Гестаційний процес та пологова діяльність у вагітних з різними типами вегетативної регуляції

Abstract

The objective: is to analyze the frequency of gestational complications and labor abnormalities in pregnant women with different types of autonomic regulation disorders. Materials and methods. 129 women were examined. The type of autonomic regulation was determined by recording the time and spectral parameters of heart rate variability by computer cardiointervalography with use of CardioLab Bebicard diagnostic system. The main group consisted of 66 pregnant women with established autonomic regulation disorders. 63 patients with a normal autonomic state, a balanced level of sympathetic and parasympathetic activity formed a control group. To assess the status of the mother-placenta-fetus, an ultrasound examination with doplerometry was performed. Results. A significant increase of the central regulatory activity in pregnant women with autonomic dysfunction was established. The cardiointervalography indicate a balanced activity of the autonomic nervous system in the control group. The gestational complications were significantly more frequent in women of the main group in the context of detected autonomic dysfunction than in the control group. Labor anomalies were more common in pregnant women of the main group. Women with high parasympathetic astivity noted an increased frequency of labor dystocia. In patients with a superiority of sympathetic and humoral regulation, an increased frequency of labour activity weakness was observed. The fast deliveries often determined in pregnant women with decreased activity of both departments of autonomic nervous system. The incidence of urgent caesarian deliveries was significantly higher in the main group, including due to the ineffectiveness of the medical correction of labor abnormalities. Conclusions. The cardiointervalography is informative for the diagnosis of autonomous regulation and adaptive disorders, which may be the prerequisites for the gestational complications and labor abnormalities development. Using the heart rate variability analys is in pregnant women will improve the early prediction of gestational pathology and pathological birth process, reduce the risk of obstetric and perinatal complications. Key words: heart rate variability, autonomic regulation, gestational complications, labor activity abnormalities.