation is retained. The patients with gestosis who did not receive calcium antagonists were found to have a circulatory hyperdynamic response with increased myocardial oxygen uptake (during surgery in particular).

[Experimental investigations of the analgesic activity of fentanyl and the non-opiodal agents -clonidine and isradipine, and protease inhibitors].

The analgesic activity of clonidine, isradipine, antagosane (aprotinine), transamine, and their combinations with fentanyl in subanalgesic doses was experimentally studied on mice, by using the tail-flick test. Analgesic activity was found in clonidine, antagosane, and transamine. A combination of fentanyl used in subanalgesic doses and clonidine, isradipine, antagosane, or transamine had supertotal analgesic activity.