Діагностика, профілактика та прогнозування перинатальної патології при аномаліях плацентації (ретрохоріальні гематоми та аномалії розташування плаценти)

Abstract

The objective: depression of frequency of perinatal pathology at various pathology of placentation (retrochorial hematomas and anomalies of locating of placenta) on the basis of improvement and introduction of algorithm of diagnostic, treatment-and-prophylactic and prognostic actions. Patients and methods. Researches were conducted in two stages - on 1 us at first the retrospective analysis of clinical course of pregnancy and labors at 100 women (retrospective group) with a retrochorial hematoma is carried out, and then 150 pregnant women who were divided into three subgroups prospective are surveyed. At the 2 stage 250 women entered research – 2 group, from which 200 – with misplaced of placenta and 50 – with normal. Results. Use of the algorithm of maintaining women improved by us with retrochorial hematomas allows to reduce the frequency of early genesial losses (from 25.0% to 10.0%), to improve perinatal results (lack of cases of perinatal losses in the prospective researches and 40,0‰ in retrospective, to reduce perinatal case rate (from 30.0% to 15.6%), and also promotes pregnancy prolongation. At women with misplaced of placenta allows to reduce the frequency of placental dysfunction from 42.0% to 28.0%; fetus arrests of development – from 30.0% to 18,0%; premature births – from 18.0% to 8.0%; perinatal mortality – from 30.0‰ to 10.0‰ and a post-natal case rate – from 28.0% to 16.0%. Conclusion. Results of the conducted researches testify that prophylaxis of perinatal pathology at women with various options of pathology of placentation to which we referred existence of retrochorial hematomas and placenta misplaced, has to have complex stage-by-stage character taking into account results of clinical and additional methods of researches, and also on the basis of introduction improved by us to algorithm. Key words: retrochorial hematoma, placenta misplaced, perinatal pathology, prophylaxis.