THE CONDITION OF UTEROPLACENTAL HEMODYNAMICS IN PREGNANT WOMEN AS A RESULT OF THE ASSISTED REPRODUCTIVE TECHNOLOGIES APPLICATION

Abstract

The aim of research. To study in the dynamics of the First trimester of pregnancy the features of hemodynamics in pregnant women after ART .Materials and methods. 299 pregnant women were comprehensively examined: the main group included 249 women whose pregnancy occurred as a result of the ART application. The control group consisted of 50 pregnant women with spontaneous pregnancy and its physiological course, which were registered in antenatal clinic at 6-8 weeks. The I group included 94 women with tubal-peritoneal factor of infertility, the II group was formed by 87 women with endocrine factor of infertility, and the III group included 68 women whose infertility is caused by the male factor.Common clinical and laboratory tests were performed on pregnant women of the examined groups, which included a General analysis of blood, urine, and Doppler measurements of uterine arteries indicators.The results of the research and their discussion. Determination of utero-placental hemodynamics in women of the main group after the ART application indicates the need for their dynamic monitoring during the I trimester of pregnancy.As a result of the analysis of the obtained data, it was found that the highest intensity of hemodynamics in the uterine artery basin at 11-12 weeks of gestation was registered in the group of patients with the physiological course of pregnancy. Thus, the systolic-diastolic ratio in the right and left uterine arteries in these patients was 1,9 (1,8-2,7) and 2,1 (1,9-2,6), respectively.In contrast to the subjects with uncomplicated course (group IV), in pregnant women after the ART application analyzed indicators were significantly higher (1,6 – 1,9 times, p<0,0001). The systolic-diastolic ratio in the right uterine artery in group III was 3,0 (2,4-3,5), and in group I – 3,3 (3,1- 3,4). Similar data were obtained during the curves of blood flow rates analyses the in the left uterine artery – 2,9 (2,1-3,5) and 3,0 (2,7-3,6), respectively.The highest peripheral resistance, both in the right (3,6 (3,4-3,7)) and in the left (3,5 (3,2-3,8)) uterine arteries, was registered naturally in group II pregnant women.Own research has shown that the vast majority of 36 (72,0%) patients with uncomplicated course and favorable gestational outcome at 11-12 weeks of pregnancy did not register blood flow in the interval space. Less than one-third of the patients - 14 (28,0%) color Doppler mapping revealed continuous venous-like blood flow. Arterioid-like pulsating type of flow does not reveal any one pregnant in this group.In contrast, the vast majority - 50 (73,5%) of group I pregnant women registered two types of blood flow in the intervertebral space: pulsating arterioid and continuous venous flow. Only 18 (26,5%) patients of this group the blood flow in intervention space was not determined.Conclusions. The results of the research allow us to attribute Doppler to highly informative research methods, which makes it possible to predict pregnancy complications in pregnant women as a result of art quite effectively. Pregnant women with no hemodynamic abnormalities in the utero-placental pool in combination with normal ultrasound data, including assessment of the fetal condition, constitute a group with a truly low risk of an adverse outcome