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SPECIAL FEATURES IN THE COURSE OF POSTNATAL PERIOD IN WOMEN WITH HYPOGALACTIA USING PHYTOMEDICATIONS

Автор Доклада: 
Bakun O., Berbets A., Nitsovich I.
Награда: 
SPECIAL FEATURES IN THE COURSE OF POSTNATAL PERIOD IN WOMEN WITH HYPOGALACTIA USING PHYTOMEDICATIONS

SPECIAL FEATURES IN THE COURSE OF POSTNATAL PERIOD IN WOMEN WITH HYPOGALACTIA USING PHYTOMEDICATIONS

 

Bakun Oksana, assistant
Kupchanko Volodymyr, physician
Berbets Andrii, associate professor
Nitsovich Ihor, associate professor
Bukovinian State Medical University, City Clinical Maternity Hospital 1, Chernivtsi

 

The course of postnatal period of women in childbirth with hypogalactia using phytomedications has been under study. The phytomedication “Shirafza”has been demonstrated to improve lactation and course of postnatal period signidicantly.
Key words: postnatal period, hypogalactia, phytomedications.

Робота присвячена вивченню перебігу післяпологового періоду у породіль з гіпогалактією з використанням фітопрепаратів. Показано, що фітопрепарат “Ширафза” значно покращує лактацію та перебіг післяпологового періоду.
Ключові слова: післяпологовий період, гіпогалактія, фітопрепарати.

Introduction. Rational nutrition means, first of all, feeding infants during the first year of their lives with mother’s breast milk. The unique feature of breast milk lies in the fact that it is the healthiest, optimally balanced by nature food easily digested. It meets all nutritional and energetic needs of an infant to the full from its birth till no less than 5-6 months without any food supplements. Among numerous problems of breast deeding the most frequent one is mother’s complaint of not having sufficient amount of milk. Hypogalactia is a condition of decreased secretory activity of mammary glands in lactational period [1,5]. Primary and secondary hypogalactias are distinguished. Primary one is conditioned by anatomical and functional peculiarities of mammary glands as well as by mother’s severe diseases associated with extragenital pathology (diabetes mellitus, diffuse toxic goiter), occurs rarely, only in 4-10% of women. The following factors can also cause hypogalactia: genetic and iatrogenic. Cases in which medicamental methods activating and stimulating labor activity (estrogens, prostaglandins, oxytocin) are used in pregnant or lying-in women belong to the latter. Later on, women-in- childbirth who took these preparations had no lactation at first hours or days after labor or lactation appeared in later periods and was insufficient [3,6].

Secondary hypogalactia can be caused by complicated pregnancy, labor and postnatal period (late gestosis of pregnant, anemia of pregnancy, uterine hemorrhages, oth.,) as well as by disorder in dietary regimen, irrational nutrition, psychical and physical strains, irregular organization of the infant’s feeding regimen and technique, diseases of mammary glands (cracks of nipples, mastitis). Secondary hypogalactia is mostly a temporary condition [2,8]. Whereas at primary hypogalactia chances for treatment are limited, at secondary hypogalactia it is possible to recover lactation in treated timely. The reason that caused hypogalactia should be found out to this aim [4,7].

A special group of women can be distinguished according to the development of primary hypogalactia – these are the women who underwent Cesarean section. Early hypogalactia is singled out as to the time of its occurrence. It appears during first 10 days after labor. Late hypogalactia occurs 10 days after.

The aim of this work was to study special features of clinical course of postnatal period and investigate the effect of “Shirafza” phytomedication on lactation in women in childbirth with a decreased lactational function.

Material and methods of the study. 60 women in childbirth have been examined who were divided into two groups: I main group – 30 women with a decreased lactational function. II – control group – 30 women in childbirth with a preserved lactational function. Life history, somatic and gynecologic diseases in the history, special features of menstrual and reproductive functions, the course of pregnancy, labor and postnatal period have been studied in all women. In newborns there were determined: condition at birth, evaluation by Apgar’s scale, primary loss of body-weight and the degree of its recovery by the fourth-fifth day of life, peculiarities of the course in early postnatal adaptational period. Lactational function in women was evaluated on the fourth-fifth day of postnatal period on the basis of clinical examinations of the woman in childbirth, day amount of milk that is produced, food supplements of mixtures to the infant’s feeding and indeces of weight loss and its restoration during first four-five days after birth. Normal lactation was regarded a condition without food supplements, when maximum weight loss was no more than 6%, restoration of initial weight no less than 95% during early neonatal period. S.N. Gaidukov’s classification has been used to evaluate the degree of insufficiency of lactational function (1999): I degree of failure was regarded milk deficiency no more than 25% from the needed quantity; II degree – 50%, III degree – up to 75%, IV degree – over 75%. Anamnesis data, extragenital diseases, complications in the courseof pregnancy, labor and postnatal period were taken into account at making a diagnosis of oligogalactia function.

Statistical processing of the data was performed on a personal computer IBM by means of statistical programme EXCEL making use of variational statistical methods. Authenticity of special features was established by means of Student’s t-criteria. Differences of indeces were regarded authentic at value of p<0,05.

Results of the study and discussion. At the age examination it was determined that the majority of women in childbirth were from 19 till 30: in the main group – 25 (83,3%), in the control – 21 (70%)(p>0,05). Average age of women in labor didn’t differ for a fact (25,8±4,2 and 25,1±4,1 of a year correspondingly), A high frequency of somatic pathology has been found out: in the main group – in 22 (73,3%), in the control – in 12 (40%) of women (p<0,05). Thus, diseases of cardio-vascular system were registered twice more often in 8 (26,6%). Besides, in the women of the main group there was observed a clear tendency to the increase in frequency of respiratory system diseases in 5 (16,6%), urinary excretive system diseases in 11 (36,6%), diseases of gastrointestinal tract – in 9 (30%). More often there were registered acute respiratory infections – in 4 (13,3%). Gynecological diseases in the anamnesis are regarded a factor of risk for disorders in the reproductive system which causes hormonal disturbances, failure of childbearing function with further complications of postnatal period and also affects formation and duration of lactation. There were gynecological diseases in the anamnesis in 23 (76,6%) women in the main group and 11 (36,6%) (p<0,05) – in the control. Inflammatory diseases of female genital sphere in both groups were marked down with approximately similar frequency. At the same time menstrual function disorders were really more often in the main group – 21 (70%) womem in comparison with the control group – in 4 (13,3%) (p<0,05). In the main group in the structure of menstrual function disorders attention was drawn to the predominance of such nosologic forms as dysmenorrheal – in 5 (16,6%), polymenorrhea – in 2 (6,6%), irregular menses – in 12 (40%) women. Only in the main group in the anamnesis there were revealed such disorders as late menarche – in 1 (3,3%) (p<0,05), hypomenstrual syndrome – in 1 (3,3%) patient.

When analyzing obstetrical anamnesis it should be noted that every third woman in childbirth both in the main and control groups had artificial abortions in the life history: 11 (36,6%) and 9 (30%) correspondingly. Every second woman in the main group (16, 53,3%) had indications in the anamnesis of incompetent pregnancy mostly due to spontaneous abortions – in 12 (40%) and premature delivery – in 3 (10%). An uncomplicated course of postnatal period was registered significantly more seldom in the main group of lying-in women – in 4 (13,3%)(p<0,05) than in the control group – in 16 (53,3%). A normal course of postnatal period in the main group was observed in 4 women (13,3%) in the control – in 16 (53,3%).

Decrease of lactational function – in 22 (73,3%) women of the main group and 4 (13,3%) in the control one, subinvolution of uterus – in 4 (13,3%) women of the main group and 1 (3,3%) woman of the control group. As subinvolution of uterus occurred more often in women from the main group, the factors which contributed to the appearance of this complication were analysed. In women from the main group cardiovascular diseases were registered more often – in 8 (26,6%) and in the control group – 4 (13,3%). Inflammatory diseases in the organs of the small pelvis in the anamnesis can be regarded as a factor that affects involution of uterus and reduction of lactational function in postnatal period. Thus, chronical salpingo-oophoritis was registered in the majority of women in childbirth of both groups: in the main group – in 19 (63,3%), in control – in 7 (23,3%) (p<0,05). Half of the women in labor with subinvolution of uterus pointed to the presence of uterine cervix erosion in the anamnesis – in 2 (50%) in the main group. In women with a reduced lactational function there is a high frequency of disorders in menstrual cycle and salpingo-oophoritis in the anamnesis: in the main group – in 21 (70%) and 19 (63,3%); in the control group – in 4 (13,3%) and 5 (16,6%) correspondingly (p<0,05). Incompetent pregnancy in the anamnesis as a factor causing hypogalactia was registered in 53,3% women from the main group. In the majority of women in labor from the main group having hypogalactia there was a thread of abortion – 14 (46,6%), gestosis – in 10 (33,3%), anemia – in 27 (40%); placental insufficiency in 12 (40%), in the control group – in 16,6; 3,3;53,3 and 6,6% cases correspondingly.

The most serious intranatal factors for disorders of lactational function after labor were anomalies of labor activity and blood loss over 500 ml that were registered in both groups with almost similar frequency. Both in the main and control groups there weren’t found out any authentic significant perinatal factors among full-term neonates that wound influence the formation of lactation in postnatal period. According to the data of retrospective analyses it was determined that women with lactational failures gain weight more slowly (only on the fifth day they recovered the initial body weight).

The formation of lactation during first 5 days after labor is influenced by the woman’s somatic health condition, her obstetrical-gynecologist status, obstetrical complications which were registered more frequently in women from the main group that’s why we have suggested recovery of lactational function in this group of patients by means of “Shirafza” phytomedication, that is a natural method of high quality based on vegetable raw material which due to complex effect on the woman’s organism stimulates all stages of lactation, prevents problems of overweight in feedings mothers and rise of glucose level in blood. Shirafza effect is conditioned by herbs in its composition. Fennel (Foeniculum Mill) contains the mixture of trans-anethol with fenhon, estragol and other components. Structural resemblance of anethol and catecholamine can support estrogenic activity. Dopamin has a stimulating effect on lactation, in this way anethol can cause milk production responding to dopamine on the determined sections of receptors. Due to this the effect of dopamine decreases in stimulating milk production. Biologically active substances in Fennel composition stimulate lactogenous action in feeding mothers and also remove evidences of meteorism, improve digestion release spasms and mobility of the intestine. Caraway provides the increase of milk amount and its nutritional qualities. Trigonella manycoloured improves bloodflow in the mammary gland, stimulates lactatation and provides the increase of nutritional value of breast milk. Common dill (anethum graveolens) has a sedative and soothing action, so women in childbirth are less anxious and its anti-inflammatory action diminishes the risk of mastitis occurrence. Alcaloids of common dill only increase the amount and quality of breast milk, but in interaction with other components of “Shirafza” pass over together with mother’s milk to the infant and prevent meteorism in this way and release abdominal pain (colics) in a breast-fed infant. The preparation was taken by women from the main group because they complainted mostly of insufficient milk production. The preparation was-taken from the 4-th day of postnatal period by 1 capsule three times a day. 25 women-in labor (83,3%)were marked down to increase the volume of milk on the 5-6th day of the intakes as well as to improve milk quality which manifested inself in the absence of dry “swaddling clothes” syndrome, the baby was actively sucking mother’s breast, the woman in childbirth felt the rush of milk, the infant didn’t cry of began to gain weight actively. As one of the reasons for secondary hypogalactia was nipple cracks found in 11 (36,6%) women in the main group and 4 (13,3%) – control group who mainly complainted of the pain in the nipples – so this group of women was recommended to use “Kalendit-E” cream, a natural preparation from pot-marigold (Calendula) and echinocea medical extractions. “Kalendit-E” stimulates tissue granulations, prevents from staphylococcus and streptococcus infections, hinders the development of inflammatory processes and finally-accelarates healing of cracks. In this way, already on the following day there were evidences of pain relief and adhesions of cracks in 10 women from the main group and 3 from the control one.

Conclusions.

  • 1. Women in childbirth show a high frequency of complications in postnatal period (73,3%), that is significantly higher than the analogous index in the control group (40%)
    2. Usage of “Shirafza” preparation contributes to the improvement of lactational function in women in childbirth already on the 5-th day of postnatal period.
    3. “Kalendit-E” preparation in woman in labor releases painful syndrome and makes for the adhesion of cracks in the nipples.

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It enjoys me greatly, while

It enjoys me greatly while reading your article with ideas of vital interest and importance in such an important branch of medicine. It stimulates the free expression of ideas on open discussion and makes us interested and encouraged about the items in your paper. Have a great final success!

Very interesting article. But

Very interesting article. But I have some questions.... Is it depend on age women from this pathology?
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