Lecture number 17. Toxicosis of pregnant women

Toxicosis of pregnant women (gestosis) is a pathological condition during pregnancy associated with the development of the fetal egg, disappearing in the postpartum period. This is a complication of pregnancy, which is a consequence of the lack of adaptive capabilities of the mother, in which her body cannot adequately meet the needs of the growing fetus. Gestoses are manifested by various disorders of neurohumoral regulation. There are disorders of the functions of the central and autonomic nervous system, cardiovascular and endocrine systems, as well as a violation of a number of metabolic processes, the immune response, etc. Allocate early and late toxicosis.

Early toxicosis of pregnant women

It develops in the first 20 weeks of pregnancy and is called toxicosis of the first half of pregnancy. Of the existing many theories for the development of early toxicosis (such as neurogenic, corticovisceral, hormonal, allergic, immune), they currently adhere to the theory of violations of neuroendocrine regulation and metabolism, which develop as a result of previous diseases, pregnancy characteristics, and the impact on the body of adverse environmental factors. Early toxicosis of pregnancy is most often accompanied by vomiting and salivation (ptyalism).

Vomiting It is typical for approximately 50-60% of pregnant women, however, only 8-10% of them need inpatient treatment. The appearance of vomiting is associated with a hormonal imbalance. The onset of vomiting temporarily corresponds to the peak production of human chorionic gonadotropin. With vomiting of pregnant women, the endocrine activity of the adrenal cortex may change in the direction of reducing the production of corticosteroids. Vomiting of pregnant women can also be regarded as an allergization of the body when particles of trophoblast enter the maternal bloodstream. Vomiting is most pronounced in multiple pregnancies and hydatidiform mole.

There are III degrees of severity of vomiting of pregnant women.

I. Mild degree is characterized by vomiting up to 5 times a day, while the condition of the pregnant woman is not disturbed, vomiting may be associated with food intake or odors or appear on an empty stomach.

II. Moderate severity is accompanied by vomiting up to 10-12 times a day, symptoms of intoxication, weakness, weight loss and decreased diuresis.

III. Severe (uncontrollable, or excessive, vomiting) is characterized by repeated vomiting (up to 20 times or more per day), leading to rapid weight loss, exhaustion, metabolic changes, and dysfunction of vital organs. Severe vomiting is characterized by severe weakness, agitation or apathy, low-grade fever, tachycardia, lowering blood pressure, the appearance of acetone, protein and cylinders in the urine. Often with severe vomiting, jaundice occurs, in rare cases, toxic liver dystrophy develops.

Treatment of vomiting of pregnant women of the I degree of severity is carried out on an outpatient basis with the control of the dynamics of weight gain of the pregnant woman and regular urine tests for acetone. A diet with frequent, fractional meals, rinsing the mouth with astringents is prescribed, frequent walks in the fresh air are recommended, acupuncture is prescribed.

Treatment of vomiting of pregnant women II and III severity is carried out in a hospital. A complex treatment is prescribed, the purpose of which is to normalize the functions of the central nervous system, restore the loss of nutrients and fluids, correct electrolyte balance and acid-base balance. Termination of pregnancy is performed in case of treatment failure, with persistent subfebrile body temperature, severe tachycardia, progressive weight loss, proteinuria, cylindruria, acetonuria, jaundice.

hypersalivation often present with vomiting of pregnant women, but sometimes it can be in the form of an independent form of early toxicosis of pregnant women. With severe salivation, the loss of saliva per day can reach 1 liter or more. Abundant salivation has a depressing effect on the psyche of a pregnant woman, leads to dehydration, hypoproteinemia, sleep disturbance, loss of appetite and body weight. Sometimes there is maceration of the skin and mucous membranes of the lips. Treatment of hypersalivation is advisable to carry out in the clinic. In this case, atropine and local infusion of astringent and antiseptic herbs (oak bark, chamomile, sage) are used. Severe hypoproteinemia is an indication for plasma transfusion. Hypnosis and acupuncture are used as auxiliary methods.

A special form of early preeclampsia is jaundice due to cholestasis (cholestatic hepatitis). This form of toxicosis occurs rarely, as a rule, occurs at the beginning of the second trimester of pregnancy and progresses as its duration increases. It is characterized by a predominant lesion of the liver, often accompanied by itching of the skin, an increase in cholesterol and alkaline phosphatase activity in the blood with normal alanine aminotransferase activity. This form of gestosis is often complicated by premature termination of pregnancy, bleeding during childbirth, and the formation of fetal malformations. When the pregnancy is terminated, jaundice disappears, but may recur in subsequent pregnancies. The differential diagnosis is carried out with jaundice that occurred during pregnancy due to viral hepatitis, cholelithiasis, intoxication of the body, hemolytic anemia. Treatment is carried out in accordance with the general principles of hepatitis treatment. A diet, vitamins, glucose, protein preparations, etc. are prescribed. Considering the extremely serious significance of liver damage during pregnancy, primarily for a woman, the question of its premature termination is often raised.

Early toxicosis of pregnant women can also be expressed in some forms of dermatosis. The most common is pruritus. It can appear at the beginning and end of pregnancy, it can be local and limited to the vulva or spread throughout the body. Itching can be pronounced and constant, which worsens the well-being and mood of the pregnant woman. Perhaps the appearance of insomnia, irritability. With this form of toxicosis, it is necessary to exclude diseases accompanied by pruritus. It is necessary to exclude diabetes mellitus, fungal and parasitic skin lesions, trichomoniasis, helminthic invasion, an allergic reaction, etc. Treatment is reduced to the appointment of agents that regulate the functions of the nervous system, desensitizing agents, and UV radiation.

Occasionally, dermatosis manifests itself in the form of eczema, herpes, impetigo herpetiformis. With impetigo herpetiformis, the likelihood of perinatal mortality is high. These dermatoses are treated in the same way as in the absence of pregnancy.

Tetany is one of the rare forms of pregnancy toxicosis. Its cause is a violation of calcium metabolism in pregnant women. A manifestation of this form of toxicosis is the occurrence of muscle spasms of the upper and lower extremities, the face. It is also necessary to take into account the possibility of manifestations of hypoparathyroidism in connection with pregnancy. Calcium preparations are used to treat this form of toxicosis. An even rarer form of early toxicosis of pregnant women is bronchial asthma. It should be differentiated from exacerbation of previously existing bronchial asthma. Treatment includes the appointment of calcium preparations, sedatives, a complex of vitamins, general UVI.

Pregnant women who have undergone early toxicosis need careful outpatient monitoring, since they often later develop late toxicosis.

Late toxicosis of pregnant women

Toxicosis that develops after 20 weeks of pregnancy is called late or toxicosis of the second half of pregnancy. In the 1990s this term has been replaced by the term "OPG-preeclampsia" (edema, proteinuria, hypertension). OPG-preeclampsia is a syndrome of multiple organ failure resulting from the development of pregnancy. The causes of this pathology have not yet been clarified enough. The immunological theory explains the occurrence of symptoms of OPG-preeclampsia by the reaction of the body of a pregnant woman to fetal antigens. In this case, the formation of autoimmune complexes that activate the kinin system occurs. Subsequently, arterial hypertension occurs. In addition, hemocoagulation increases, accompanied by the deposition of fibrin, impaired blood supply to the placenta and organs of the pregnant woman. The immune theory of the occurrence of OPG-preeclampsia is confirmed by the detection of subendothelial complement deposits, immunoglobulins G and M in the kidneys of a pregnant woman.

Generalized vasospasm with subsequent or simultaneous development of hypovolemia is important in the development of OPG preeclampsia. According to most scientists, the primary is a violation of the uteroplacental circulation, after which a spasm of peripheral vessels occurs, as a result of which the volume of the vascular bed decreases, and hypovolemia occurs.

V. N. Sterov and co-authors believe that there are two main reasons for the development of OPG-preeclampsia: diffusion-perfusion insufficiency of uteroplacental circulation and the presence of extragenital pathology in a pregnant woman, primarily circulatory disorders in the kidneys. In both cases, there is a syndrome of multiple organ failure with a different clinic and consequences. Mixed forms of OPG-gestosis are possible, in which several systems are affected simultaneously.

For all the reasons for the development of OPG-gestosis, there is a violation of the functions of the placenta. Uteroplacental perfusion sharply decreases: with a full-term physiological pregnancy, it is 162 ml/min per 100 g of placental tissue, with OPG-gestosis - only 59 ml/min per 100 g of placental tissue. This is mainly due to a decrease in pulse blood pressure and deterioration of venous outflow. With a mild course of OPG-gestosis, perfusion disturbance is eliminated by increased cardiac activity of the pregnant woman and an increase in blood pressure. With an increase in the symptoms of OPG-preeclampsia, hypoxia and acidosis develop in the mother's body. They lead to a continued decrease in uteroplacental perfusion, which can have consequences such as hypoxia, malnutrition and fetal death. Obesity, multiple pregnancies, polyhydramnios, stress, physical stress are additional factors contributing to an increase in uteroplacental perfusion disorders. In the position of a woman lying on her back, the uterus presses the inferior vena cava, which impairs perfusion. Vascular disorders resulting from the development of OPG-gestosis disrupt the diffusion capacity of the placenta. The process is also enhanced by the activation of lipid peroxidation. The products of incomplete breakdown of fats cause damage to cell membranes, which leads to a sharp deterioration in gas exchange, disruption of the barrier, filtration and purification, endocrine, immune and metabolic functions of the placenta, in which areas of thrombosis, ischemia, hemorrhages and edema begin to form. As a result of these changes in the placenta, the needs of the fetus are not fully met, and its development is delayed. In the placenta, the synthesis of estrogens and progesterone, which contribute to the normal development of pregnancy, decreases. Basically, violations of perfusion and diffusion functions are associated with each other. Expressed perfusion-diffusion insufficiency of the placenta in severe form of OPG-preeclampsia V. N. Sterov and co-authors call shock placenta syndrome.

There is a more frequent development of OPG-gestosis during repeated births, if signs of it were observed in previous pregnancies, as well as in women with urinary system disease, hypertension, and diabetes mellitus.

Clinical picture and diagnosis. Clinical manifestations of OPG gestosis are as follows: significant increase in body weight, the appearance of edema, proteinuria, increased blood pressure, convulsions and coma.

OPG-preeclampsia manifests itself in four clinical forms. These are dropsy, nephropathy, preeclampsia and eclampsia.

Dropsy pregnant women is expressed in the appearance of pronounced persistent edema in the absence of proteinuria and normal blood pressure. Initially, edema may be hidden (positive symptom of the ring, McClure-Aldrich test), there is an excessive increase in body weight. Further, visible edema appears on the lower extremities, in the vulva, trunk, upper extremities and face. The general condition of a pregnant woman usually does not suffer. Pregnancy in most cases ends with delivery on time. Sometimes nephropathy of pregnant women develops.

Nephropathy pregnant women are three main symptoms: proteinuria, edema, increased blood pressure.

Allocate III severity of nephropathy.

I. Edema of the lower extremities, blood pressure up to 150-90 mm Hg. Art., proteinuria up to 1 g / l - I degree.

II. Edema of the lower extremities and anterior abdominal wall, blood pressure up to 170/100 mm Hg. Art., proteinuria up to 3 g / l - II degree.

III. Severe edema of the lower extremities, anterior abdominal wall and face, blood pressure above 170/100 mm Hg. Art., proteinuria more than 3 g / l - III degree. The onset of preeclampsia and eclampsia can occur with II and even with I degree of severity of nephropathy.

When prescribing treatment for nephropathy in pregnant women, it is also necessary to take into account the degree of impairment of the state of the cardiovascular, urinary systems, kidneys, and liver function. The severity of nephropathy is characterized by an increase in diastolic and a decrease in pulse pressure, as well as asymmetry in blood pressure. Further development of preeclampsia leads to an increase in hemodynamic disturbances: the volume of circulating blood decreases, central and peripheral venous pressure decreases, the value of cardiac output decreases, peripheral vascular resistance increases, and metabolic changes in the myocardium increase. To accurately determine the degree of proteinuria, the daily excretion of protein in the urine is determined. It increases with the progression of preeclampsia and in severe nephropathy exceeds 3 g. A violation of the concentration function of the kidneys can be assumed from stable hypoisosthenuria (urine specific gravity - 1010-1015) in the study according to Zimnitsky. With worsening preeclampsia, diuresis decreases, the nitrogen excretion function of the kidneys decreases (the urea content in the blood reaches 7,5 mmol / l or more).

At the same time, there is a decrease in the amount of protein in the blood plasma (up to 60 g / l or less). The development of hypoproteinemia is associated with several reasons, one of them is a violation of the protein-forming and antitoxic functions of the liver and a decrease in the colloid-oncotic pressure of the blood plasma. An increase in the permeability of the vascular wall and, as a result, the appearance of protein in the extracellular space can also be the causes of hypoproteinemia. The more severe the gestosis, the lower the protein content in the blood plasma. The severity of preeclampsia is indicated by its early onset and prolonged course, as well as severe thrombocytopenia and fetal malnutrition. In severe nephropathy, there is a high probability of premature detachment of the placenta, premature birth, intrauterine death of the fetus. Nephropathy can result in preeclampsia and eclampsia.

Preeclampsia. It is characterized by signs associated with dysfunction of the central nervous system. according to the type of hypertensive encephalopathy (cerebrovascular accident, increased intracranial pressure and cerebral edema). Excitement of patients is noted, less often drowsiness. Against the background of high blood pressure, a woman experiences headaches, dizziness, and blurred vision (flickering spots before her eyes). Phenomena of hypertensive angiopathy of the retina are noted. Some pregnant women experience pain in the epigastric region, nausea, and vomiting. At this time, hemorrhages in the brain and other vital organs are possible. Sometimes premature birth, premature placental abruption, and fetal death occur. As the clinical manifestations of gestosis increase, cerebral circulation is disrupted. As a result, convulsive readiness appears, eclampsia occurs - convulsions and loss of consciousness.

Eclampsia occurs most often against the background of preeclampsia or nephropathy. It is characterized by convulsions and loss of consciousness. A seizure in eclampsia may have a sudden onset, but in most cases it is preceded by symptoms of preeclampsia. It develops in a certain sequence.

The first stage lasts 20-30 s. At this time, small fibrillar contractions of the muscles of the face are noted, which then pass to the upper limbs.

The second stage lasts 15-25 s. It is characterized by the appearance of tonic convulsions of all skeletal muscles, while there is a violation or complete cessation of breathing, cyanosis of the face, dilated pupils, loss of consciousness.

At the onset of the third stage, lasting 1-1,5 minutes, tonic convulsions turn into clonic convulsions of the muscles of the trunk, then the upper and lower extremities. Breathing becomes irregular, hoarse, foaming at the mouth, stained with blood due to biting the tongue.

The fourth stage is characterized by the fact that after the cessation of seizures, the patient falls into a coma (usually lasts no more than 1 hour, sometimes several hours or even days). Consciousness returns gradually, amnesia is noted, the patient is worried about headache, weakness. Sometimes the coma persists until a new seizure. A convulsive seizure may be single, or there is a series of seizures up to several dozen, recurring at short intervals (eclamptic status). The more seizures there were, the more often they were, the longer the period of the patient's coma, the more severe the eclampsia and the worse the prognosis. There may be a sudden loss of consciousness, not accompanied by convulsions. Complications of eclampsia include the development of heart failure, pulmonary edema, acute respiratory failure, aspiration pneumonia. There is also brain damage in the form of edema, ischemia, thrombosis, hemorrhage. Perhaps the development of retinal detachment, an acute form of disseminated intravascular coagulation, hepatic and renal failure. With eclampsia, premature detachment of the placenta, termination of pregnancy is not excluded. During respiratory arrest, fetal death may occur due to hypoxia.

Therapy of preeclampsia depends on its severity. Treatment of dropsy of pregnancy is based on diet. Limit fluid intake to 700-800 ml and salt to 3-5 g per day. Diets are used in the form of unloading apple or cottage cheese days no more than once a week. In case of nephropathy in pregnant women, sedatives are additionally prescribed (motherwort tincture, Relanium (2,0 ml intramuscularly), phenobarbital (0,05 at night)), desensitizing agents (diphenhydramine 0,1 2 times a day). Antihypertensive drugs are used taking into account individual sensitivity and under regular control of A / D (2,4% eufillin - 10,0 ml intramuscularly, no-shpa - 2,0 ml intramuscularly, clonidine - 0,000075 each, 25% magnesium sulfate - 5,0-10,0 ml intramuscularly). In order to normalize the permeability of the vascular wall, askorutin is prescribed - 1 tablet 3 times a day, calcium gluconate - 0,5, 5% ascorbic acid - 2,0 ml intravenously.

Reflexotherapy, electrotranquilization have a good effect.

Hypovolemia is corrected using infusion therapy (10-20% albumin - 100,0 ml intravenously, hemodez - 400,0 ml intravenously). To restore water-salt metabolism, diuretics are used in the form of herbs (decoction of bearberry leaves), veroshpiron - 1 tablet 2-3 times a day, lasix - 40 mg intravenously. Methionine, folic acid, asparcam are used to normalize metabolism. For prophylactic and therapeutic purposes, in the event of intrauterine hypoxia and fetal hypotrophy, nootropic drugs are prescribed - piracetam - 5,0 ml intravenously, ambrobene, hormones, tocolytics. To improve the rheological and coagulation properties of blood, antiplatelet agents are prescribed: chimes 1 tablet 2-3 times a day, as well as reopoliglyukin - 400,0 ml intravenously, trental - 2,0 ml intravenously, antioxidants (vitamin E - 200 mg 1 time, Essentiale - 1 capsule 3 times a day).

The immunomodulator Derinat is administered in the form of 10,0 ml of a 0,25% solution, 1 drop into the nose up to 8 times a day for 3-5 days, or 5,0 ml of a 1,5% solution intramuscularly from 3 to 5 -8 injections.

Therapy of preeclampsia and eclampsia requires a special approach.

The basic principles were developed by V. V. Stroganov.

1. Creation of a medical and protective regimen, including rest, sleep and rest.

2. Carrying out activities aimed at normalizing the functions of the most important organs.

3. The use of medications to eliminate the main manifestations of eclampsia.

4. Fast and gentle delivery.

All activities are carried out in the intensive care unit by an obstetrician-gynecologist together with an anesthesiologist-resuscitator. All manipulations (injections, measurement of blood pressure, catheterization, vaginal examination) are carried out under anesthesia.

Eclamptic status, eclampsia in combination with large blood loss, the development of symptoms of cardiopulmonary insufficiency, eclamptic coma are regarded as absolute indications for mechanical ventilation. In these cases, it is necessary to prescribe glucocorticoids: hydrocortisone hemisuccinate (500-800 mg per day) or prednisolonehemisuccinate (90-150 mg per day) with a gradual dose reduction. Artificial ventilation of the lungs is carried out in the hyperventilation mode until, without anticonvulsant therapy, there is no convulsive readiness for 2-3 days, the patient is in contact, blood pressure stabilizes, and there are no complications from the respiratory system. To prevent the onset and development of acute renal and renal-hepatic insufficiency, inflammatory-septic diseases, blood loss is mandatory during childbirth (with caesarean section - in the early postpartum period). In addition, it is advisable to conduct active antibiotic therapy. In renal and hepatic insufficiency, extracorporeal detoxification methods (hemodialysis, hemosorption, plasmapheresis), hemoultrafiltration are carried out. Delivery at term and the use of complex therapeutic effects can reduce mortality in eclampsia.

Forecast depends on the severity of OPG-gestosis. The prognosis can be very doubtful in eclampsia, especially with the development of eclamptic coma against the background of cerebral edema, the appearance of ischemia and cerebral hemorrhages. Mortality in eclamptic coma can be 50%.

Prevention consists in the early detection of diseases of various organs and systems, especially the cardiovascular, urinary and endocrine systems before pregnancy, timely treatment and careful monitoring of a pregnant woman with the above diseases throughout the entire period of pregnancy. Particularly noteworthy are women at risk for OPG-preeclampsia on an outpatient basis. An obstetrician-gynecologist should examine these patients at least once every 1 weeks in the first half of pregnancy and once a week in the second half.

One of the important preventive measures is the timely detection and treatment of pretoxicosis. It is characterized by such features as asymmetry of blood pressure in the arms (difference of 10 mm Hg or more in the sitting position), pulse pressure of 30 mm Hg. Art. and less, a decrease in the oncotic density of urine, a decrease in daily diuresis to 900 ml, slight proteinuria and excessive weight gain.

Author: Ilyin A.A.

<< Back: Birth injury

>> Forward: Uterine bleeding during pregnancy

We recommend interesting articles Section Lecture notes, cheat sheets:

▪ International Financial Reporting Standards. Crib

▪ Fundamentals of social work. Crib

▪ Endocrinology. Crib

See other articles Section Lecture notes, cheat sheets.

Read and write useful comments on this article.

<< Back

Latest news of science and technology, new electronics:

The existence of an entropy rule for quantum entanglement has been proven 09.05.2024

Quantum mechanics continues to amaze us with its mysterious phenomena and unexpected discoveries. Recently, Bartosz Regula from the RIKEN Center for Quantum Computing and Ludovico Lamy from the University of Amsterdam presented a new discovery that concerns quantum entanglement and its relation to entropy. Quantum entanglement plays an important role in modern quantum information science and technology. However, the complexity of its structure makes understanding and managing it challenging. Regulus and Lamy's discovery shows that quantum entanglement follows an entropy rule similar to that for classical systems. This discovery opens new perspectives in the field of quantum information science and technology, deepening our understanding of quantum entanglement and its connection to thermodynamics. The results of the study indicate the possibility of reversibility of entanglement transformations, which could greatly simplify their use in various quantum technologies. Opening a new rule ... >>

Mini air conditioner Sony Reon Pocket 5 09.05.2024

Summer is a time for relaxation and travel, but often the heat can turn this time into an unbearable torment. Meet a new product from Sony - the Reon Pocket 5 mini-air conditioner, which promises to make summer more comfortable for its users. Sony has introduced a unique device - the Reon Pocket 5 mini-conditioner, which provides body cooling on hot days. With it, users can enjoy coolness anytime, anywhere by simply wearing it around their neck. This mini air conditioner is equipped with automatic adjustment of operating modes, as well as temperature and humidity sensors. Thanks to innovative technologies, Reon Pocket 5 adjusts its operation depending on the user's activity and environmental conditions. Users can easily adjust the temperature using a dedicated mobile app connected via Bluetooth. Additionally, specially designed T-shirts and shorts are available for convenience, to which a mini air conditioner can be attached. The device can oh ... >>

Energy from space for Starship 08.05.2024

Producing solar energy in space is becoming more feasible with the advent of new technologies and the development of space programs. The head of the startup Virtus Solis shared his vision of using SpaceX's Starship to create orbital power plants capable of powering the Earth. Startup Virtus Solis has unveiled an ambitious project to create orbital power plants using SpaceX's Starship. This idea could significantly change the field of solar energy production, making it more accessible and cheaper. The core of the startup's plan is to reduce the cost of launching satellites into space using Starship. This technological breakthrough is expected to make solar energy production in space more competitive with traditional energy sources. Virtual Solis plans to build large photovoltaic panels in orbit, using Starship to deliver the necessary equipment. However, one of the key challenges ... >>

Random news from the Archive Cyborg bugs instead of drones 04.04.2016 The place of drones may soon be taken by remotely controlled cyborg beetles. The results of the successful management of live insects were demonstrated by American and Singaporean engineers. Insects are controlled with electrodes and backpacks with electronics mounted on their backs. Electrodes attached to the limbs, visual lobes of the brain and muscles of the beetles are activated by radio signals - and the biorobots begin to move at a given speed, take off and land, turn in flight. There is no need for constant monitoring by the operator: the beetles independently maintain the set course, and a person needs to intervene only to change the route. It is emphasized that the use of living "robots" allows saving on equipment. "Unlike "iron" robots, which need hundreds of parts, sensors and servomotors, insect-computer hybrid systems use living organisms as ready-made natural robots," the authors of the article write. The cost of "stuffing" one biorobot does not exceed seven US dollars. The test subjects for engineers were large bronze Mecynorrhina torquata (weigh about eight grams) - they can carry heavy loads: a microphone and a temperature sensor. Electronics are attached to beetles using wax that is harmless to health. In the future, the researchers plan to switch to remote (wireless) control of cyborg beetles, as well as change lithium batteries to batteries recharged by solar energy.

Other interesting news:

▪ Ears need noise

▪ Scientists have learned to compress water

▪ Fast Pair - New Bluetooth Pairing Technology

▪ Llamas help fight the flu

▪ Dangerous sequins

News feed of science and technology, new electronics

Interesting materials of the Free Technical Library:

▪ section of the site Audio Art. Article selection

▪ article Barbed wire. History of invention and production

▪ article Is it possible to eat the same way? Detailed answer

▪ Article Warehouse Manager. Job description

▪ article Audio engineering. Directory

▪ article The PIPE program helps to make printed circuit boards. Encyclopedia of radio electronics and electrical engineering

Leave your comment on this article:

All languages ​​of this page

Arabic	Hebrew	Polish
Bengali	Hindi	Portuguese
Chinese	Italian	Spanish
English	Japanese	Turkish
French	Korean	Ukrainian
German	Malay	Vietnamese

Home page | Library | Articles | Website map | Site Reviews

www.diagram.com.ua
2000-2024