Особливості вагітності, пологів, стану плода та новонародженого у жінок з невиношуванням в анамнезі (Ретроспективний аналіз)

Abstract

Perinatal aspects of miscarriage, despite advances in the study of the pathogenetic mechanisms of prematurity of pregnancy, continue to be leading in modern obstetrics. The issues of forecasting, prevention and prevention of perinatal complications require a clear understanding of the mechanism of the impact of the threat of spontaneous miscarriage and premature birth on the fetus. The objective: to study the frequency and causes affecting the main indicators of the results of preterm pregnancy to improve organizational measures aimed at the prevention of perinatal and obstetric complications and improve medical care for preterm infants. Materials and methods. We conducted a retrospective clinical and statistical analysis of 1976 histories of pregnancy and childbirth of women who were treated and delivered in the Kiev City Maternity Hospital No. 3 for 2014–2018 years. Particular attention was paid to the analysis of indicators of the fetal biophysical profile, which was performed in 140 pregnant women. For in-depth study of the causes and consequences of preterm birth, we analyzed the results of 83 histomorphological studies of placenta in preterm birth. Results. The main factors of the development of miscarriage, according to the results obtained by us are the young and late reproductive age of pregnant women, low social status, late registration in the women’s clinic, concomitant extragenital and gynecological pathology. Prior to the main pregnancy complications in the examined pregnant women, the threat of abortion in the first and second trimesters and the threat of premature birth preceding hospitalization were considered. Childbirth was burdened with premature rupture of the fetal bladder, abnormalities of labor, manual examination of the walls of the uterine cavity. Early neonatal period in premature newborns was complicated by pathology caused primarily by immaturity of organs and systems. Pathomorphological examination of the placenta after premature birth revealed a cell-parenchymal type of placental insufficiency. Analysis of the results of immunological reactivity showed an increase in alloantigens of fetal origin in pregnant women with miscarriage. Conclusion. A retrospective clinical and statistical analysis of the frequency and course of preterm birth over the past five years revealed a number of social, medical and biological factors that contribute to the induction of prematurity and adversely affect the functional state of the fetus and, accordingly, may have a prognostic character. Key words: pregnancy, miscarriage, premature birth, fetal biophysical profile, perinatal complications.