STUDY OF THE INFLUENCE OF HORMONAL FUNCTION IMPAIREMENT OF THE PLACENTA ON THE STATE OF FETUS AND NEWBORN IN WOMEN WITH NODULAR GOITER

Abstract

The thyroid gland pathology is one of the most common in the world and is on the samelevel with diabetes mellitus and diseases of the cardiovascular system in its importance.Extragenital pathology, in particular, nodular goiter in pregnant women acts as anadditional stress factor that can negatively affect hormonal relationships in the motherplacenta-fetus system and contribute to an increase in the frequency of complications ofpregnancy, childbirth, and impairment of the fetus and newborn condition.The aim of this work – to study the disturbance effect in the hormonal function of theplacenta on the condition of the fetus and newborn from women with nodular goiter.Material and methods. The analysis of the state of the fetus and newborn of 20 apparentlyhealthy women (control group) and 54 women with nodular goiter (main group). Of these,30 newborns from women with grade I nodular goiter were included into group I, and24 newborns from women with grade II nodular goiter were included into group II. Theintrauterine fetus state was judged about according to the data of cardiotocography, fetalbiophysical profile (FBP), ultrasound examination, and Doppler results. The functionalstate of the fetoplacental complex was assessed by determining the serum concentrationof estradiol (Е2), estriol Е3), progesterone, placental lactogen, as well as the results ofhistological examination of the placentas.Results. The study of the placenta hormonal function, the results of ultrasound diagnosticsand histological examination of the placentas indicate the presence of placentaldysfunction in pregnant women with nodular goiter, that affected the condition of thefetus and newborn. Thus, the cardiotocographic index in fetuses from pregnant women,suffering from nodular goiter, is significantly less than in healthy pregnant women(p<0.05). The average PPI score in women with nodular goiter is also significantly lowerthan in the control group (p<0.05). Doppler data indicate a change in the parameters of the maternal hemodynamics, that led to a violation of the uteroplacental blood flow, thedevelopment of fetal hypoxia.Conclusions. The presence of nodular goiter in the mother is a risk factor for placentaldysfunction. Starting from the second trimester of pregnancy, there are significant changesin the content of placental hormones in the blood. A decrease in the concentration ofprogesterone in the blood serum in pregnant women with nodular goiter, in the latestages of pregnancy, can serve as a marker of the threat of termination of pregnancyand premature birth. A decrease in the content of estradiol and placental lactogen inthe maternal blood serum can be used as a marker of fetal distress in pregnant womenwith nodular goiter. The condition of the fetus and newborn is in direct proportion to thedegree of manifestation of the nodular goiter and the functional state of the placenta.