HEMODYNAMICS STATE IN «MOTHER-PLACENTA-FETUS» SYSTEM OF PREGNANT SMOKERS

Abstract

Smoking is one of the risk factors in the disturbance development in the "mother-placenta-fetus" system which serves as one of the major preventable factors of pregnancy unsuccessful outcome for both mother and fetus. In order to identify characteristics of hemodynamic status of "mother-placenta-fetus" system in smoking pregnant women the analysis of physiological indicators of Doppler ultrasound had been done by means of the of uteroplacental, fetoplacental and fetal blood flow assessment. The study included 120 pregnant women of Northern Medical Clinical Center named after N. A. Semashko of Russian Federal Medical and Biological Agency at 30-34 weeks' gestation period (group of smokers - 80 people and non-smokers - 40 people); 85.0% of pregnant smokers have a slight degree of nicotine dependence, 5.0% - a moderate, and 10.0% - strong according to Fagerstrem's test; smoking history was 10,6 ± 3,9 years. Changes in the feto-placental blood flow predominate in the group of the pregnant smoking women. It is indicated by the systolic-diastolic ratio and resistance index, reflecting the kind of "brain protection effect of the fetus" and occurred in Doppler signs of increased blood flow in the middle cerebral fetal artery, against decrease of blood flow in the umbilical artery. The necessity is justified to spend additional Doppler study of utero-placental, feto-placental and fetal blood flow to identify compensatory changes in placenta blood vessels, umbilical cord and forecasting the development of hypoxia in the fetus of vascular origin, during the third ultrasound screening of smoking pregnant women.