Особливості перебігу вагітності в жінок із передчасними пологами

Abstract

Purpose - to determine the peculiarities of the course of pregnancy and childbirth in women who had complications from the group of major obstetric syndromes, clinically manifested by premature birth (PB). Materials and methods. A retrospective clinical-statistical analysis of the course of pregnancy and childbirth of n=69 pregnant women with spontaneous PB at a gestation period of 24-36 weeks and 6 days was carried out. Depending on the period of pregnancy, they were divided into groups: the Group I - 9 pregnant women 24-26 weeks 6 days, the Group II - 28 women 28-31 weeks 6 days, the Group III - pregnant women 32-36 weeks 6 days. The Control group (CG) consisted of 56 practically healthy pregnant women with a healthy reproductive history and an uncomplicated course of this pregnancy. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. Were received significant differences between the Group I and the CG (p=0.007), in the presence of signs of the threat of termination of pregnancy during the second “wave” of cytotrophoblast invasion, so the chance of giving birth in the early term is 4.2 times higher than at term. In the presence of isthmic-cervical insufficiency (ICN), the reliability of differences between the Groups I and II (p=0.0021), Groups I and III (p=0.012) is observed between the Group I and CG (p=0.00083) and the risk of very early PB is 2.6 times higher than the risk of premature, late premature - 2.2 times. Disturbances in uteroplacental blood circulation have the presence of significant differences between Groups I and II (р=0.0051). There is a direct relationship between the level of blood pressure and blood circulation in the uterine arteries. Therefore, the observed difference is not accidental: in the Group II, preeclampsia was observed significantly more often. Violation of feto-placental hemodynamics when comparing groups demonstrated the existence of statistically significant differences between the Groups I and II (p=0.048), as well as between the Group I and CG (p=0.02). In the presence of clinical signs of fetal growth retardation syndrome (GRS), there is a significant difference between the Groups I and II (р=0.033). Conclusions.The features of the course of pregnancy with premature birth include the threat of termination during the second “wave” of cytotrophoblast invasion; isthmic-cervical insufficiency, which can lead to very early premature birth; vaginal infectious-inflammatory and dysbiotic diseases. Severe forms of placental insufficiency and preeclampsia are more often an indication for termination of pregnancy at 28-33 weeks 6 days. The research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research. No conflict of interests was declared by the author.