CONDITION OF FETOPLACENTIAL COMPLEX IN SINGLE WOMEN ON THE BACKGROUND OF THE DEVELOPED ALGORITHM FOR PREGNANCY AND BIRTH

Abstract

The article presents the results of a study of the status of the fetoplacental complex against the background of the developed algorithm for managing pregnancy and childbirth in single women.Objective: to assess the status of the fetoplacental complex in single pregnant women on the background of a comprehensive algorithm of treatment and preventive measures during pregnancy and childbirth.Materials and methods: the fetoplacental complex was evaluated in 50 single women against the backdrop of the proposed complex algorithm (main group I), in 50 single women (main group II) and 50 married women (comparison group) with conventional pregnancy and childbirth. The study of the status of the fetoplacental complex was carried out at 36-40 weeks of gestation. The algorithm for conducting pregnancy and childbirth in single women included hypnotic psychotherapy, autogenic training, cognitive, behavioral, and positive psychotherapy.Results: A study of the status of the fetoplacental complex in single pregnant women revealed an increase in the frequency of fetal growth retardation (16.5%), polyhydramnios (21.3%), echographic changes in the placenta (53.8%), significant pathological hemodynamic and cardiotocographic changes, as manifested by a violation of blood flow in the umbilical arteries, uterine arteries and the middle cerebral artery, a decrease in heart rate variability, a decrease in the duration of acceleration, an increase in the number of decelerations.Confirms the progression of placental dysfunction in single women by a decrease of 1.6 times, progesterone and prolactin by 1.2 times, placental lactogen by 1.3 times and chorionic gonadotropin by 1.5 times with an increase in cortisol by 1.6 times and changes in the content of placental proteins: a 1.9-fold increase in alpha-fetoprotein, a 1.7- fold increase in alpha2-microglobulin, 1.5-fold increase in testosterone-estradiol-binding globulin, and a 1.9-fold decrease in placental alpha-1-microglobulin decrease in 1.9 trophic beta glycoproteide 1.5 times.The proposed pregnancy management algorithm allowed to reduce by 12% the echographic and cardiodynamic changes of the fetoplacental complex, improve the hormonesynthesizing function of the placenta: increase the level of estriol (by 12%), progesterone (by 14%), placental lactogen (by 12%), chorionic gonadotropin (by 14%) and the content of placental proteins: trophic beta-glycoprotein (by 16%); a decrease in the content of alpha-fetoprotein (by 10%); placental alpha-1 microglobulin (12%), alpha-2 microglobulin fertility (14%) and testosterone-estradiolbinding globulin (16%). Conclusions. According to the results of the research, a high frequency of placental dysfunction (28%) was found in single women, which was three times higher than in 8.7% of married women. The psychotherapeutic complex of measures carried out for single women during pregnancy significantly improved the condition of the fetoplacental complex, which is confirmed by hemodynamic, endocrinological, metabolic changes and satisfactory functional condition of the fetus