Особливості перебігу вагітності та пологів у жінок із ранньою та пізньою формами затримки росту плода

Abstract

Purpose - to determine the features of the course of pregnancy and childbirth in women who had complications from the group of major obstetric syndromes (MОS), which were clinically manifested by early and late forms of fetal growth retardation syndrome (GRS). Materials and methods. A prospective analysis of the characteristics of the course of pregnancy and childbirth was conducted in 99 women who had complications from the group of MОS and were clinically manifested by fetal GRS, of which the Group I - 21 pregnant women with an early form of GRS, the Group II - 78 pregnant women with a late form of GRS. The diagnosis of GRS was established on the basis of ultrasound and Doppler examination data using percentile curves. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. The analysis of the course of the II trimester in the Group II of pregnant women showed that the threat of termination of pregnancy occurred in 22 (28.2%) cases, with the transition to isthmic-cervical insufficiency and was 5 (6.4%) cases. An increase in the frequency of arterial hypertension was noted up to 3 (14.3%) cases in the Group I of pregnant women, while acute respiratory diseases in 6 (7.7%) cases and gestational pyelonephritis in 4 (5.1%) cases occurred only in the Group II female patients. The diagnosis of placental insufficiency and GRS was made more often in the Group I and amounted to 6 (5.8%) cases. In the III trimester of pregnancy in the examined patients, it was found that the diagnosis of placental insufficiency was in 7 (33.3%) patients, preeclampsia in 6 (28.6%) pregnant women and arterial hypertension in 3 (14.3%) patients and met reliably more often in the Group I (p<0.05), and such complications as fetal distress in 4 (5.1%) cases, acute respiratory diseases in 6 (7.7%) cases occurred only in the Group II. It was established that in the group with the early form of GRS, the average delivery time was 31 weeks, and in the group with the late form of GRS - 39 weeks. The frequency of delivery by caesarean section in the Group I was significantly higher and amounted to 13 (61.9%) cases against 21 (26.9%) cases in the Group II (p<0.05). Conclusions. The course of pregnancy in women with various forms of the GRS syndrome has its own characteristics, namely: with the early form of the GRS, pregnancy is significantly more often complicated by the threat of termination, gestational anemia, bacterial vaginosis, early development of placental insufficiency, and preeclampsia, which in turn leads to a significant increase in the frequency of cesarean delivery autopsy in case of premature pregnancy. 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. Women’s informed consent was obtained for the study. No conflict of interests was declared by the authors.