ОЦЕНКА СОСТОЯНИЯ ПЛОДА И ОСОБЕННОСТИ ТЕЧЕНИЯ НЕОНАТАЛЬНОГО ПЕРИОДА У ДЕТЕЙ, РОЖДЕННЫХ ОТ ЖЕНЩИН ПОЗДНЕГО РЕПРОДУКТИВНОГО ВОЗРАСТА, ПРОЖИВАЮЩИХ В ЧЕЧЕНСКОЙ РЕСПУБЛИКЕ

Abstract

Objective of the research: conduct a Doppler ultrasound (DUS) assessment of utero-placentalfetal blood flow and the condition of newborns in the early neonatal period from women of the late reproductive period (LRP), depending on the parity of delivery, using the example of women in the Chechen Republic. Material and methods: retrospective multicenter study. DUS assessment of the state of utero-placental-fetal blood flow and the state of newborns in the early neonatal period was performed in 95 pregnant women, including: group 1–35 primiparous of LRP and their 35 newborns, group 2 – 35 multi-pregnant (MP) of LRP and their 35 newborns. The 3 control group included 25 healthy pregnant women aged 18 to 25 years and their 25 newborns. DUS was performed on Aloka SD SSD 3500 device (Japan), and a transvaginal sensor was used if necessary. Newborns were assessed on the APGAR score at 1 and 5 minutes after birth. Of the instrumental methods for examining newborns, brain ultrasound examination (neurosonography) was used. Results: analyzing the DUS results of LRP pregnant, depending on the labor parity, it was found that in the 1st group there was an increase in resistance in both uterine arteries (61%), an increase in the resistance index and pulsation index, a decrease in diastolic blood flow, characteristic of arteries with high resistance. Hemodynamic parameters in the mid-brain artery (MBA) of the fetus remained normal in all pregnant women. LRP women often born children in a state of asphyxia, with neurological disorders, and these children often has more complex postnatal adaptation and concomitant pathology. Among LRP women, primiparous has significantly more severe disorders. Conclusion: the data of uteroplacental fetal blood flow of the 1st group correspond to blood flow disorders of the IA degree, which indirectly indicates a compensatory reaction of the vascular system of uteroplacental fetal blood flow, as well as the absence of a tendency to an increase in the severity of fetoplacental insufficiency. It is possible that high incidence of neurological disorders in children born to LRP women is associated with age-related changes in their germ cells, use of assisted reproductive technologies, intake of hormonal drugs at an early stage of pregnancy and environmental factors associated with iodine deficiency in the region which includes the North Caucasus.