[Use of diuretics in pregnancy].
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Biomedical subjects
Publications and source records attributed to M M Shekhtman.
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The authors analyze the incidence and structure of acute and chronic visceral diseases in pregnant women and the incidence and structure of maternal death because of extragenital diseases. Causes of maternal mortality are discussed and approaches to reducing maternal morbidity and mortality in visceral diseases outlined.
Due to the fact that therapy of lymphogranulomatosis has recently provided better results, a question has arisen whether pregnancy can be preserved in females suffering from the disease. The paper yields the data available in the literature and their own results. The examination showed that the pregnancy occurring after a long-term remission was not accompanied by a recurrence. Detection of the disease during pregnancy is an indication for its interruption.
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The authors' and literature results concerning the peculiarities of a clinical course, diagnosis and therapy of the upper digestive tract in women during pregnancy were summed up. Exacerbation or first symptoms of diseases like cardiospasm, reflux esophagitis can often occur during pregnancy. Peptic ulcer in most pregnant women has a favorable course, exacerbations are rare. A conclusion has been made that measures aimed at the prevention of exacerbations and complications of these diseases, are recommended to women with chronic diseases of the digestive tract during pregnancy.
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In the course of chronic active hepatitis (CAH) 61 patients (CAH of virus etiology in 75% and of obscure etiology in 25%) had 211 pregnancies which terminated in delivery in 80 (38%) cases, spontaneous abortions in 12 (6%) cases, and medical abortions in 119 (56%) cases. In most cases there was successful termination of pregnancies without deterioration resulting from liver disease including patients treated adequately with immunosuppressive drugs. CAH exacerbations associated with pregnancies and their outcomes were noted in 23 (38%) cases. They were more frequent and more severe in patients with liver cirrhosis (LC) unrecognized by the time of pregnancy. There were no mothers' deaths. CAH made a negative effect on the course and outcomes of pregnancies: the frequency of premature delivery was 9%, that of cesarean-5%, perinatal mortality-75%. Of 74 infants born alive 2 died within the first months after birth as a result of congenital liver cirrhosis, a double kidney was detected in one infant, the rest of the infants were healthy. Problems of therapeutic tactics in CAH patients after onset of pregnancy are discussed.
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