Perinatal losses in anamnesis as a factor of fetus adaptation damage

• Main Authors: В. В. Камінський, О. І. Жданович, Л. І. Воробей, Т. В. Коломійченко, І. В. Рогава
• Format: Article
• Language: English
• Published: Publishing House TRILIST 2019-06-01
• Series: Репродуктивная эндокринология
• Subjects: perinatal loss; fetal distress; cardiointervalography; newborn; neonatal adaptation
• Online Access: http://reproduct-endo.com/article/view/170089
• ISSN: 2309-4117; 2411-1295

In literature there are many works about prediction of chronic hypoxia of fetus, based on the assessment of the mother-placenta-fetus system, such as ultrasound, doppler velocimetry, cardiotocography, placental hormones and proteins tests; separate immunological, biochemical, hemostasiological and functional markers were introduced. However, the prognostic value most of these methods is insufficient by the standards of evidence-based medicine; they do not have a complex pathogenetically based approach. In this regard, the search for new methods for timely prediction and preclinical detection of fetal hypoxia continues to be a priority for obstetrics and perinatology. Cardiointervalography can be a promising method to study the relationship of the mother-placenta-fetus system; it allows simultaneous registration and assessment of the functional systems of mother and fetus. The high probability of such interrelations is evidenced by previous studies. Study aim was to assess the adaptation disorders of the fetus and newborn, to determine perinatal outcomes with a burdened obstetric history. A total of 200 pregnant women with perinatal losses in history (main group) and 100 pregnant women without perinatal losses in history (control group) were examined. According to the results of fetal cardiointervalography in women with perinatal losses in history, the state of regulation of the fetal autonomic nervous system is characterized by a tendency to hypersympathicotonia, stress adaptation systems in the fetus in 66.0% of women. In 10.0% of women, hypertension of the regulatory systems of the fetus enters the stage of exhaustion and breakdown of adaptation, which is confirmed by the diagnosis of fetal distress. Assessing the condition of the fetus with an automatic analysis of the cardiotogram by the Dawes-Redman criteria showed an STV value of <4 in 89.6% of women with fetal distress. The total assessment of the biophysical profile of the fetus was 4.43 ± 0.31 points. The results of the Gausknecht test were less than 15 s, and in severe cases they dropped to 5–7 s. 76.1% of children after intrauterine distress are born in a state of asphyxia, which causes a high frequency of disadaptation syndromes: most often central nervous system disorders (73.9%) and cardiovascular disadaptation (41.3%) was occured.