Особенности фетоплацентарного комплекса и перинатальные исходы у беременных, перенесших СOVID-19

Abstract

Aim: Analysis of the features of a comprehensive laboratory and instrumental assessment of the state of the fetoplacental complex and perinatal outcomes in the be-radiation, which have undergone a new coronavirus infection caused by SARS-COV-2, at different stage of gestation. Design. The one-central prospective cohort comparative study for the period from April 2020 to March 2023 conducted a survey of 625 pregnant women who underwent COVID-19 of varying severity at different gestation periods observed in the Moscow Hospital named after S.S. Yudin. Materials and methods. The study included 700 pregnant women: 625 women who have undergone COVID-19 of varying severity at different gestation periods (main group) and 75 with a normal pregnancy without COVID-19 (comparison group). Pregnant women who have undergone a new coronavirus infection were divided into groups depending on the gestation period: I trimester — 32 (5.1%), II trimester — 168 women (26.9%), III trimester — 425 (68.0%). All patients conducted an ultrasound examination, including echography with biometria in accordance with the adopted protocols for the gestation, 1 and 2 screening studies under the Astraia program and on protocols adopted in Moscow; Dopplerometry in the uterine arteries, the arteries of the fetal-placental, the middle cerebral artery, the venous duct of the fetus; assessment of localization, thickness and structurality of the placenta; the amount and quality of amniotic fluid; cardiotocography. Based on the results of the primary ultrasound examination according to the indications, non -invasive prenatal testing, therapeutic amniocentesis and amniodrainage were carried out. Results. The frequency of almost all parameters of violation of the state of the fetoplacental complex was statistically distinguished, the differences in the frequency of violations of the uterine-placental blood flow, especially among women who transferred COVID-19 to the first half of gestation, were most significant in comparison with the control group (among the gestational-hay diabetes (among all groups of women with NCI), anemia of varying severity. The frequency of low water also turned out to be significant, and in 19 observations of 118 (16.1%) — this was a pronounced inexumpit and anhydramnion in the III trimester of gestation. The large frequency of thrombotic complications in women who have been the COVID-19 in terms of 22–38 weeks of pregnancy is noteworthy, which requires the expansion of indications for the prevention of a given type of pathology in women, including with the use of NMGs who have suffered even easy and moderate forms of the disease. 3 women with multi-guide (3/56 (5.4%)) required amnio-adiralization. Conclusion. Based on the data we have received and the analysis of the literature, we can conclude that short-term and long-term consequences for the development of children from mothers who have arisen during pregnancy COVID-19 are alarming, requiring an additional diagnostic search and dynamic postnatal observation. Keywords: new coronavirus infection, COVID-19, echography, dopplerometry during pregnancy, cardiotocography, mother–placenta–fetus system.