Features of hemodynamics in the mother-placenta-fetus system in women who had complications from the group of major obstetric syndromes, clinically manifested by placental insufficiency
DOI:
https://doi.org/10.15574/HW.2023.169.20Keywords:
major obstetric syndromes, placental insufficiency, vascular dopplerometry, fetoplacental complex, ultrasound examinationAbstract
Purpose - to study the features of hemodynamics in the mother-placenta-fetus system during pregnancy in women who had complications from the group of major obstetric syndromes (MOS), clinically manifested by placental insufficiency.
Materials and methods. A prospective analysis of ultrasound examination of blood circulation in the mother-placenta-fetus system during pregnancy in 99 pregnant women with complications from the group of MOS - placental insufficiency - was performed. These women constituted the Main group (MG). The Control group (CG) included 50 practically healthy pregnant women with a good reproductive history and an uncomplicated pregnancy. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs.
Results. The study revealed an increase in all vascular resistance indices. An increase in the vascular resistance index is associated with an increase in peripheral vascular resistance and a decrease in diastolic blood flow, which, in turn, is due to a decrease in vascularisation of the terminal villi as a morphological and functional manifestation of placental insufficiency after 35 weeks of pregnancy: the resistance index in the umbilical cord artery was 0.71±0.02 in the MG versus 0.48±0.07 in the CG (p>0.05).In the study, the indices of vascular resistance in the fetal aorta increased: the resistance index was 0.74±0.05 in the MG vs. 0.44±0.55 in the CG (p<0.05) and at 22-27 weeks of pregnancy 0.98±0.06 in the MG vs. 0.50±0.40 in the CG (p<0.05). It was found that 69 (69.7%) pregnant women in the MG had hemodynamic disorders: 39 (39.4%) patients had uteroplacental circulation disorders with preserved fetal-placental circulation; 23 (23.2%) pregnant women had fetal-placental circulation disorders with preserved uteroplacental circulation; 7 (7.1%) pregnant women had simultaneous uteroplacental and fetal-placental circulation disorders.
Conclusions. Dynamic ultrasound monitoring of the functional state of the fetoplacental complex in women with MOS revealed that from the early stages of gestation, there is a violation of placentogenesis, which is accompanied by functional failure of the fetoplacental complex and leads to early exhaustion of the compensatory capabilities of the fetoplacental system.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper.
Women's informed consent was obtained for the study.
No conflict of interests was declared by the author.
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