Abstract
The aim. To reduce the incidence of perinatal pathology in women who have used various methods of contraception, based on the study of the functional state of the fetoplacental complex (FPS), as well as improving diagnostic measures and tactics of pregnancy. Materials and methods. 140 pregnant women were studied with their division into control and 3 test groups depending on the method of contraception in the anamnesis, using clinical, laboratory and instrumental research methods during pregnancy and childbirth. Results. The study found that women with a history of intrauterine contraception (IUC), in contrast to combined oral contraception (COC) and combined oral contraception containing folate (COC+F), had a higher incidence of complications during pregnancy and childbirth, as well as fewer newborns with a satisfactory condition at birth. Assessment of folic acid levels at 6-8 weeks of gestation showed significantly better results among women with a history of COC+F, compared with IUC and COC. In the group of women with IUC in the anamnesis, significantly worse mean endocrinological values prevailed, and there was also a greater number of pregnant women with disorders of fetal-placental blood flow. More pronounced dystrophic changes in the placentas of women in this group were pathomorphologically confirmed. Conclusions. The presence in the anamnesis of IUC is accompanied by a high proportion of pregnant women with various pathological conditions and is a risk factor for FPS dysfunction. The use of COC+F in the anamnesis is the best option for women of different risk groups.
Highlights
Disturbance in the functioning of FPS leads to the formation of placental dysfunction (PD)and complications such as fetal distress, fetal growth restriction (FGR), increased perinatal morbidity, etc., subsequently causing underdevelopment of the central nervous system, high incidence in early and late neonatal periods and more [1, 2]
The analysis of the first half of pregnancy showed that in group III, in which women used contraception containing folate (COC+F), women with threatened abortion were absent, which is significantly lower than in the control, II and IV groups, while intrauterine contraception (IUC) in the history resulted in more women with threatened abortion and bacterial vaginosis (BV) compared to other groups (Table 1)
The results showed that taking in anamnesis COC and COC+F is quite positive for a normal pregnancy, in contrast to the IUC
Summary
Disturbance in the functioning of FPS leads to the formation of placental dysfunction (PD)and complications such as fetal distress, fetal growth restriction (FGR), increased perinatal morbidity, etc., subsequently causing underdevelopment of the central nervous system, high incidence in early and late neonatal periods and more [1, 2]. Despite the progress in its improvement [5, 6], including adding folate in the COC, because it is known that folate is involved in metabolic processes through nucleotide synthesis, DNA replication, which ensure cell division and growth [7, 8], the level of complication in the use of contraception remains significant and not fully studied from the standpoint of its impact on the functional state of FPS. It is of interest to study the peculiarities of its functioning in women who used different methods of contraception before pregnancy. The aim – to reduce the incidence of perinatal pathology in women who have used various methods of contraception, based on the study of the functional state of FPS, as well as improving diagnostic measures and tactics of pregnancy managment
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