FEATURES OF THE COURSE OF THE PERINATAL PERIOD AND DELIVERIESDURING PREGNANCY WITH A SINGLE UMBILICAL ARTERY OF THE FETUS

Abstract

Among the anomalies in the number of vessels of the umbilical cord,thesingle umbilical artery (SUA) is most often found. A significant impact of SUA on the course of such pregnancy and deliveries is expected. The article presents some peculiarities of the deliveries and condition of newborns after pregnancies with SUA compared with pregnant women with three umbilical cord vessels and physiological deliveries. The objective of the workwasto analyze the peculiarities of the perinatal period and deliveries after pregnancy with SUA, to conduct a comparative analysis of the revealed features with the corresponding indicators among pregnant women with two umbilical arteries and physiological births. Thestudygroupconsistedof 31 pregnant women with a SUA (study group)and control group – 62 pregnant women with 2 arteries of the umbilical cord. According to our data, pregnant womenwith SUA were hospitalized earlier and spent more time in the maternity hospital, although the terms of delivery did not differ between the two study groups, although there was a tendency to an earlier term of delivery in pregnant women with SUA. Among pregnant women with SUA, deliveries were premature in 4 women (12.9 %). No differences were found between pregnant women with SUA and control group in such indicators as early discharge of amniotic fluid, anthropometric indicators of pregnant women, entanglement of umbilical cord, pelvic presentation, rupture of the perineum or episiotomy during deliveries. The duration ofI, II and III periods of deliveries also did not differ significantly between the two study groups. Weakness of patrimonial activity was more often in women with SUA, accounting for 12.9 % of all deliveries, compared to 3.2 % in the control group. Fetal hypoxia in deliveries was observed in 25.8 % of cases among pregnant women with SUA, and in 4.8 % among pregnant women in the control group. Fetal distress in deliveries was estimated at 4 (12.9 %) and 4 caesarean sections were performed. Physiological childbirth occurred in all cases in the control group. In the SUA group, the infant weight was significantly lower than the control group children, but the Apgar score at 1 and 5 minutes did not differ between the two study groups. Cardio-respiratory depression, risk of neurological disorders, and congenital malformations (esophageal atresia, Gothic palate, and syndactylium) were more frequently reported in the SUA group. Long-term hospitalization of pregnant women, weakness in delivery, premature birth, fetal hypoxia in delivery, fetal distress and incidence of cesarean delivery are much more common in SUA group. The weight of newborns from pregnancies with SUA is significantly lower, however, the infants' status on the Agar scale after pregnancies with SUA did not differ from those of children in the control group. Cardiovascular depression, the risk of neurological disorders, and congenital malformations (esophageal atresia, Gothic palate, and syndactyly) were more common in the SUA group.