Гіпергомоцистеїнемія як основний предиктор виникнення антенатальної загибелі плода

Abstract

This article presents the main markers of prediction of antenatal fetal death, their pathogenetic justification and possible complications of pregnancy with hyperhomocysteinemia. The objective: search for prognostic markers and criteria for the occurrence of antenatal fetal death to optimize the course of pregnancy and childbirth with the elimination of negative perinatal outcomes in high-risk groups for the development of antenatal fetal death. Materials and methods. From 2013 to 2018, we provided a comprehensive survey of 244 pregnant women was carried out, which, depending on the characteristics of the course of pregnancy and childbirth, was divided into groups. The control group included 151 pregnant women with uncomplicated gestational periods, without the presence of extragenital pathology of complications during pregnancy. The main group included 93 patients with a complicated pregnancy, in which violations of the fetal-placental relationship were found, and high homocysteine values. Results. There was an increase in the prothrombin index and the content of RFMC, which poses a risk of thrombosis and the development of chronic DIC in women at high risk for antenatal death. One of the most frequent pregnancy complications in the main groups was preterm delivery. Conclusions. The direct dependence of the influence of disorders of the hemostasis system on the course of pregnancy and tactics of delivery in women from the group of high risk of antenatal fetal death has been established. The fact that the course of pregnancy on the background of hyperhomocysteinemia is proved to be complicated by the occurrence of late gestosis and chronic placental dysfunction on the background of exacerbation of extragenital pathology. Key words: predictors, antenatal fetal death, hyperhomocysteinemia, fetal distress.