MAIN ASPECTS OF DIAGNOSTICS AND PREVENTION OBSTETRICAL AND PERINATAL PATHOLOGY IN PREGNANT WOMEN WITH CORONAVIRUS DISEASE COVID-19

Kaminskyi V. V., Vorobei L. I., Gervazyuk О. І., Tkachuk R. R., Fastovets О. Р.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

COVID-19 is a global public health emergency that can cause devastating health problems during pregnancy. The purpose of the study is to determine the main methods of diagnosis and prevention of obstetric and perinatal pathology in pregnant women with the coronavirus disease COVID-19. The study was conducted on the basis of the Kyiv City Center for Reproductive and Perinatal Medicine, Department of Obstetrics, Gynecology and Reproductive Medicine of the P.L. Shupyka. Two research groups were formed: Group I (main) – 100 pregnant women with coronavirus infection, Group II (control) – 100 women with a physiological course of pregnancy. According to the degree of severity, the main group is divided into: O1 group – 44 pregnant women with a critical and severe course of coronavirus infection, O2 group – 56 pregnant women with an average degree of coronavirus infection. In pregnant women with a critical and severe course of the coronavirus disease, changes in the general blood test are determined (anemia, leukocytosis with lymphocytopenia and monocytopenia, and thrombocytopenia). Leukopenia with lymphocytopenia and monocytopenia are characteristic of pregnant women with a moderate to severe course of the coronavirus disease. In the patients of the main group, activation of the procoagulant link of the hemostasis system is observed, both by external and internal pathways, as well as laboratory signs of thrombinemia. Pregnant women with coronavirus infection have significantly high levels of «inflammatory markers» (CRP, procalcitonin, and IL-6). According to the ultrasound examination of the «mother-placenta-fetus» system, signs of placental dysfunction are revealed: structural changes in the placenta (93.2% in the O1 group and 69.6% in the O2 group), pathology of the amniotic fluid (low amniotic fluid – 54.5% in O1 group and 51.8% in the O2 group, and polyhydramnios – 29.5% and 14.3%, respectively), fetal growth retardation, and the II and III degrees of ZRP were observed only in pregnant women with coronavirus infection (II degree ZRP – 20.5% in the О1 group versus 10.7% in the О2 group and 3rd degree OA – 9.0% versus 1.8%, respectively). As a result of the dopplerometric study, 52.3% of pregnant women in the O1 group and 48.2% in O2 had hemodynamic disorders of the II degree noted, hemodynamic disorders of the II degree were observed only in patients with coronavirus infection and had no significant differences (20.5% in the O1 group and 14.3% in the O2 group), while hemodynamic disorders of the III degree significantly prevailed in patients of the O1 group (11.4% vs. 5.4%, respectively). Evaluation of CTG according to the Dawes-Redman criteria revealed signs of fetal cardiac reactivity disorder specifically in pregnant women with coronavirus infection. Thus, the initial signs of acidemia were found in 43.2% of the examined in the O1 group and 39.3% in the O2 group, acidosis was observed in 18.2 women in the O1 group against 10.7% in the O2 group, severe acidosis and the threat of antenatal death of the fetus with a significant preponderance were diagnosed in the examined O1 group (9.1% versus 3.6% and 4.5% versus 1.8% in the O2 group, respectively). The course of childbirth in patients with coronavirus disease was complicated by premature birth in 81.8% of pregnant women in the O1 group and 67.9% in the O2 group, PRPO – in 52.3% in the O1 group and 51.8% in the O2 group, early fusion of the amniotic sac water – 36.4% in the examined O1 group against 23.2% in the O2 group.

COVID-19,coronavirus disease,obstetric complications,perinatal complications

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«Bulletin of problems biology and medicine» Issue 4 (167), 2022 year, 151-159 pages, index UDK 618.3/.7-07-084:578.834.1:616.988.7

10.29254/2077-4214-2022-4-167-151-159