Perinatal losses in anamnesis as a factor of fetus adaptation damage
Keywords:perinatal loss, fetal distress, cardiointervalography, newborn, neonatal adaptation
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.
- Cousens, S., Blencowe, H., Stanton, C., et al. “National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis.” Lancet 377.9774 (2011): 1319–30.
- Korotova, S.V., Fatkullina, I.B., Namzhilova, L.S., et al. “Modern view on the problem of antenatal fetal death.” Siberian Medical Journal (Irkutsk) 130.7 (2014): 5–10.
- Baranova, V.V. “Peculiarities of the psychoemotional condition of women who have reproductive loss in history, in the context of present pregnancy.” Perinatology and Pediatrics 1 (2017): 70–3.
- “Psychoemotional status of women with fetal loss.” Topical issues of pediatrics, obstetrics and gynecology 1 (2012): 64–6.
- Chehonatskaya, M.L., Chernyshkova, E.V., Chehonatskiy, A.A., Kipchatova, T.Y. “Features of psychoemotional status in pregnant women with placental insufficiency.” Saratov Medical Journal 8.2 (2012): 541–7.
- Devisme, L., Merlot, B., Ego, A., et al. “A case-control study of placental lesions associated with pre-eclampsia.” Int J Gynaecol Obstet 120.2 (2013): 165–8.
- Blinov, D.V., Terentiev, S.S. “Protein markers of hypoxic-ischemic damage to the central nervous system in the perinatal period.” Neurochemistry 30.1 (2013): 22–8.
- Strizhakov, A.N., Lipatov, I.S., Tezikov, Y.V. Placental insufficiency: Pathogenesis. Prediction Diagnostics. Prevention. Obstetric tactics. Samara. Ofort Ltd (2014): 239 p.
- Makarov, I.O., Yudina E.V. Cardiotocography during pregnancy and labor. Moscow. MEDpress-inform (2012): 112 p.
- Lakhno, I.V. “Non-invasive antenatal computerized electrocardiography of the fetus versus cardiotocography: the first experience in Ukraine.” Emergency Medicine 1.40 (2012): 101–5.
- Van Leeuwen, P., Geue, D., Lange, S., Grönemeyer, D.H. “Modeling fetal-maternal heart-rate interaction”. IEEE Eng Med Biol Mag 28.6 (2009): 49–53.
- Seliger, G., Stenzel, A., Kowalski, E.M., et al. “Evaluation of standardized, computerized Dawes/Redman heart-rate analysis based on different recording methods and in relation to fetal beat-to-beat heart rate variability.” J Perinat Med 1.7 (2016): 785–92.
- Figueras, F., Gardosi, J. “Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management.” Am J Obstet Gynecol 204.4 (2011): 288–300.
- Radzinskiy, V.E., Urakova, N.A., Urakov, A.L., Nikitiyuk, D.B. “Sample Gausknecht as a way to predict cesarean section and resuscitation of the newborn.” V.F. Snegirev Archive of obstetrics and gynecology 2 (2014): 14–8.
- Mekenbaeva, R.T. “The state of the cardiovascular system in newborns and young children who have undergone chronic intrauterine and / or perinatal hypoxia.” Clinical Medicine of Kazakhstan 1.27 (2013): 42–9.
- Blinov, D.V. “Current approaches to the pathogenesis and prediction of outcomes of hypoxic-ischemic CNS damage in the perinatal period.” Obstetrics, gynecology, reproduction 6.3 (2012): 34–8.
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