Fetoplacental complex and «great obstetrics syndromes»
DOI:
https://doi.org/10.15574/HW.2022.163.26Keywords:
women, pregnancy, major obstetric syndromes, preeclampsia, preterm birth, placental insufficiency, fetoplacental complex, ultrasound examinationAbstract
Purpose - to determine the peculiarities of the functional state of the fetoplacental complex (FPC) during pregnancy in women with complications from the group of «great obstetrics syndromes» (GOS), which were clinically manifested by preeclampsia, preterm birth and placental insufficiency.
Materials and methods. A retrospective analysis of ultrasound examination of the FPC during pregnancy in 239 pregnant women (the main group - MG) who had complications from the group of GOS was performed: 103 pregnant women with severe preeclampsia, 67 pregnant women with placental insufficiency, 69 pregnant women with spontaneous preterm birth at 22-36 weeks’ gestation. The control group (CG) consisted of 56 practically healthy pregnant women with a favourable reproductive history and an uncomplicated pregnancy. Statistical processing of the study results was performed using standard software Microsoft Excel 5.0 and Statistica 6.0.
Results. In the trimester I of pregnancy, chorionic hypoplasia was diagnosed significantly more often in pregnant OG - 45 (18.8%); thickening of the decidua basalis - 41 (17.1%); deformation of the ovum and increased endometrial tone (especially in the location of the chorion) were significantly more common among women of OG - in 44 (18.4%) cases (p<0.05) and 58 (24.2%) cases (p<0.01), respectively, than among women of CG - in 4 (7.1%) cases and 7 (12.5%) cases, respectively. In the trimester II, placental thickening along with increased diffuse hyperhomogeneity was observed in 34 (14.2%) pregnant women with OH versus 5 (8.9%) pregnant women with CG (p<0.05); functional hypertrophy of the placental tissue was accompanied by signs of hyperhomogeneity in 28 (11.7%) cases of OH versus 5 (8.9%) cases of pregnant women with CG (p<0.05). In the trimester III of pregnancy, placental hyperplasia and placental hypoplasia were significantly (p<0.05) more prevalent than placental hyperplasia; destructive changes in the placenta - by 1.7 times (p<0.05); 19 (7.1%) pregnant women of OG had preeclampsia, and 68 (28.4%) women had ultrasound signs of fetal growth retardation syndrome.
Conclusions. Dynamic ultrasound monitoring of the functional state of the FPC in women with GOS revealed that from early gestation there is a violation of placentogenesis, accompanied by functional failure of the FPC and leading to early depletion of the compensatory capacity of the fetoplacental system.
The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. Informed consent was obtained from the women.
No conflict of interests was declared by the author.
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