It is estimated that more than 40% of pregnant women in the world have anemia. It is assumed that at least half of this burden of anemia is caused by the deficiency of iron.
To meet the nutrient needs of the women's and their developing fetus, pregnant women additionally requires alignment additives and folic acid. The deficiency of iron and folic acid during pregnancy can have a potential negative impact on the health of the mother, its pregnancy, as well as the development of the fetus.
The most recent data suggests that the use of iron and folic acid additives is associated with a reduced risk of developing iron deficiency and anemia in pregnant women.
* Equivalent of 60 mg of elementary iron are 300 mg of iron sulfate heptahydrate, 180 mg of fumarate iron or 500 mg of iron gluconate. ** Reception of folic acid should begin as early as possible (if possible, before conception) for the prevention of defects in the development of the nervous tube. *** This recommendation replaces the last WHO Recommendation (Daily Iron and Folic Acid Supplementation in Pregnant Women, 2012).
Integrated genetic study, which is an analysis of six genetic markers associated with the risk of chromosomal anomalies and isolated malformations in the fetus (Daun disease, other trisomy disease, non-nervous tube, etc.), as well as with predisposition to Increased blood clotting from the mother.
The loss of pregnancy in early terms is often caused by genetic disorders of the fetus and defects in the development of the placenta due to its thrombotic damage.
One of the leading causes of non-banking pregnancy in the early stages is the genetic factor. A special place is occupied by the predisposition to and hypergomocysthenemia. This genetic study includes two groups: blood coagulation factors and folic acid metabolism genes and vitamin B12.
With the uncomplicated course of pregnancy in the hemostasis system, changes occur: the general geeking properties (the number of blood coagulation factors increases by 1.5-2 times) and the anticoagulant potential decreases. The risk of a thrombophylastic state increases.
Microtrombosis during pregnancy - a frequent cause of obstetric pathology (gestosis, placental insufficiency, premature detachment of a normally located placenta, the usual fetus loss, etc.).
The tendency to thrombosis carries a threat mainly for the fetus: the blood circulation generated blood clotting, and the fruit is not enough for nutrients. As a result, pregnancy interruption may occur, as well as other complications associated with increased blood coagulation.
The medical and social significance of congenital and hereditary pathology in children from mothers suffering from epilepsy, puts its warning in the category of the most important health problems of all countries of the world.
Epilepsy - chronic brain disease, characterized by repeated attacks, which arise as a result of excessive neural activity and are accompanied by various clinical and paraklinic manifestations.
The frequency of occurrence of epilepsy - 50-70 cases per 100 thousand population per year, the prevalence of epilepsy - 5-10 cases per 1 thousand people, not less than 1 seizure during the course of life transfer 5% of the population, in 20 -30% of patients with illness is lifelong. About 1% of pregnant women suffer from epilepsy, among them in 13%, the manifestation of the disease falls for a period of pregnancy, and approximately 14% of the seizures in women are observed exclusively during pregnancy - the so-called gestational epilepsy (5).
In the study of the combination of epilepsy and pregnancy, three main problems arise: the effect of pregnancy and childbirth for epilepsy, the effect of epilepsy and anti-epileptic therapy on the gestational process, as well as the effect of epilepsy and anti-epileptic therapy on the perinatal state of the fetus.
The cause of high perinatal morbidity in most newborns from epilepsy mothers is the defeat of the central nervous system (CNS). Thus, under clinical observation, neurological symptoms are detected in 35.4% of newborns from patients with epilepsy mothers, 11.6% is preserved after extracting from the hospital. This is explained by the fact that the fruit in epilepsy has a lag in the ripening of the nervous system, which is due to the use of anti-confusion therapy of the underlying disease (7).
The percentage of cases that caused the death of children in the first years of life from congenital and hereditary diseases, rather high, despite well-developed pediatric assistance in developed countries. In the absence of prevention, congenital and hereditary diseases cause death of at least 14 children out of 1000 in the first 3 years of life, while half of the cases fall on congenital defects (EPR) (9).. Almost every fourth child who died of complications associated with developmental vices suffered from DNT (3).
When analyzing the database, obtained from regional registers of Russian territories monitors congenital defects in children, in the structure of VDS inside each group of defects, spinal cerebral hernias and anensphalia were the most numerous (up to 70% of all central nervous system ), lips and sky clefts (57.23% in the group of vices of the digestive system) (2).
It is known that the sample information that folic acid deficiency in pregnant women is a risk risk factor for the most severe correction factor, PRD - DNT from the fetus, appeared in world medical seals in the early 1990s . The total results of clinical studies conducted in Hungary, Great Britain, France, the United States and other countries published in 2000 showed that the daily use of folic acid or polyvitamins containing 0.4-1.0 mg of folic acid, women in the period preceding conception, and in the first months of pregnancy reduces the risk of primary and re-born children with a defect of the head and spinal cord, as well as other defects of development. This scientific discovery and the resulting prophylactic effect had great importance for practical health care, since this group of defects in the structure of the UPR, leading to infant mortality and early disabilities, occupies a leading place (8).
So, in the group of so-called folat-dependent industries, in addition to the DNT, reduction defects of the limbs were entered, defects of the urogenital system and some maxillofacial anomalies, as well as a number of voids of the cardiovascular system. The main risk factors of the primary fetal or child damage, except for the lack of maternal content of folic acid and violation of vitamin-status B1, are diabetes, the use of valproic acid and carbamazepine, obesity (4).
Folic acid can be useful in epilepsy for the following reasons. After an attack, the folic acid content in the brain falls. Anticonvulsant drugs also reduce the level of folic acid in the blood, therefore it has arisen that vitamin deficiency in both cases can contribute to an increase in the frequency of attacks.
Thus, it becomes clear that the decrease in the frequency of the Arbitration and perinatal mortality from the malformations is possible only in the presence of effective and carefully consistent prophylaxis.
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