HYPERBARIC OXYGENATION IN COMPLEX TREATMENT OF PREGNANT WOMEN WITH DIABETES MELLITUS TYPE
Abstract
The article presents a comparative analysis of treatment of 76 pregnant women with diabetes mellitus type I, divided into two groups: basic and control. In the control group carried out conventional medical therapy, and patients of the main group along with those received courses of hyperbaric oxygenation. Evaluating the effectiveness of therapy based on the data of carbohydrate metabolism, glycated hemoglobin, Doppler and cardiotocography before treatment and after its completion. Shown that the use of hyperbaric oxygenation in complex treatment of pregnant women with diabetes mellitus type I reduces the complications of pregnancy, improve perinatal outcomes.
Yes in Russia we have studies with Hbot 1,3-1,5 ata for pregnant women’s with diabetes type 1 :
http://journals.rudn.ru/medicine/article/viewFile/3403/2857
I will translate only final conclusion ok?
Material and research methods:
We evaluated the results of therapy in 76 pregnant women suffering from diabetes I, with single pregnancy. The contingent of the subjects was divided into two groups: the main and the control group. The main group consisted of 32 (42.1%) patients who received a comprehensive treatment of diabetes using HBO. All pregnant women admitted to hospital were given the standard medical treatment for diabetes mellitus I, which included insulin therapy. The use of another drug therapy depended on the complications of the course of pregnancy.
At the same time, pregnant women of the main group included in the complex of therapy sessions of HBO, which consisted in exposing the body to excessive atmospheric pressure of 1.3-1.5 atm. in baro-camera conditions. A single-use OKA-MT system (Russia) was used, equipped with an air conditioner of 54–58 A and designed for conducting sessions under conditions of elevated oxygen pressure. Mode of operation – one excess atmosphere. HBO courses included 5–7 daily sessions lasting 40 minutes each. Pregnant women received 3 courses of HBO. The first course was carried out in 6-8 weeks., The second – in 16-18 weeks. and the third in 22–24 weeks. of pregnancy.
The choice of these terms of pregnancy was determined by the most important periods of formation of the uteroplacental region. Since the earliest period of therapeutic effect on the blood flow in the uteroplacental region in order to correct its disorders can be considered 7–8 weeks. and 16-18 weeks. gestation, until the end of the first and second waves of cytotrophoblast invasion. When prescribing HBO sessions for pregnant women, absolute and relative contraindications were taken into account.
The treatment of the studied patients of both groups resulted in a decrease in the glycemia level. At the same time, in cases of applying HBO this decrease was more pronounced. If, prior to the courses of HBO, the glycemia level in the main group was on average 7.3 ± 1.3 mmol / l, after receiving the full course of HBO – 5.3 ± 0.7 mmol / l. In the same patients who received insulin therapy without HBO, glycemia indices did not differ significantly during the entire pregnancy and averaged 7.0 ± 1.3 mmol / l.
The criteria for the compensation of diabetes is not only noreglycemia, but also the normalization of the level of glycated hemoglobin.
On the background of treatment with HBO, there was a significant decrease in this indicator: from 7.1 ± 1.2 to 5.6 ± 0.7%. After conducting HBO courses in the studied patients, a significant improvement in Doppler data was observed. Indicators of uterine and fetoplacental blood flow increased by 32%, while in patients receiving conventional therapy, only by 17%. With the use of HBO, cardiotocography parameters improved: the amplitude of oscillations increased, the number of accelerations increased, and decelerations disappeared. The condition of all newborns was assessed on the Apgar scale.
In newborns from mothers who received traditional therapy, the Apgar score was in the first minute of life 7.2 ± 1.4 points, in the fifth minute 7.8 ± 1.2 points; in newborns from mothers who received HBO courses, in the first minute of life 7.6 ± 0.6 points, in the fifth minute 8.4 ± 0.7 points. Thus, both in the first minute and in the fifth minute, the average Apgar score in the main group was significantly higher compared to the control group. The frequency of neonatal asphyxia in the main group (1.3%) was significantly lower than in the control group (5.3%). The number of children born with signs of diabetic fetopathy in the main group (3.1%) was significantly lower than in the control group (9.1%).
T V Kuzenkova
Peoples, Friendship University of Russia
Department of Obstetrics and Gynecology with the course of Perenathology
I A Litvinenko
Peoples, Friendship University of Russia
Email: pishite2003@bk.ru
Department of Obstetrics and Gynecology with the course of Perenathology
A A Lukaev
Peoples, Friendship University of Russia
Email: aleksei_lukaev@mail.ru
Department of Obstetrics and Gynecology with the course of Perenathology
T V Zlatovratskaya
Clinical Hospital № 29
G S Bogdanova
Clinical Hospital № 29
T A Starceva
Clinical Hospital № 29
N T Tabatadze
Clinical Hospital № 29