Obstetric and Perinatal Aspects of Metabolic Disorders in Pregnant Women

Abstract

The aim: To determine the feasibility of using Tivortin in metabolic disorders during pregnancy and its effect on the course of pregnancy, childbirth, fetal and neonatal status. Materials and methods: We examined 210 pregnant women with metabolic disorders using clinical and laboratory data, uterine artery Doppler, determi¬nation of lipid peroxidation and antioxidant system, leptin and placental growth factor content. The fetal condition was assessed by ultrasound examination with Doppler, determination of biophysical profile, and cardiotocography. Results: Metabolic disorders in pregnant women increase the risk of obstetric and perinatal complications by activating lipid peroxidation and inhibiting the antioxidant system, reducing the content of placental growth factor and increasing the level of leptin in the blood plasma. After treatment, there was a significant decrease in leptin levels and an increase in placental growth factor levels, normalization of lipid peroxidation and antioxidant system, uterine artery pulsatility index and umbilical cord peak systolic velocity index, systolic-diastolic ratio, fetal biophysical profile and cardiotocography. The incidence of complications in childbirth decreased by 3 times, surgical interventions – by 2 times, postpartum infectious complications – by 1.7 times, and the birth of infants in a state of asphyxia – by 1.8 times. Conclusions: Metabolic disorders in pregnant women are a significant factor in the development of obstetric and perinatal complications due to the intensity of lipid peroxidation and depression of the antioxidant system, and a decrease in the content of placental growth factor. The use of Tivortin in the treatment of pregnant women with metabolic disorders has proven its safety and efficacy.