Соматичний та репродуктивний анамнез вагітних, які мали ускладнення із групи великих акушерських синдромів

Abstract

Purpose - to conduct retrospective clinical and statistical analyses of somatic, reproductive history of mowen, with complications from the group of great obstetrical syndromes (GOS). Materials and methods. We conducted retrospective clinical and statistical analyses of somatic and reproductive history of 239 pregnant women (Ist - main group), who had coplications from the group of GOS, who were subdivided into 3 groups: Ia group (n=103) pregnant with severe preeclampsia, Ib group (n=67) pregnant with placenta insufficiency, with clinical manifestation by intrauterine growth retardation syndrome (IUGR); Ic group (n=69) pregnant with preterm delivery with gestational term 22-34 weeks. Control group (CG) was formed by 56 practically healthy pregnant with favourable reproductive history and non complicated course of current pregnancy. Statistical analyses was conducted by using standart programs Microsoft Excel 5.0 and Statistica 6.0. Results. We stated, that in I group the incidence of complicated heredity of cardiovascular pathology was significantly higher: 69 (28.8%) in I group (χ2=5.46, р=0.03, OR=2.79, CI 95% 1.14-6.79), in CG this factor was diagnosed only in 4 (7.1%) of patients. In subgroup Ib (patients with IUGR of 2-3 stage) the incidence of abortions and miscarriages in history was higher: in subgroup Ib these parameters were 0.83 (1.37) and 0.32 (0.59) correponding, and in CG - 0.19 (0.85) and 0.07 (0.42) corresponding (р<0.05). The most reasonable difference compated to CG were diagnosed in patients from Ic subgroup (patients with spontaneous preterm deliveries). The highest incidence of patiens with obesity was diagnosed in subgroups Ia and Ic - 18 (17.5%) and 16 (23.2%), the difference compared to CG clinically significant (р<0.01). A high incidence of anemia was noted in pregnant, especially among the ones with pregnancy complications - in I group anemia was diagnosed in more that half of patients - in 179 (74.8%), in CG - every third - in 18 (32.1%) (χ2=21.48, р<0.01, OR=2.95, CI 95% 1.85-4.71). The data in CG are approximately the same as the incidence of this pathology in population of pregnant women of Ukraine. Diseases, characterized by elevated blood pressure in group I were diagnosed several times higher, compared to CG - 41 (17.1%) compared to 5 (8.9%) (χ2=11.1, р<0.01, OR=6.08, CI 95% 1.84-20.1). In subgroup Ia the incidence of patients with this pathology was the highest - 25.2% (n=26) (χ2=20.78, р<0.01, OR=11.03, CI 95% 3.21-37.9). Results. Peculierities of somatic and reproductive history of pregnant were gisgnosed in pregnant, who had complications grom GOS group that may be high risk factors of significant increase of obstetrical and perinatal complications from materal and fetal side. The usage of routine treatment and prophylactic measures were not effective enough, that is quite convincing reason for making up a new approach for decreasing the incidence and severity of GOS in these patients, and their prophylaxis is a relevant problem of modern obstetrics. The research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research. No conflict of interests was declared by the author. Key words: retrospective analys, clinical and statistical analyses, somatic history, reproductive history, great obstetrical syndromes.