Placental dysfunction as a basic pathology of perinatal complications
DOI:
https://doi.org/10.18370/2309-4117.2021.58.107-112Keywords:
placental dysfunction, perinatal complicationsAbstract
Research aim was to study the features of perinatal complications depending on the nature and timing of therapy in pregnant women with primary placental dysfunction.
Materials and methods. 82 pregnant women with verified placental dysfunction (chorionic hypoplasia at 12–13 weeks) against the background of the threat of pregnancy termination and genital tract infections were included. All examined were divided into 2 groups: group I consisted of 42 pregnant women who started treatment before 16 weeks of gestation, group II consisted of 40 pregnant women whose treatment was started after 16 weeks of gestation. Women in group I received micronized progesterone, venotonic Normoven, Magnicum and Artihol. Antibacterial sanitation was carried out before 16 weeks of gestation. Group II also received micronized progesterone only. Antibacterial sanitation in this group was carried out after 16 weeks of gestation.
Research results. After antibiotic therapy in group I monoinfections value decreased from 26.8 to 9.5%, mixed infections value decreased from 56.1 to 20.7%, while in group II the effectiveness of antibacterial therapy after 16 weeks was significantly lower. Statistically significant differences in weight, volume and area of the placenta in patients of studied groups were obtained. Assessing perinatal complications showed that the frequency of gestosis, premature birth, intrauterine growth retardation and intrauterine infection of the fetus were almost 2 times less frequent in group I than in group II.
Conclusions. Placental dysfunction, which developed in the first trimester against the background of the threat of pregnancy termination and genital tract infections, is the basic pathology for complications of the perinatal period. A timely prescribed set of medical supplies, including micronized progesterone, venotonic Normoven, Artihol and Magnicum, was as an effective method of preventing perinatal complications in pregnant women with primary placental dysfunction. Antibiotic therapy up to 16 weeks of gestation does not fully prevent the development of perinatal complications, but it can significantly reduce the level of severe gestational pathology.
References
- Airapetov, D., Ordiyants, I. “Endocrine changes in women with recurrent miscarriage and homology of HLA antigens.” Doctor 8 (2012): 71–3.
- Antonyan, M.I. “Modern approaches to the prevention of placental dysfunction in pregnant women after in vitro fertilization.” Bulletin of the Russian State Medical University 2 (2013): 140–3.
- Belotserkovtseva, L.D., Kovalenko, L.V., Kasparova, A.E. Progressive placental insufficiency and intrauterine pathology of the fetus. Moscow. Litterra (2016): 208 p.
- Voevodin, S.M., Shemanaeva, T.V., Shchegolev, A.I. “Placental insufficiency and the threat of abortion: a modern view of the problem.” Gynecology 4 (2017): 50–2. DOI: 10.26442/2079-5696_19.4.50-52
- Jobava, E.M., Danelyan, S.Z. “Placental insufficiency and threatening preterm birth: topical and controversial issues of diagnosis, therapy and prevention.” Treatment and prevention 1 (2012): 56–60.
- Dubossarskaya, Z.M. “Cellular-molecular dialogues in the endometrium and placenta during physiological and pathological pregnancy (literature review).” Female doctor 3 (2012): 34–8.
- Zhabchenko, I.А., Tsypkun, A.G., Zhitsky, A.M., et al. “Modern approaches to the diagnosis and treatment of placental dysfunction.” Tavria medical and biological bulletin 14.3 Part 1(55) (2011): 81–8.
- Zhuk, S.I., Dankovych, N.O., Ablyaeva, E.S. “Placental dysfunction and naturopathic methods of its treatment.” Women's Health 2 (2012): 96–9.
- Zefirova, T.P., Zhelezova, M.E. “New aspects of the pathogenesis of placental insufficiency.” Consilium medicum 20.6 (2018): 46–9. DOI: 10.26442/2075-1753_2018.6.46-49
- Lazareva, G.A., Khuraseva, A.B., Klycheva, O.I. “Modern view on the problem of placental insufficiency.” Scientific statements. Medicine series. Pharmacy 18.189 Issue 27 (2014): 5–10.
- Larina, E.B., Mamedov, N.N., Nefedova, N.A. “Fetal growth retardation syndrome: clinical and morphological aspects.” Questions of gynecology, obstetrics and perinatology 12.1 (2013): 22–7.
- Levkovich, M.А., Linde, V.A., Andreeva, V.O., et al. “Immuno-hormonal interactions in the genesis of early miscarriage.” Obstetrics and gynecology 8-1 (2012): 10–4.
- Lupoyad, V.S., Borodai, I.S., Aralov, O.N., et al. “Habitual miscarriage: a modern view of the old problem.” International Medical Journal 4 (2011): 54–60.
- Makarov, I.O., Shemanaeva, T.V. “Placental insufficiency and the protective role of magnesium.” Gynecology 2 (2012): 28–30.
- Melnyk, Y.M., Zhuk, S.I., Pekhno, N.V. “The value of sonographic assessment of blood flow in the venous duct in the diagnosis of placental dysfunction and prediction of labor.” Woman health 7 (2015): 54–7.
- Pasieshvili, N.М., Lupoyad, V.S., Ilchenko, V.A., Moshko, Y.A. “Placental dysfunction (failure) and fetal growth retardation (literature review).” International Medical Journal 1 (2019): 43–51.
- Pestrikova, T.Y. “Audit of the main performance indicators of the obstetric and gynecological service of the Far Eastern Federal District in 2018.” In: Materials of the XVII Far East Regional Scientific and Practical Conference “New Technologies in Obstetrics and Gynecology”. Khabarovsk (2019): 5–34.
- Pestrikova, T.Y. “Monitoring of the main performance indicators of the obstetric and gynecological service of the Far Eastern Federal District in 2017.” In: Materials of the ХVI Far East Regional Scientific and Practical Conference “New Technologies in Obstetrics and Gynecology”. Khabarovsk (2018): 10–52.
- Putilova, N.V. “Thrombophilia and pregnancy. Prediction of perinatal complications and optimization of management tactics.” Obstetrics and gynecology 4 (2011): 31–5.
- Serov, V.N., Tyutyunnik, V.L., Mikhailova, O.I. “Modern ideas about the treatment of placental insufficiency.” Russian medical journal 3 (2011): 3–5.
- Serov, V.N., Blinov, D.V., Zimovina, U.V., Jobava, E.M. “Results of the study of the prevalence of magnesium deficiency in pregnant women.” Obstetrics and gynecology 4 (2014): 33–40.
- Sukhikh, G.T., Vanko, L.V. “Immune factors in the etiology and pathogenesis of pregnancy complications.” Obstetrics and gynecology 1 (2012): 128–36.
- Unanyan, A.L., Arakelov, S.E., Polonskaya, L.S., et al. “Placental insufficiency: features of etiopathogenesis, therapy and prevention.” Consilium medicum 6 (2015): 37–40. Available from: [https://www.science–education.ru/ru/article/view?id=22344], last accessed Feb 17, 2021.
- Чеботарева, Ю.Ю. Профилактика и коррекция плацентарной недостаточности у первородящих повторно беременных женщин [Электронный ресурс] / Ю.Ю. Чеботарева, Ю.А. Петров, Т.Ю. Байкулова // Электронный научный журнал. Современные проблемы науки и образования. – 2015. – No 5.
- Shevtsova, E.P., Andreeva, M.V., Fofashkina, L.G. “Drug prevention of placental insufficiency.” Medicinal Bulletin 12.3.71 (2018): 42–7.
- Yakovleva, Е.А., Demina, O.V., Babadzhanyan, E.N., Yakovenko, E.A. “Placental dysfunction.” International Medical Journal 2 (2017): 47–51.
- John, V.I., Tsilou, E., Fisher, S., et al. “Placental Origins of Adverse Pregnancy Outcomes: Potential Molecular Targets – An Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.” Am J Obstet Gynecol 215 (2016): 1–46. DOI: 10.1016/j.ajog.2016.03.001
- Kohli, S., Isermann, B. “Placental hemostasis and sterile inflammation: New insights into gestational vascular disease.” Thromb Res 151 (2017): 30–3. DOI: 10.1016/S0049-3848(17)30063-4
- Morgan, T.K. “Role of the Placenta in Prenerm Birth: A Review.” Am J Perinatol 33.3 (2016): 258–66. DOI: 10.1055/s-0035-1570379
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