Analysis of perinatal consequences against the background of the proposed treatment complex in pregnant women after the application of assisted reproductive technologies

Abstract

The course of pregnancy that occurs as a result of the application of assisted reproductive technologies is accompanied by numerous complications that affect the indicators of perinatal morbidity and mortality. Nowadays in Ukraine, there is no unified approach to the management of women whose pregnancy occurred as a result of ART application, which determined the direction of this work.The objective: to assess perinatal consequences against the background of the introduction of the proposed treatment complex in women whose pregnancy occurred as a result of the application of assisted reproductive technologies.Materials and methods. 249 pregnant women were examined, which were divided into: group I – 94 women with tubo-peritoneal, group II – 87 women with endocrine and group III – 68 women with male types of infertility. Depending on the prescribed therapy, women of groups I, II and III are divided into: subgroup IA – 49 pregnant women with tubo-peritoneal, subgroup IIA – 48 pregnant women with endocrine, subgroup IIIA – 36 pregnant women with male factor of infertility who received the proposed therapeutic and preventive complex; subgroup IB – 45 pregnant women with tubo-peritoneal, subgroup IIB – 39 pregnant women with endocrine, subgroup IIIB – 32 pregnant women with male factor of infertility, which were observed in accordance with generally accepted standards of obstetric care.Results. Against the background of prescribing the proposed complex, there was a significant decrease in the frequency of threatened miscarriage in women of Group I by 41.6%, in women of Group II by 37.1% (p<0.05). In the second and third trimesters, there was a significant decrease in the number of cases of threatening late spontaneous miscarriages, threatening premature birth, placental dysfunction, preeclampsia, and fetal growth retardation syndrome (p<0.05). A significant indicator of the effectiveness of the proposed treatment complex is a significant increase in the proportion of urgent labor in women of subgroups IA and IIA. Thus, 46 (93.8%) women of subgroup IA and 46 (95.8%) women of subgroup IIA had urgent labor.Assessing the pathological conditions of newborns, it should be noted that in children from women in labor of subgroups who received the proposed complex, respiratory disorders syndrome (p<0.05), intraventricular hemorrhages (p<0.05), hypoxic-ischemic encephalopathy (p<0.05), and cases of antenatal infection (p<0.05) were determined in a significantly smaller number of cases.Conclusions. The effectiveness of the proposed treatment complex and the complex of psychoemotional correction in pregnant women after the use of assisted reproductive technologies is confirmed by a reliably better course of the first, second and third trimesters of pregnancy, a reliably better course of Labor, which was reflected in an increase in cases of urgent labor and a decrease in cases of complications in childbirth, which was reflected in a significant decrease in the number of cesarean sections.Improvement of perinatal consequences against the background of the use of the proposed treatment complex and the complex of psychoemotional correction in newborns from women in labor after the use of assisted reproductive technologies is confirmed by a significantly larger mass of newborns, a significantly smaller number of newborns with low gestational weight, a significantly higher Apgar score, a significantly smaller number of cases of pathological and transient conditions, and a significantly shorter duration of stay of women in labor and newborns in an obstetric hospital, as well as the absence of cases of early neonatal and perinatal mortality among newborns.