CLINICAL AND PATHOGENETIC ASPECTS OF DEVELOPMENT OF GESTATIONAL COMPLICATIONS WITH MULTIPLE PREGNANCY

Abstract

In order to evaluate the value of the placenta growth factor (PlGF) in the gestational complications during multiple pregnancy, a study of this indicator in serum in 320 pregnant women with multiple pregnancies in the first trimester and in 40 pregnant women with single pregnancy constituted a control group.Goal – The purpose of the study is to investigate the effect of the dynamics of placental growth factors on gestational process during multiple pregnancy.Material and methods of research. A prospective study of maternity pregnancy in 320 females with multiple pregnancy was conducted, which comprised the main group of the subjects and 40 healthy women with singleton pregnancy. The level of PlGF in serum was determined by solid-phase enzyme-linked immunosorbent assay using monoclonal antibody sets in the first trimester of pregnancy. Indicators of the hemostasis system (vascular trombocyte and coagulation link) were evaluated according to generally accepted methods. Dopplerometry of placental and fetal blood flow was performed in uterine arteries (MA), arteries (PA) and umbilical cord veins (PV), middle cerebral artery (CMA) fetuses.Results of the research and their discussion. Women with multiple pregnancy are at risk for developing gestational complications - premature births in 67.9% (p <0.01), fetoplacental dysfunction, preeclampsia - in 17.6% (p <0.05) cases. The revealed violations of the vascular thrombocyte and coagulation homeostasis in the first trimester of pregnancy are the main risk factors for early premature abortion. It has been shown that the low level of placental growth factor in serum of pregnant women with multiple pregnancies in the case of premature labor, fetoplacental dysfunction and preeclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg / ml) is a prognostic marker in the development of gestating complications, which is reliably confirmed by the conducted research (p <0.01) in comparison with the corresponding indices in single-pregnancy (418.2 ± 10.4 pg / ml).Conclusions. Timely medical correction of gestational complications during multiple pregnancy with the use of micronized progesterone, low molecular weight heparins, angioprotectants allowed prolonging the pregnancy with monochoric type of placentation by 3.2 weeks (up to 34.2 ± 2.4 weeks), and in the case of dichorionique placentation - to term full-term pregnancy