Vorobey L. I.

CURRENT ASPECTS OF FETAL DISTRESS DIAGNOSIS IN PREGNANT WOMEN WITH COMPLICATED OBSTETRIC HISTORY


About the author:

Vorobey L. I.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scentific article

Annotation:

Purpose of the study: to determine the fetal distress diagnostic criteria in pregnant women with complicated obstetric history. Object and methods. 91 women with perinatal losses in previous pregnancies were examined. Ultrasound imaging with Doppler ultrasound was performed to assess the placenta-fetus system status on a Philips HD11XE device (Austria) in the third trimester. The fetus functional state assessment was performed by cardiotocography on the Avalon FM20. In addition, the fetal heart rate variability was evaluated in the III trimester of pregnancy by cardiointervalography with the Fetal Monitor “Cardiolab BabyCard” (Ukraine). Biochemical markers were determined by immunochemical method with electrochemiluminescent detection of ECLIA (estradiol, progesterone, cortisol) and biochemical electrophoresis in urine (excretion of catecholamines). Results. The fetal heart rate variability study revealed the decreased levels of hypothalamic-pituitary regulation (decreased SDNN 17.3±1.8, RMSSD 12.9±1.4, pNN50 3.6±0.4 and increased AMO 67.4±7.1), decreased metabolichumoral regulation level (VLF-698,6±73,2) and hyperactivity of the sympathetic link (LF 267±28,0) in women of the main group compared to control group (p<0,05). An ultrasound examination revealed signs of placental dysfunction in 57 (62.6%) pregnant women with perinatal losses: the IUGR Grade I and II are 4.5 times more common than controls (p<0.05), Grade III IUGRs was detected only in women of main group; an oligohydramnios was found 2.9 times more common in women with complicated obstetric history (p<0.05). Dopplerometry allowed to identify the “mother-placenta-fetus” system hemodynamic abnormalities in 16 (17.6%) pregnant women of the main group. The hormonal analysis revealed functional depletion of the fetoplacental complex by the decreased progesterone levels to 83.1±8.7 ng/mg, estradiol to 513.7±53.9 ng l and placental lactogen up to 2.6±0.3 mg/l with high concentration of cortisol-63.4±6.6 mcg/dl in pregnant women of the main group. Conclusion. Conducting cardiointervalography, ultrasound, Doppler ultrasound, placental hormonal function and cortisol levels examination in pregnant women with complicated perinatal history may be a reserve for reducing fetal distress cases.

Tags:

fetal distress, perinatal losses, heart rate variability, cardiointervalography.

Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 73-77 pages, index UDK 618.3-071.1-02:618.5-06:616-053.31-001.8

DOI: