Criteria for prediction of complications in pregnant women with antenatal fetal death

The study of the etiology of antenatal fetal death, despite the large number of studies, remains relevant. This is due, firstly, to the increase in the share of antenatal fetal death in the structure of miscarriage (from 45 to 86.6%), and secondly, in 20-40% of cases, the cause of antenatal fetal death remains unknown.(1,3,5)

According to the literature, about 7% of the causes of antenatal fetal death (AFD) are chromosomal abnormalities. Endocrine disorders are from 8 to 20 %, 12-15 % have anatomical features and functional disorders of the uterus.(2,4.)

Objective: to develop a differentiated approach to the management of pregnancy in women with antenatal fetal death on the basis of the study of the immune and hormonal systems to reduce perinatal morbidity and mortality.

Materials and methods research: We studied indicators of gemostosiogramms, hormone status, saliva and blood, the excretion of blood cytokines and growth factors in patients with AFD, the complement system and NST test in pregnant healthy and AFD. Group I control - 20 pregnant healthy women, group II-40 women with AFD.

Results of research: It is known that increased IMB (>30kg/m) is associated with an increase in the risk of thromboembolic conditions (Rocky M. G., 2007; Mochalov, A. A. 2011; Rudakova E. B. 2015). In this context, there were analyzed the indices of coagulation in the groups studied.There was a connection of BMI increase and positive markers of thrombus formation in 100% of cases. Among patients with signs of activation of intravascular coagulation (AOIC) 11 people (55%) had excess body weight and 9 people (45%) - obesity of various degrees. Of the patients with high rates of D-dimer19 people (54.3%) had excess body weight.

Evaluation of the results of coagulation in the subgroups showed that in the group with AFD increase in AOIC was observed in 19 people (47.5%), which is significantly higher. The growth of D-dimer was observed in 21 people (52.5%), which is statistically significant. Hormonal interactions play a significant role in the development of spontaneous premature labor. It is known that progesterone is necessary to maintain the uterus in normal tone by suppressing the formation of slit contacts, the synthesis of prostaglandins and oxytocin receptors. The concentration of estriol in the maternal bloodstream is a direct marker of the activity of the fetal hypothalamic-pituitary-adrenal axis, which, presumably, is activated before the development of labor.

Thus, as a result of the study we have proved the multidirectional character of cytokine excretion and growth factors in pregnant women with AFD. In General, on the basis of the above, it should be noted that the prognostic significance is to determine the level of IL-8 cytokine in the blood sample, which is the most objective indicator of the degree of activity of exacerbation of chronic obstructive pyelonephritis.


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Year: 2018
City: Shymkent
Category: Medicine