Predictors of the development of placental dysfunction and methods for its correction in patients with retrochoric hematoma in the I trimester of gestation

Authors

DOI:

https://doi.org/10.18370/2309-4117.2018.39.60-64

Keywords:

predictors, placental dysfunction, retrochorionic hematoma, treatment

Abstract

The objective of study was to determine the predictors of the development of placental dysfunction and to develop methods for its prevention and treatment in patients with retrochoric hematoma in the first trimester of gestation.

Patients and methods. Under observation, there were 58 pregnant women with retrochoric hematoma in the first trimester (main group) and 20 women with a physiological pregnancy (control group). All pregnant women underwent a standard clinical and laboratory examination. In the ultrasound study, the volume of the retrochoric hematoma, its localization, and also the coccygeal-parietal size of the embryo, the heart rate, the volume of the fetal egg, the mid-inner diameter of the yolk sac, the vascularization of the yellow body, the hemodynamics in the myometrium were assessed. In a transvaginal ultrasound study, a special three-dimensional VOCAL program was used to calculate the chorion volume and evaluate its vascular system.

Results. Predictors of placental dysfunction in the detachment of the chorion in the I trimester of gestation are associated not only with the volume and localization of the retrochoric hematoma, but also, first of all, with the state of extraembryonic structures.

Decreased vascularization of the chorion, its hypoplasia, pathological nature of the blood flow in the yellow body, and hemodynamic disturbances in the myometrium creates high risks of placental dysfunction and worsens the pregnancy prognosis. The developed preventive measures include the 3 stage of treatment, the medicament means are aimed not only at halting the bleeding, but also on the effective restoration of microcirculation and the provision of adequate conditions for the passage of the second wave of trophoblast invasion.

Conclusion. The proposed three-step corrective therapy contributes to the normalization of uterine-chorionic blood flow, the restoration of effective embryochorial interrelations and significantly reduces the incidence of placental dysfunction in the future.

Author Biographies

О. В. Кравченко, Bukovinian State Medical University, Chernivtsi

MD, professor, head of Obstetrics, Gynecology and Perinatology Department

І. В. Бойко, Bukovinian State Medical University, Chernivtsi

Postgraduate student at Obstetrics, Gynecology and Perinatology Department

References

  1. Alexandrova, N.V., Bajev, O.R. “Early stages of the formation of the mother-placenta-fetus system.” Obstetrics and gynecology 8 (2001): 4–10.
  2. Ignatko, I.V., Martirosyan, N.T. “Comparative evaluation of drug correction of pregnancy complications in women with the threat of interruption and detachment of the chorion in the first trimester.” In: Materials of the X All-Russian Forum “Mother and Child”. Moscow (2009): 75–6.
  3. Kiryushchenkov, P.A., Belousov, D.M., Alexandrina, O.S., Alekseyeva, M.S. “Clinico-laboratory and ultrasound evaluation, tactics of pregnancy management for various forms of pathology of the chorion in the first trimester.” Obstetrics and gynecology 1 (2010): 19–23.
  4. Milovanov, A.P., Kirichenko, A.K. Cytotrophoblastic invasion is a key mechanism of normal and complicated pregnancy development. Krasnoyarsk (2009).
  5. Radzinsky, V.E., Orazmuradova, A.A. Early pregnancy. 2nd ed. Moscow. Status Praesens (2009): 478 p.
  6. Savelyeva, G.M., Panina, O.B., Kurtser, M.A., et al. “Prenatal period: physiology and pathology.” Russian bulletin of the obstetrician-gynecologist 10.2 (2010): 61–5.
  7. Strizhakov, A.N., Ignatko, I.V. Pregnancy loss. Moscow (2007): 145–6.
  8. Tetruashvili, N.K., Agadzhanova, A.A., Ionanidze, T.B. “Bleedings up to 22 weeks of pregnancy: clinic, diagnosis, haemostatic therapy.” Medical advice 9 (2014): 60–3.
  9. Ferri, F.F. Vaginal bleeding during pregnancy. In: Ferri’s clinical advisor. Mosby (2014): 1143 p.
  10. Nagy, S., Bush, M., Stone, J., et al. “Clinical significance of subchorionic and retroplacental haematomas detected in the first trimester of pregnancy.” Orv Hetil 146.42 (2005): 2157–61.

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Published

2018-02-28

How to Cite

Кравченко, О. В., & Бойко, І. В. (2018). Predictors of the development of placental dysfunction and methods for its correction in patients with retrochoric hematoma in the I trimester of gestation. REPRODUCTIVE ENDOCRINOLOGY, (39), 60–64. https://doi.org/10.18370/2309-4117.2018.39.60-64

Issue

No. 39 (2018)

Section

Pregnancy and childbirth

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Copyright (c) 2018 О. В. Кравченко, І. В. Бойко

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