Оптимізація тактики ведення вагітних з перинатальними втратами в анамнезі

Abstract

The objective: to improve the effectiveness of gestational complications prevention in women with a previous perinatal losses (PL) by diagnostic methods optimization. Patients and methods. 85 pregnant women with previous perinatal losses were examined. Group II (control group) included 89 pregnant women without PL. The relationship between neurovegetative violations and pregnancy complications in women with adverse obstetric history were found using the heart rate variability method and determination of mother–placenta–fetus system status. Results. The overbalance of the sympathetic effects, mostly in the third trimester, was observed in pregnant women with previous perinatal losses, unlike the control group (p<0,05). This may be explained due to depletion of compensatory reserves of autonomic nervous system. In the second trimester increased sympathetic tone was established after stress tests in women of the main group, probably, because of the compensatory-adaptive reactions of all parts of the autonomic nervous system realization. Conclusion. Vegetative homeostasis violations with increased sympathetic tone cause placental dysfunction with metabolic changes, fetal growth retardation and other gestational complications. The dominance of sympathetic tone in pregnant women with previous perinatal losses and hormonal function of mother–placenta–fetus system indicate an imbalance of neurohumoral regulation and can be the diagnostic and prognostic sign of pregnancy complications. Key words: neurovegetative regulation, perinatal losses, placental dysfunction, cardiointervalography.