Пренатальный скрининг как предиктор гестационных осложнений

Abstract

Objective.To analyze the course and outcomes of pregnancies in women at high risk of fetal chro-mosomal abnormalities, preeclampsia, fetal growth retardation, and preterm birth according to the results of prenatal screening. Patients and methods. This prospective study included 443 women with singleton pregnancies. Study participants were divided into two groups: Group 1 included women at high risk of complica-tions (n = 235), while Group 2 (control) comprised women at low risk of gestational complications (n = 208). Patients in Group 1 were further subdivided into 4 subgroups: subgroup 1A included women at risk of fetal chromosomal abnormalities (CA) (n = 69); subgroup 1B included women at risk of preeclampsia (PE) (n = 66); subgroup 1C included women at risk of fetal growth retardation (FGR) (n = 48); and subgroup 1D included women at risk of preterm birth (PB) (n = 52). Confirmed chromosomal abnormalities were considered as an exclusion criterion. Results. Threatened miscarriage (TM) and bleeding in the first trimester were significantly more common in patients from Group 1. In the second trimester, the risk of TM was increased among women from subgroups 1A, 1B, 1C, and particularly 1D. In the third trimester, we observed sig-nificant differences in the frequency of FGR between group 1 (subgroups 1A, 1С, 1D) and controls. In subgroups 1A, 1B, 1C, and 1D, the incidence of PE and FGR was higher in patients who did not receive aspirin. The frequency of threatened PB was higher in subgroups 1B, 1C, and 1D compared to Group 2 (p < 0.05). Conclusion. High prenatal risk of fetal CA should be considered as a risk factor for PB, TM, FGR, and PE. Key words: prenatal screening, chromosomal abnormalities, preeclampsia, fetal growth retarda-tion, preterm birth, pregnancy, perinatal risk