Особливості преморбідного фону, акушерські та перинатальні наслідки розродження жінок із перинатальними втратами в анамнезі

Abstract

Purpose - to conduct a clinical and statistical analysis of the premorbid background, obstetric and perinatal consequences of childbirth in women with a history of perinatal losses. Materials and methods. Control group (CG) - 50 obstetrically and somatically healthy pregnant women, delivered through the natural birth canal. The main group (MG) - 50 pregnant women with a history of perinatal losses. Data processing was carried out using the «Stat Soft Statistica 8.0» software package. Results. The average period between pregnancies in MG was 2.1±0.2 years; 42.0% of patients received various rehabilitation measures, the most common of which were antibiotic therapy 6 (12.0%); psychoprophylactic effect 5 (10.0%); sedative therapy 4 (8.0%); immunocorrection 4 (8.0%) and spa treatment 2 (4.0%). Peculiarities of the course of the 1st half of pregnancy in pregnant women of the MG: a significantly high level of threat of abortion 10 (20.0%); bacterial vaginosis 26 (52.0%) and gestational anemia 28 (56.0%) p<0.05. II half of pregnancy: significantly higher frequency of the following complications: gestational anemia 28 (60.9%), secondary placental insufficiency 12 (26.1%) p<0.05, bacterial vaginosis 15 (32.6%) and preeclampsia 8 (17.4%) p<0.05. As a consequence of such a high specific gravity of various obstetric complications, we observed a significantly high frequency of cesarean sections in this group of pregnant women - 16 (39.1%) versus 3 (6.0%) cases in pregnant women of CG, p<0.05. It is necessary to note the high level in the MG of medium-severe forms of asphyxia of newborns 10 (21.7%); fetal growth retardation 15 (32.6%) versus 2 (4.0%) in CG p<0.05, and clear signs of intra-amniotic infection 5 (10.9%). Perinatal losses among women of the MG amounted to 65.2‰ (3 cases). Conclusions. Pregnancy in women with a history of perinatal losses is accompanied by a high frequency of early interruption due to the diagnosis of abnormalities of fetal development and spontaneous abortions, as well as a significant level of anemia in pregnancy, placental insufficiency, fetal growth retardation syndrome, bacterial vaginosis and preeclampsia. The birth of women with a history of perinatal losses occurs against the background of a high frequency of premature rupture of membranes, fetal distress, anomalies of labor, premature detachment of the placenta, which leads to a significant level of premature births and cesarean sections. Perinatal pathology in women with a history of fetal loss is characterized by a high frequency of perinatal mortality, as well as a significant level of medium-severe forms of asphyxia, posthypoxic encephalopathy and intrauterine infection. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.