The status of fetal autonomic nervous regulation in women with «short cervix» syndrome

Abstract

The objective: was to investigate the coefficients of acceleration capacity (AC) and deceleration capacity (DC) in women with «short cervix» syndrome.Materials and methods. A total of 292 pregnant women were examined. They were divided into several groups according to the results of the study of cervical length and methods of prevention of premature birth. Group I included women with normal cervicometry data. In other groups there were women with a «short cevix». In group II, there were women who underwent cerclage. In group III – used a pessary; Group IV – prescribed intravaginal progesterone; V – used cerclage and pessary; and in VI – cerclage and progesterone vaginally.Results. The level of preterm births was 2.1%, 10.9%, 8.9%, 9.3%, 6.9% and 7.5% in women of groups I, II, III, IV, V and VI, respectively (p<0.05 by criterion χ2 compared with women with normal cervical length).The values of AC/DC at 26 weeks were low and did not differ by groups. Subsequently, the values of AC/DC in women with cervical shortening were equal to the control only in groups III and VI. The fact that women who received vaginal progesterone as monotherapy or additionally to cervical cerclage significantly reduced the relative risk of fetal distress is of great interest. Thus, the normalization of AC/DC in pregnant women with «short cervix» syndrome under the influence of progesterone reflected the development of nervous regulation, which contributed the reduction the level of fetal distress.Conclusions. In patients with «short cervix» syndrome, there was a decrease in the level of AC/DC, which reflected the deterioration of the processes of autonomic nervous regulation of fetal hemodynamics. This captured the increased level of fetal distress. The use of vaginal progesterone contributed to normalize AC/DC and reduce the relative risk of fetal distress.