Abstract
The objective: to establish the features of heart rhythm autonomic regulation in mother and the fetus and their correlation with mother–placenta–fetus functional system in women with complicated obstetric anamnesis.Materials and methods. 97 pregnant women with perinatal losses in history were examined. The heart rate variability of mother and the fetus was evaluated using cardiointervalography. The standard methods were performed such as cardiotocography and ultrasound examination with doplerometry to study the fetus state. An early neonatal period was analised and the macroscopic and histological examination of the placenta was performed.Results. A study of heart rate variability revealed predominance of the sympathetic nervous system tone both during rest and during loading tests in women with complicated obstetric anamnesis (p<0,05). Time characteristics of the fetus heart rate variability determined the desynchronization of neurohumoral regulation mechanisms with sympathetic hyperfunction as a result of reducing the adaptive capacity and metabolic–humoral effects on the cardiovascular system. Ultrasound signs of placental dysfunction in pregnant women with perinatal losses in history were reliably more often than in women from control group. Newborns from mothers with complicated obstetric anamnesis tend to have complicated early neonatal period (p<0,05). Results of histological studies showed signs of placental dysfunction with a significant difference in main and control group.Conclusions. Women with complicated obstetric anamnesis have significant tension of the sympathetic nervous system with a fetus sympathetic activity decrease. This can testify the fetus energy reserves depletion and may be diagnosed at preclinical stage by cardiointervalography. The results of the histological study indicate the presence of placental dysfunction in most pregnant women with perinatal losses in history.
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