Obstetric and antenatal risk factors for intrauterine growth restriction

Hromova, A. M.; Berezhna, V. A.

doi:10.14739/2310-1210.2020.3.204949

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Therefore, the thickness of the pla-centa was significantly greater in the main group than in the control group (p = 0.0001). Ultrasound examination revealed only 4 people from the main group (9.8%) with placental hypoplasia and 24 people (58.5%) had structural changes in the form of petrifications [11].…”

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confidence: 99%

Features of Ultrasound Imaging in Fetal Intrauterine Growth Retardation

Berezhna

2021

Med. and Ecol. probl.

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Fetal growth retardation complicates an average of 10% of all pregnancies. Today, ultrasound examination is used in obstetrics for diagnosis. Therefore, early detection of this complication is the key to adequate treatment and reduction of perinatal consequences. A deeper understanding of the early accompanying ultrasound parameters will allow timely detection or prevention of intrauterine fetal development. The aim of the research was to conduct an ultrasound antenatal examination of women with intrauterine growth retardation. Ultrasound fetometry and placentometry were conducted in women with intrauterine growth retardation (the main group, n-41) and women in the comparison group with the physiological course of pregnancy (n-12). At the initial ultrasound examination, among women in the main group, fetuses below the 10th percentile were probably more common and had a decrease in biparietal head size and abdominal circumference (p = 0.001, p = 0.08). With repeated ultrasound examination, the frequency of detecting decreased indicators of biparietal head size, head circumference, abdominal circumference, femoral shaft length below the 10th percentile among women in the main group increases by 1.5 times, and significantly differs from the indicators of the comparison group. (p = 0.0002, p = 0.001). A decrease in the biophysical profile of the fetus to 6-7 points accompanies 63.4% of pregnancies with intrauterine growth retardation. The amniotic fluid index below the 5th percentile in relation to the gestational age in women at the initial examination was 2.4%, and at the second examination - 7.3%. The placental ultrasound marker of premature maturation by gestational age 21.4%, the presence of petrification in 58.5%. In case of timely detection of the fetometric and placentometric changes, it is possible, from the standpoint of modern obstetrics, to start etiopathogenetic therapy and prevention of this complication of pregnancy.

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Section: Resultsmentioning

confidence: 99%

Features of Ultrasound Imaging in Fetal Intrauterine Growth Retardation

Berezhna

2021

Med. and Ecol. probl.

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Obstetrical and perinatal consequences of childbirth in women with antenatally undiagnosed fetal growth restriction

Puchkov,

Pavliuchenko,

Bohomolova

2023

Modern Medical Technology

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Fetal growth restriction (FGR) is one of the most studied topics in the medicine of the mother and fetus. However, not identified antenatally FGR can have an increased risk of both perinatal morbidity and mortality, as well as adverse long-term consequences. The identification of FGR during pregnancy will contribute to the reduction of both perinatal morbidity and perinatal mortality. Aim. Based on a retrospective analysis, assess the obstetric and perinatal consequences of childbirth in women with antenatally undiagnosed fetal growth restriction. Materials and methods. An analysis of 488 cases of childbirth in women with singleton pregnancy, who gave birth to a live child, was conducted. In all cases, the gestational age was ≥22 weeks with a fetal weight less than the 10th percentile for the corresponding gestational age. Depending on the antenatally established diagnosis of FGR, two study groups were formed: group I consisted of 204 (41.8 %) cases with antenatally diagnosed FGR, group II – 284 (58.2 %) cases in which signs of FGR were identified after the birth of the child. Maternal characteristics, neonatal outcomes, and evaluation of short-term infant outcomes were analyzed. Results. Both groups were dominated by women with first births, the number of which was almost the same. Somatic pathology was almost 2 times more common in women of group I, 17.2 %, compared to 9.2 % of women in group II (p < 0.01), this indicates that the majority of women who were not diagnosed with FGR during pregnancy belong to the low-risk group. Fetuses with impaired blood flow in the umbilical cord arteries were twice as common in group I, 49.5 % versus 23.9 % in group II (p < 0.0001), and the frequency of absent/reversible end flow in the umbilical arteries in group I compared to group II, prevailed 3 times (p < 0.0001), indicating more serious lesions of the placenta and, as a result, early manifestation of the fetal condition disorder. The frequency of premature abdominal delivery was 3.75 times higher in group I compared to group II. The most frequent indication for cesarean delivery in both groups was signs of fetal distress syndrome. Analysis of neonatal outcomes showed that the average birth weight was significantly lower in group I and was 2180 ± 55 g against 2420 ± 61 g in group II (p < 0.0001). The need for hospitalization of newborns in the intensive care unit had no statistical difference between the groups (p > 0.05). However, the complications of the early neonatal period and the total length of stay in the hospital were greater in children of the I group, compared to the II group (p < 0.0001). Conclusions. The results of the conducted research indicate a low level of prenatal diagnosis of fetal growth restriction. Most pregnant women with antenatally undiagnosed fetal growth restriction belong to the group of low perinatal risk. The most frequent indication for cesarean section operation, regardless of the date of delivery, in both groups were signs of fetal distress, the frequency of which was 1.5 times higher in the antenatally diagnosed fetal growth retardation group. Newborns with an undetected growth anomaly before delivery have an increased risk of fetal distress, the severity of which is determined by the degree of deterioration of fetal oxygenation, and not by weight percentile, which requires more careful observation of fetuses with signs of growth restriction.

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Cd68+ M1 Macrophages Is Associated With Placental Insufficiency Under Fetal Growth Restriction

2021

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The aim: To elucidate the possible involvement of M1 and M2 macrophages in the placentas of women, whose pregnancies were complicated by fetal growth restriction (FGR) and resulted in term births after 37 weeks of gestation and preterm births up to 37 weeks of gestation. Materials and methods: CD68+ and CD163+ macrophages were studied by immunohistochemical method, placental morphology in the placentas of 16 women whose pregnancies were complicated by FGR and resulted in term births at a gestational age after 37 weeks (1-st group, n = 7) or resulted in preterm births at a gestational age up to 37 weeks (2-nd group, n = 9). The control group consisted of 10 placentas of women with physiological pregnancies and births. Results: Women 2-nd group showed significantly low weight of the placenta, a short gestation period at the time of delivery, and a prolonged labor period than women of the control group (p <0.001; p <0.001; p <0.05, respectively). The level of CD68+ and CD163+ macrophages in the placentas of women 2-nd group was significantly higher than in woman 1-st group (p <0.001, p <0.001, respectively). A significant correlation was found between the expression level of CD68+ monocytes in the intervillous space and the weight of a newborn (r = – 0.765; p = 0.016) in women 2-nd group. Conclusions: These studies suggest that in the placentas of women whose pregnancies were complicated by FGR and resulted in preterm births, the increased activation of CD68+ macrophages of the pro-inflammatory pool may be associated with disorders of the vascular and stromal component of the villous chorion with the development of involutive and dystrophic changes. In general, this fact probably determines the progress of chronic placental insufficiency and aggravates the development of fetal growth restriction.

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Obstetric and antenatal risk factors for intrauterine growth restriction

Cited by 3 publications

References 11 publications

Features of Ultrasound Imaging in Fetal Intrauterine Growth Retardation

Features of Ultrasound Imaging in Fetal Intrauterine Growth Retardation

Obstetrical and perinatal consequences of childbirth in women with antenatally undiagnosed fetal growth restriction

Cd68+ M1 Macrophages Is Associated With Placental Insufficiency Under Fetal Growth Restriction

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