THE ABNORMAL CHORION LOCATION: CLINICAL AND ANAMNETIC RISK FACTORS

Abstract

Among the factors that adversely affect the maternal and perinatal mortality rates include the abnormal chorion location (AChL), and later, the abnormal placenta location (APL): placenta previa (PP) and a low‐lying placenta (LLP). Perinatal mortality with APL reaches 22.2-81 ‰. Maternal morbidity in case of PP is 23%. Abnormal placentation adversely affects the course of pregnancy and childbirth. In the early gestation period AChL increases the risk of spontaneous abortion. In late pregnancy and childbirth APL is accompanied by uterine bleeding, often massive, and is the main cause of premature delivery. Aim. Identify the risk factors for the low location of the chorion in the I trimester of gestation. Material and methods. 104 pregnant women with a low chorion location (less than 2 cm from the internal os) were examined in the first trimester. The control group included 136 practically healthy patients with a location of chorion in the body and in the the bottom of the uterus. The parameters of somatic, gynecological, obstetric anamnesis and clinical studies were retrospectively evaluated. Research results. The risk factors for the abnormal location of the chorion are: the age of the pregnant woman over 35 years of age; infectious diseases that have been infected in the past; later menarche and prolonged formation of the menstrual cycle; the presence of extragenital diseases; reproductive loss in history, benign diseases of the cervix; sexually transmitted infections, dysbiosis and inflammatory diseases of the lower segments of the genital tract, manifestations of reproductive "dysfunction" associated with the use of acute curettage of the uterine cavity (with abortion, during caesarean section), manual examination of the walls of the uterine cavity. Conclusions. Careful identification of the risk factors for the abnormal location of the chorion in the stage of preparation for pregnancy, will reduce the frequency of abnormal placentation and reduce the level of obstetric and perinatal complications associated with it.