Perinatal Loss as an Urgent Issue of Obstetrics and Perinatology

Abstract

Perinatal losses are an urgent medical and socioeconomic problem of obstetrics and perinatology. Perinatal mortality in the world is about 30‰, varying widely across continents and countries. Perinatal losses are one of the main indicators of the level of medical care, characterize, on the one hand, the state of health of a woman and the fetoplacental system, and therefore the degree of viability of the fetus, and on the other, the quality of medical care for the mother during pregnancy, childbirth and the child before and during childbirth, as well as after birth. In numerous studies, the study of the structure of perinatal loss factors and adverse perinatal outcomes is of paramount importance. The most significant factors, according to some researchers, are intrauterine hypoxia and fetal asphyxia in childbirth, intrauterine anomaly of fetal development, respiratory disorders, intrauterine infections, placental and umbilical cord pathology, birth injuries, intraventricular hemorrhages, neonatal infections. Perinatal losses suggest a high risk of pregnancy. This dictates the need for a correct approach to assessing perinatal risk during pregnancy during the follow-up period with an obstetrician-gynecologist, in most cases there is an underestimation of the degree of risk, incorrect management of pregnancy. Women who have undergone COVID-19 in the first trimester of pregnancy may be at increased risk of adverse perinatal and maternal complications. The increase in the number of surgical interventions in obstetric practice over the past decades, noted in all countries of the world, is directly related to the expansion of the indications for the performance of caesarean section operations to prevent perinatal pathology. At the same time, being a unique measure of preserving the health and life of a mother or fetus, a global increase in its frequency is alarming. Currently, one of the main tasks remains the development of a clear multifactorial, highly differentiated system for predicting perinatal losses in order to prevent them.