The aim: Improving perinatal outcomes in pregnant women at high risk of intrauterine infection by developing diagnostic criteria and algorithms for managing pregnancy
and childbirth.
Materials and methods: The study of pregnancy and childbirth was conducted in 72 patients at high risk of IUI, which formed the main group. The control group consisted of
64 patients with a low infectious risk of IUI. Culture, bacterioscopic and biochemical methods were used to identify microorganisms. Peculiarities of infection in the examined
women were investigated by determining the concentration of Ig M and IgG in the blood serum and performed polymerase chain reaction for measles virus, cytomegalovirus,
parvovirus B19. Serum for the presence of specific immune globulins to these pathogens was examined by ELISA. Comprehensive ultrasound examination in B-mode was performed
to determine the feto metry of the fetus and assess its development with the determination of the estimated mass, location, size and structure of the placenta, the amount of
amniotic fluid. To determine the condition of the fetus, a Doppler study of blood flow in the uterine arteries, umbilical artery, middle cerebral artery of the fetus and venous duct.
Results: Analyzing the course of this pregnancy in women of the studied groups threatened miscarriage and the threat of premature birth occurred in 24 (33.3%) cases, with
signs of isthmic-cervical insufficiency were diagnosed in 13 (18.1%) patients. In the control group of patients, the threat of abortion was diagnosed in 15 (23.4%) patients.
According to ultrasound examination, patients in the main group in 12 (16.7%) cases were diagnosed with fetal growth retardation, in 25 (34.7%) patients at high risk of IUI
there were changes in the placenta, namely, hyper echogenic inclusions in the placenta occurred in 7 (9.7%) cases, dilation of the intervillous space in 8 (11.1%) cases, placental
hyperplasia in 7 (9.7%) cases, polyhydramnios was diagnosed in only 5 (6), 9%) cases, with 1 (1.4%) acute polyhydramnios in patients with signs of acute respiratory viral
infection during pregnancy.
Conclusions: Women at high risk for IUI require close monitoring of the fetus due to the increased frequency of hemodynamic changes in uteroplacental-fetal circulation,
including fetal-placental – 22.2% and the occurrence of intrauterine growth retardation.
Women with suspected cytomegalovirus infection require determination of seroconversion; in case of immunologically confirmed infection, it is desirable to recognize PCR for
cytomegalovirus in the amniotic fluid in order to determine further management and monitoring of this pregnancy.
С.І. ЖУК д. мед. н., професор, завідувачка кафедрою акушерства, гінекології та перинатології Національної академії післядипломної медичної освіти ім. П.Л. Шупика О.А. НОЧВІНА к. мед. н., асистент кафедри акушерства і гінекології № 2 Вінницького національного медичного університету ім. М.І. Пирогова, Центр матері та дитини, м. Вінниця А.В. КАМІНСЬКИЙ завідувач відділенням планування сім'ї та допоміжних репродуктивних технологій з кабінетом ендокринної гінекології і денним стаціонаром Українського державного інституту репродуктології НМАПО ім. П.Л. Шупика Контакти: Жук Світлана Іванівна Київський міський пологовий будинок № 2 04074, Київ, Мостицька, 11 тел.
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