Тактика прогнозування акушерських та перинатальних ускладнень у жінок, які народжують уперше

Abstract

The objective: to develop and introduce tactics of forecasting of obstetric and perinatal complications at the primapara. Materials and methods. The material, allowing to construct classifications for creation of prognostic screening programs of obstetric and perinatal complications at primapara, were the courses of pregnancy given clinical-statistical research, labors, a condition of a fetus and the newborn at 400 primapara. The method of the step-by-step discriminant analysis for which carrying out actual data of clinical-statistical research about prevalence of gestational, patrimonial and perinatal complications at the primapara in interrelation with complex of studied factors are used is the basis for forecasting of possible complications. Results. A method of the step-by-step discriminant analysis were selected the most significant criteria of the forecast (parity; body height; age; age of menarche of the woman; duration of gestation at debut of placental dysfunction; an average assessment on Fisher; a mark assessment of detseleration on a cardiotocogram; concentration - -fetoprotein, chorionic Gonadotropinum, placental lactogen, a theelol, Progesteronum at the end of the III trimester of pregnancy; the systolodiastolic relation in 36-40 weeks; an assessment of the newborn on a scale Apgar on the first and fifth minutes of life of risk of realization and development of obstetric and perinatal complications in the primapara. Discriminant functions which with probability from 59.6 to 92.88% allow to define risk of realization of placental dysfunction, developments of anomalies of patrimonial activity and fetus distress at first labor are constructed. Conclusion. The results received by us allow to recommend the developed algorithm for introduction in practical health care. Key words: pregnancy, labors, complications, forecasting.