Особливості моніторингу стану плода у вагітних з обтяженим акушерським анамнезом

Abstract

The objective: to establish the features of fetus functional state definition in pregnant women with perinatal losses in history. Patients and methods. 89 pregnant women with perinatal losses in history were screened. The fetus functional status evaluation was based on cardiotocography and definition of fetal heart rate variability by cardiointervalography. Results. Received data showed the decrease of SDNN, RMSSD and pNN50 in pregnant women with perinatal losses in history, indicating the prevalence of parasympathetic effects on the fetal myocardium (p<0.05). Studies of mathematical time characteristics of fetal heart rate revealed a significant overweight of the metabolic-humoral regulatory circuit in women with normal pregnancy (p<0.05). Dynamic stress index evaluation indicates the centralization of heart rate regulation and significant intensity of the fetal compensatory mechanisms in pregnant women with perinatal losses in history. The cardiotocography revealed no difference between the fetal status in women of comparative groups (p>0.05). Conclusions. In pregnant women with perinatal losses in history owing to autonomic nervous system disregulation a significant intensity of fetal regulatory systems and the centralization of fetal cardiac rhythm control were observed. The cardiotocography and cardiointervalography data with revealed signs of excessive sympathetic activation can serve as preclinical signs of gestational pathology. Key words: perinatal losses, fetal functional state evaluation, cardiotocography, cardiointervalography, autonomic nervous system.