Перебіг вагітності після грипу, перенесеного у І триместрі

Abstract

The endpoint of the negative impact of adverse processes in the mother’s body with influenza is the formation of placental insufficiency, the basis of which is a violation of the uteroplacental blood flow. The objective: to study the features of the course of pregnancy, the state of the fetus and the newborn after the influenza in the first trimester of pregnancy. Materials and methods. 120 women who had the influenza in the first trimester of pregnancy were examined. In 68 (56.7%) pregnant women signs of feto-placental dysfunction were observed, 2 groups were distinguished: the main group - 68 patients with feto-placental dysfunction, the comparison group – 52 pregnant women without signs of feto-placental insufficiency. Results. 3 times more often than women without manifestations of placental insufficiency (42.6% versus 15.4%; p<0.05) a severe course of influenza was observed, it accompanied by a high frequency of clinical manifestations, including in almost all patients (95.6% versus 67.3%; p<0.05), body temperature rose to 38 °C and higher, and in 61.7% of women it stayed for 4–6 days (versus 11.5%; p<0.05). Among the complications of influenza: bronchitis (25.0% versus 9.3%; p<0.05), pneumonia (17.6% versus 5.7%; p<0.05), sinusitis (17.6% versus 7.7%; p<0.05). The threat of abortion was noted in 57.4% of cases, the threat of preterm birth was observed in 39.7% of women. Most often, placental dysfunction was associated with fetal distress (76.5% versus 13.5%; p<0.05) and growth retardation (54.4% versus 3.8%; p<0.05). 32.4% versus 13.5% of women had preeclampsia (p<0.05). The frequency of both polyhydramnios (17.6%) and low water (10.3%) is significantly higher. By cesarean section, 35.3% women were delivered (versus 15.4%, (p<0.05). Delivery was preterm in 17.6% of women versus 7.7% (p<0.05). Premature discharge of amniotic fluid (17.6%) and pathological blood loss during childbirth (16.2%), fetal distress during childbirth (48.5% versus 9.6%; p<0.05) were noted. Maternal placental dysfunction, fetal distress, prematurity (17.6%) and malnutrition (22.1%) led to a high incidence of birth asphyxia (46.5% versus 19.2%, p <0.05). Half (51.5%) of children had disadaptation syndromes, most often neurological disorders (32.4% versus 11.5%; p<0.05) and respiratory disorders (27.9% versus 7.7%; p<0.05). Conclusion. Influenza in early pregnancy with a severe course and a high frequency of complications is associated with a high frequency of feto-placental dysfunction and other obstetric and perinatal complications, which requires a more detailed study to determine risk factors and develop tactics for managing this category of pregnant women. Keywords: pregnancy, influenza, feto-placental dysfunction, obstetric and perinatal complications, newborn.