Case reports of patients with chronic disorders of consciousness in obstetric and gynecological practice
- Authors: Ivanova A.O.1, Kondratyeva E.A.2, Yarmolinskaya M.I.1,3, Misharina E.V.1, Florova M.S.1, Kondratyev A.N.4
-
Affiliations:
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Russian Research Neurosurgical Institute named after Professor A.L. Polenov, V.A. Almazov National Medical Research Center
- North-Western State Medical University named after I.I. Mechnikov
- Russian Research Neurosurgical Institute named after Professor A.L. Polenov, V.A. Almazov National Medical Research Center
- Issue: Vol 69, No 6 (2020)
- Pages: 31-42
- Section: Original Research
- URL: https://journals.rcsi.science/jowd/article/view/43557
- DOI: https://doi.org/10.17816/JOWD69631-42
- ID: 43557
Cite item
Abstract
According to the modern classification system, chronic disorders of consciousness are defined as an altered state of consciousness that develops after coma and is accompanied by the restoration of wakefulness without the complete recovery of conscious activity for more than 28 days after traumatic brain injury. Clinical cases of chronic chronic disorders of consciousness development in women after surgical interventions related to various obstetrical and gynecological pathologies, as well as after routine surgical interventions for comorbid somatic pathology, are of particular interest to obstetricians and gynecologists. In the presented chronic chronic disorders of consciousness related clinical cases of operations for ectopic pregnancy, as well as consequences of elective surgery for gallstone disease, the development of hypo- and normogonadotropic ovarian insufficiency associated with chronic disorders of consciousness is described. The characteristics of the thyroid status, adrenocorticotropic function, and vitamin D levels are given. Further in-depth examination and accumulation of data on patients with chronic disorders of consciousness may provide an opportunity to determine informative markers for prognostication of outcomes, as well as to develop new effective approaches to consciousness rehabilitation in this category of patients.
Full Text
##article.viewOnOriginalSite##About the authors
Alina O. Ivanova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Author for correspondence.
Email: ivanova_ao93@mail.ru
ORCID iD: 0000-0003-0792-3337
SPIN-code: 5573-6990
ResearcherId: AAL-4500-2020
MD, Junior Researcher
Russian Federation, Saint PetersburgEkaterina A. Kondratyeva
Russian Research Neurosurgical Institute named after Professor A.L. Polenov, V.A. Almazov National Medical Research Center
Email: eak2003@mail.ru
ORCID iD: 0000-0001-6362-6543
SPIN-code: 6966-3270
Scopus Author ID: 349242
MD, PhD, Leading Researcher, Head of the Group for the Study of the Minimally Conscious State, Member of the Scientific Panel on Coma and Chronic Disorders of Consciousness of the European Academy of Neurology
Russian Federation, Saint PetersburgMaria I. Yarmolinskaya
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; North-Western State Medical University named after I.I. Mechnikov
Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN-code: 3686-3605
Scopus Author ID: 7801562649
ResearcherId: P-2183-2014
MD, PhD, DSci (Medicine), Professor, Professor of the Russian Academy of Sciences, Head of the Department of Gynecology and Endocrinology, Head of the Diagnostics and Treatment of Endometriosis Center; Professor. The Department of Obstetrics and Gynecology
Russian Federation, Saint PetersburgElena V. Misharina
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: mishellena@gmail.com
ORCID iD: 0000-0002-0276-7112
SPIN-code: 7350-5674
MD, PhD, Senior Researcher. The Department of Gynecology and Endocrinology
Russian Federation, Saint PetersburgMargarita S. Florova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: fm.sergeevna@gmail.com
ORCID iD: 0000-0003-4569-3827
SPIN-code: 1480-7599
Scopus Author ID: 924120
Junior Researcher. The Department of Gynecology and Endocrinology
Russian Federation, Saint PetersburgAnatoly N. Kondratyev
Russian Research Neurosurgical Institute named after Professor A.L. Polenov, V.A. Almazov National MedicalResearch Center
Email: eak2003@mail.ru
ORCID iD: 0000-0002-7648-2208
MD, PhD, DSci (Medicine), Professor, Scientific Director of the Department of Anesthesiology and Intensive Care
Russian Federation, Saint PetersburgReferences
- Пирадов М.А., Супонева Н.А., Вознюк И.А., и др. Хронические нарушения сознания: терминология и диагностические критерии. Результаты первого заседания Российской рабочей группы по проблемам хронических нарушений сознания // Анналы клинической и экспериментальной неврологии. – 2020. – Т. 14. – № 1. − С. 5–16. [Piradov MA, Suponeva NA, Voznyuk IA, et al. Chronic disorders of consciousness: terminology and diagnostic criteria. The results of the first meeting of the Russian Working Group for Chronic Disorders of Consciousness. Annals of clinical and experimental neurology. 2020;14(1):5-16. (In Russ.)]. https://doi.org/10.25692/ACEN.2020.1.1.
- Wade DT. How many patients in a prolonged disorder of consciousness might need a best interests meeting about starting or continuing gastrostomy feeding? Clin Rehabil. 2018;32(11): 1551-1564. https://doi.org/10.1177/0269215518777285.
- Jennett B. The vegetative state. J Neurol Neurosurg Psychiatry. 2002;73(4):355-357. https://doi.org/10.1136/jnnp. 73.4.355.
- Donis J, Kräftner B. The prevalence of patients in a vegetative state and minimally conscious state in nursing homes in Austria. Brain Inj. 2011;25(11):1101-1107. https://doi.org/ 10.3109/02699052.2011.577047.
- Кондратьева Е.А., Яковенко И.В. Вегетативное состояние: этиология, патогенез, диагностика и лечение. – М.: Медицина, 2014. – 361 c. [Kondrat’eva EA, Yakovenko IV. Vegetativnoe sostoyanie: ehtiologiya, patogenez, diagnostika i lechenie. Moscow: Meditsina; 2014. 361 р. (In Russ.)]
- Iazeva EG, Legostaeva LA, Zimin AA, et al. A Russian validation study of the Coma Recovery Scale-Revised (CRS-R). Brain Inj. 2018;1-8. https://doi.org/10.1080/02699052.2018.1539248.
- Кондратьева Е.А., Вознюк И.А. Руководство по неврологическому осмотру пациентов с длительным нарушением сознания. – СПб.: Фолиант, 2019. – 56 с. [Kondrat’eva EA, Voznyuk IA. Rukovodstvo po nevrologicheskomu osmotru patsientov s dlitel’nym narusheniem soznaniya. Saint Petersburg: Foliant; 2019. 56 р. (In Russ.)]
- Rabinstein AA. Paroxysmal sympathetic hyperactivity in the neurological intensive care unit. Neurol Res. 2007;29(7): 680-682. https://doi.org/10.1179/016164107X240071.
- Пигарова Е.А., Рожинская Л.Я., Белая Ж.Е., и др. Клинические рекомендации Российской ассоциации эндокринологов по диагностике, лечению и профилактике дефицита витамина D у взрослых // Проблемы эндокринологии. − 2016. − Т. 62. − № 4. − С. 60−84. [Pigarova EA, Rozhinskaya LYa. Belaya ZhE, et al. Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults. Problems of endocrinology. 2016;62(4):60-84. (In Russ.)]. https://doi.org/10.14341/probl201662460-84.
- Romagano MP, Scorza WE, Lammers SE, et al. Treatment of a pregnant patient in a persistent vegetative state. Obstet Gynecol. 2017;129(1):107-110. https://doi.org/10.1097/AOG.0000000000001759.
- Sim KB. Maternal persistent vegetative state with successful fetal outcome. J Korean Med Sci. 2001;16(5):669-672. https://doi.org/10.3346/jkms.2001.16.5.669.
- Feldman DM, Borgida AF, Rodis JF, Campbell WA. Irreversible maternal brain injury during pregnancy: A case report and review of the literature. Obstet Gynecol Surv. 2000;55(11):708-714. https://doi.org/10.1097/00006254-200011000-00023.
- Fins JJ. When no one notices: Disorders of consciousness and the chronic vegetative state. Hastings Cent Rep. 2019;49(4):14-17. https://doi.org/10.1002/hast.1030.
- Liu R, Wen Y, Perez E, et al. 17beta-Estradiol attenuates blood-brain barrier disruption induced by cerebral ischemia-reperfusion injury in female rats. Brain Res. 2005;1060(1-2):55-61. https://doi.org/10.1016/j.brainres. 2005.08.048.
- O’Donnell ME, Lam TI, Tran LQ, et al. Estradiol reduces activity of the blood-brain barrier Na-K-Cl cotransporter and decreases edema formation in permanent middle cerebral artery occlusion. J Cereb Blood Flow Metab. 2006;26(10):1234-1249. https://doi.org/10.1038/sj.jcbfm.9600278.
- Alkayed NJ, Harukuni I, Kimes AS, et al. Gender-linked brain injury in experimental stroke. Stroke. 1998;29(1):159-166. https://doi.org/10.1161/01.str.29.1.159.
- Pelligrino DA, Santizo R, Baughman VL, Wang Q. Cerebral vasodilating capacity during forebrain ischemia: Effects of chronic estrogen depletion and repletion and the role of neuronal nitric oxide synthase. Neuroreport. 1998;9(14):3285-3291. https://doi.org/10.1097/00001756-199810050-00026.
- Hurn PD, Littleton-Kearney MT, Kirsch JR, et al. Postischemic cerebral blood flow recovery in the female: Effect of 17 beta-estradiol. J Cereb Blood Flow Metab. 1995;15(4):666-672. https://doi.org/10.1038/jcbfm.1995.82.
- Keller JN, Germeyer A, Begley JG, Mattson MP. 17Beta-estradiol attenuates oxidative impairment of synaptic Na+/K+-ATPase activity, glucose transport, and glutamate transport induced by amyloid beta-peptide and iron. J Neurosci Res. 1997;50(4):522-530. https://doi.org/10.1002/(SICI)1097-4547(19971115)50:4<522::AID-JNR3>3.0.CO;2-G.
- Vedder H, Anthes N, Stumm G, et al. Estrogen hormones reduce lipid peroxidation in cells and tissues of the central nervous system. J Neurochem. 1999;72(6):2531-2538. https://doi.org/10.1046/j.1471-4159.1999.0722531.x.
- Behl C, Manthey D. Neuroprotective activities of estrogen: An update. J Neurocytol. 2000;29(5-6):351-358. https://doi.org/10.1023/a:1007109222673.
- Mori M, Tsukahara F, Yoshioka T, et al. Suppression by 17beta-estradiol of monocyte adhesion to vascular endothelial cells is mediated by estrogen receptors. Life Sci. 2004;75(5):599-609. https://doi.org/10.1016/ j.lfs.2003.12.023.
- Wen Y, Yang S, Liu R, et al. Estrogen attenuates nuclear factor-kappa B activation induced by transient cerebral ischemia. Brain Res. 2004;1008(2):147-154. https://doi.org/10.1016/j.brainres.2004.02.019.
- Alkayed NJ, Goto S, Sugo N, et al. Estrogen and Bcl-2: Gene induction and effect of transgene in experimental stroke. J Neurosci. 2001;21(19):7543-7550. https://doi.org/ 10.1523/JNEUROSCI.21-19-07543.2001.
- Fujita K, Kato T, Shibayama K, et al. Protective effect against 17beta-estradiol on neuronal apoptosis in hippocampus tissue following transient ischemia/recirculation in mongolian gerbils via down-regulation of tissue transglutaminase activity. Neurochem Res. 2006;31(8):1059-1068. https://doi.org/10.1007/s11064-006-9114-y.
- Xu Y, Zhang W, Klaus J, et al. Role of cocaine- and amphetamine-regulated transcript in estradiol-mediated neuroprotection. Proc Natl Acad Sci U S A. 2006;103(39):14489-14494. https://doi.org/10.1073/pnas.0602932103.
- Wang X, Zhang J, Yang Y, et al. Progesterone attenuates cerebral edema in neonatal rats with hypoxic-ischemic brain damage by inhibiting the expression of matrix metalloproteinase-9 and aquaporin-4. Exp Ther Med. 2013;6(1):263-267. https://doi.org/10.3892/etm.2013.1116.
- He L, Zhang X, Wei X, Li Y. Progesterone attenuates aquaporin-4 expression in an astrocyte model of ischemia/reperfusion. Neurochem Res. 2014;39(11):2251-2261. https://doi.org/10.1007/s11064-014-1427-7.
- Si D, Li J, Liu J, et al. Progesterone protects blood-brain barrier function and improves neurological outcome following traumatic brain injury in rats. Exp Ther Med. 2014;8(3):1010-1014. https://doi.org/10.3892/etm. 2014.1840.
- Lei B, Mace B, Dawson HN, et al. Anti-inflammatory effects of progesterone in lipopolysaccharide-stimulated BV-2 microglia. PLoS One. 2014;9(7):e103969. https://doi.org/10.1371/journal.pone.0103969.
- Chen G, Shi JX, Qi M, et al. Effects of progesterone on intestinal inflammatory response, mucosa structure alterations, and apoptosis following traumatic brain injury in male rats. J Surg Res. 2008;147(1):92-98. https://doi.org/10.1016/ j.jss.2007.05.029.
- Pascual JL, Murcy MA, Li S, et al. Neuroprotective effects of progesterone in traumatic brain injury: Blunted in vivo neutrophil activation at the blood-brain barrier. Am J Surg. 2013;206(6):840-846. https://doi.org/10.1016/j.amjsurg.2013.07.016.