Возможности прогнозирования плацента-ассоциированной патологии во втором триместре беременности с помощью шкалы балльной оценки риска и кардиотокографии плода

Abstract

Objective. Рreclinical prognosis of placental pathology (PP) during the second trimester of pregnancy using a new risk assessment scale and fetal cardiotocography (CTG). Patients and methods. This retrospective study included 264 patients who had undergone risk assessment during the first trimester of pregnancy using the conventional scale followed by reassessment on weeks 12–15 using the new scale. There were 102 women with PP and 162 women with normal pregnancy and delivery. We also performed prospective analysis of CTG results obtained during the second trimester. Results. The calculation of the risk for perinatal complications during the first trimester using the conventional scale demonstrated that 31% of women had PP. After recalculating the risks in the beginning of the second trimester, we found that 90% of women had PP; there was a threefold increase in the accuracy of prognosis. Women with pathological variants of CTG and risk of PP were 1.34 times more likely to have delayed fetal growth, 1.8 times more likely to develop preeclampsia, 2.6 times more likely to have preterm birth, 1.2 times more likely to have gestational hypertension, and 1.75 times more likely to have neonatal morbidity compared to women at risk of PP, but with normal CTG variants during the second trimester. Conclusion. Combination of the new risk assessment scale and CTG during the second trimester helps to identify women at risk of gestational pathology and to find and optimal tactics of their management. Key words: CTG, placental pathology, placental insufficiency, risk scale