ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Neonatal and Postneonatal Outcomes of Various Fetoplacental Circulation Disorders

DOI:10.31550/1727-2378-2018-154-10-10-17
For citation: Trokhanova O.V., Guriev D.L., Gurieva D.D., Ermolina E.A., Matveev I.M., Martiyanova M.V. Neonatal and Postneonatal Outcomes of Various Fetoplacental Circulation Disorders. Doctor.Ru. 2018; 10(154): 10–17. DOI: 10.31550/1727-2378-2018-154-10-10-17
16 November 09:26

Study Objectives: To assess neonatal and postneonatal outcomes during the first year of life in infants born to women with various fetoplacental circulation disorders.

Study Design: This was a retrospective analysis.

Materials and Methods: The authors analyzed the labor and delivery histories of 4,592 pregnant women, 103 of whom had experienced fetoplacental circulation disorders. The first stage was a retrospective analysis of data collected from the labor and delivery histories of the 103 women with severe or moderate fetoplacental circulation disorders and 70 labor and delivery histories of women without such problems. Three groups were defined for comparative analysis. Group I consisted of 23 women with critical changes in blood flow within the umbilical artery (UA); Group II had 80 pregnant women with moderate disturbances; and Group III had 70 women whose UA blood flow parameters fell between the 5th and 95th percentiles (control group).

The second stage was a retrospective analysis of outpatient medical chart data from check-ups of infants whose mothers’ data had been analyzed in the first stage. The following three groups were defined: Group I consisted of 19 infants born to women with pronounced fetoplacental circulation disorders; Group II had 52 infants born to women with moderate impairment of fetoplacental circulation; and Group III (control) had 41 infants in whose mothers fetoplacental circulation had been normal.

Study Results: In women with pronounced fetoplacental circulation disorders, the cesarean section rate was 1.9 times higher than in women with moderate impairment and 4.5 times higher than in the control group. Fetal distress and placental abruption were seen significantly less often in the control group than in women with disturbed fetoplacental circulation.

A cerebroplacental ratio below 1.09 was associated with 2.8 times higher cesarean section rates, four times higher cesarean section rates for fetal distress, and 17.4 higher rates of intrauterine fetal growth retardation.

In the group of women with critical impairment of fetoplacental circulation, the babies’ birth weights were significantly lower and the percentages of babies with extremely low birth weight, low Apgar scores, and blood pH below 7.2 were significantly higher. Babies born to mothers from this group received CPAP therapy or were placed on mechanical ventilation significantly more often. During the first year of life, the number of infants with level III or IV neuropsychological development was significantly higher among babies born to mothers with critical disturbances in fetoplacental circulation (р<0.05). Nervous system disorders were significantly more frequent in babies born to women with pronounced fetoplacental circulation disorders (р<0.05).

Conclusion: Fetoplacental circulation disorders are an important predictor of unfavorable outcomes in babies during the first year of life, helping to foresee problems in their physical and/or psychomotor development.


O.V. Trokhanova — Yaroslavl State Medical University, Russian Ministry of Health. E-mail: Trokhanova@yandex.ru

D.L. Guriev — Yaroslavl State Medical University, Russian Ministry of Health. Regional Perinatal Center, Yaroslavl. E-mail: d_guriev@mail.ru

D.D. Gurieva — Yaroslavl State Medical University, Russian Ministry of Health. E-mail: d_guriev@mail.ru

E.A. Ermolina — Regional Perinatal Center, Yaroslavl. E-mail: ermolinaea@mail.ru

I.M. Matveev — Yaroslavl State Medical University, Russian Ministry of Health. E-mail: immatveev@mail.ru

M.V. Martiyanova — Yaroslavl State Medical University, Russian Ministry of Health. E-mail: korablyovam@mail.ru

Доктор.ру
16 November 09:26
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