EFFECT OF SECONDARY PREVENTION OF PREECLAMPSIA ON FETOPLACENTAL BLOOD FLOW RATES IN HIGHRISK WOMEN

Abstract

The paper presents research data regarding the effect of secondary prevention of preeclampsia in pregnant women of the high-risk group for this disease, which was formed at 18-20+6 weeks of pregnancy by detecting placental hypoperfusion during the second ultrasound screening. The assessment of blood flow in the uterine spiral arteries in the area of the placental site was performed in women with anamnestic risk factors for preeclampsia, namely, complicated gynecological history; first pregnancy, obstetric history; family history of preeclampsia; women of young and older reproductive age; presence of extragenital pathology, accompanied by the increase in blood pressure (chronic arterial hypertension, chronic kidney disease); overweight (body mass index 25.1-29.9) and obesity (body mass index 30 or more); anomalies in the developme nt of the uterus; history of delayed sexual development; unbalanced diet. The study included examination of 121 pregnant women (30 healthy pregnant women − the control group and 91 pregnant women with reduced blood flow in the uterine spiral arteries in the area of the placental site; this group was divided into two subgroups, the first subgroup consisted of 32 women who refused preventive treatment, and the second − 59 pregnant women taking preventive treatment). In the subgroup of the main group of women examined, who refused the proposed preventive treatment, later (up to 28-34 weeks of pregnancy) preeclampsia occurred in almost 50% of cases; moreover, a progressive decrease in blood flow in the vessels of the uteroplacentalfetal complex was determined. The introduction of proposed method of secondary prevention of preeclampsia in pregnant women at high risk for this disease (metformin, vitamin D3 and corvitin) makes it possible to reduce the incidence of clinical manifestations of preeclampsia by 1.4 times compared with the group that refused the proposed treatment, and to prevent blood flow disorders in the uteroplacentofetal system: the pulsation index has significantly decreased in the uterine vessels, reaching those of the control group; the values of all vascular resistance indices in the spiral arteries located in the placental site area, in the umbilical arteries and in the fetal middle cerebral artery, also reached those in the control group.

Keywords

• pregnancy
• preeclampsia
• vascular resistance indices
• blood flow in the fetoplacental complex