FEATURES OF HEMODYNAMICS OF FETOPLACENTAL COMPLEX IN PREGNANT WITH PERINATAL INFECTIONS

Abstract

Introduction: Perinatal infections are an important issue in modern obstetrics, perinatal and pediatric care and one of the main causes of perinatal morbidity and mortality. The persistence of infection in the mother's body can lead to an adverse outcome of pregnancy and childbirth, but it does not always mean the infection of the fetus and the development of an infectious disease. The presence of foci of infection in the body of a pregnant woman is only one of the reasons for the development of intrauterine infection. Dopplerometric study in IUI promotes identification of patients at risk of developmental retardation and helps to determine the initial signs of fetal distress. The aim: To study the features of hemodynamics of fetoplacental complex in pregnant with perinatal infections, depending on their implementation in newborns. Materials and methods: The study involved examination of 230 couples of pregnant-newborns, who were divided into clinical groups: Group I - 60 couples with viral infection; Group ІІ - 60 couples with bacterial infection; Group III - 60 couples with combined infection. Each clinical group was divided into 2 subgroups: with implementation of infection in newborns (1) and without it (0). Control group included 50 pregnant-newborns couples with physiological course of pregnancy and early neonatal period. Ultrasound (echographic and dopplerometric) study was performed according to the generally accepted technique on MINDRAY M7. The condition of the bloodstream was determined in the following vessels: umbilical artery, thoracic aorta, medial cerebral artery, uterine arteries. The resulting data was subject to statistical processing using the STATISTICA software. Results: Pregnant of the control and main groups underwent ultrasound somatogenic study with a syndromological analysis. Assessment of indices of RI and PI in the I-III clinical groups showed a tendency to increase. These values in the main group were significantly higher than the normative ones. More severe violations of the blood flow were observed in Group I and III. More pronounced changes in utero-placental-fetal blood flow were recorded in pregnant women with the implementation of infection. Peak systolic velocity in the medial cerebral artery was 1.3 times higher in Group II, 1.8 times higher in Group I and 1.6 times higher in Group III than in women with physiological pregnancy. Conclusions: Pregnant women of the main clinical group, in comparison with the normative indices of healthy pregnant, were found to have an increase in the indices of vascular resistance in the major vessels of the uterus-placental-fetal basin, which is likely due to the toxic effects of metabolic products of pathogens of infections that persist in the body on the endothelium of the blood vessels.