Gynecology, Obstetrics and Perinatology

Early terms of pregnancy: complications and prognosis of perinatal outcomes

The  objective.  Development  of  a  complex  system  of  evaluation  of  the  «mother–placenta–fetus»  system  in  women  with complications of the first half of gestation for prognosis of the course and outcomes of pregnancy. Patients and methods. A prospective examination included 265 pregnant women, of whom group 1 comprised 139 women with threatened miscarriage and retrochorionic hematoma, group 2 – 126 women with early moderate and severe toxicosis. Results.  In  women  of  the  both  groups,  management  of  pregnancy  and  childbirth  included  the  use  of  new  technologies  of evaluation  of  the  state  of  the  fetoplacental  system  and  the  fetus,  taking  into  account  the  etiopathogenesis  of  spontaneous miscarriage,  early  toxicosis  of  pregnancy  and  observance  of  the  principles  of  early  diagnosis  and  drug  correction  of complications.  The  use  of  the  developed  differential  approach  made  it  possible  to  reduce  the  frequency  of  development  of threatened miscarriage in the second and third trimester by 1.2 times, the frequency of reproductive losses in the reference group (without a differential approach to therapy) was higher by 2.87 times than in the basic group. The frequency of FGRS was reduced by 2.25 times, of gestosis – by 1.47 times. Conclusion. The use of high technological methods of examination (echography, doppler ultrasound, cardiotocography) and modern laboratory testing (diagnosis of thrombophilia, detection of the levels of growth factors), taking into consideration new understanding of the pathogenesis of threatened miscarriage (with formation of retrochorionic hematoma) and early toxicosis, permits to optimize obstetric practice in these complications, to decrease the frequency of reproductive losses, perinatal morbidity and mortality.