КЛИНИКО-АНАМНЕСТИЧЕСКАЯ ХАРАКТЕРИСТИКА ЖЕНЩИН С СИНДРОМОМ ЗАДЕРЖКИ РАЗВИТИЯ ПЛОДА

Сарасвати Рамомуртхи1, Клычева Ольга Игоревна2
1Федеральное государственное бюджетное образовательное учреждение высшего образования «Курский государственный медицинский университет» Министерства здравоохранения Российской Федерации, студент 5 курса международного факультета
2Федеральное государственное бюджетное образовательное учреждение высшего образования «Курский государственный медицинский университет» Министерства здравоохранения Российской Федерации, кандидат медицинских наук, ассистент кафедры акушерства и гинекологии

CLINICAL AND ANAMNESTIC CHARACTERISTICS OF WOMEN WITH FETAL GROWTH RETARDATION SYNDROME

Saraswati Ramomurthy1, Klycheva Olga Igorevna2
1Kursk State Medical University, student of 5th year education, international faculty
2Kursk State Medical University, PhD, Assistant lecturer of the Department of Obstetrics and Gynecology

Abstract
A study was conducted with the participation of 40 pregnant women. The patients were divided into two groups: the main group included 20 women diagnosed with fetoplacental insufficiency, the control group included 20 women with normal pregnancy. Anamnesis data and clinical and laboratory diagnostic methods were analyzed. As a result of the study, the main risk factors for the formation of fetal growth retardation syndrome were identified.

Keywords: anamnesis, diagnosis, fetal growth retardation syndrome, placental insufficiency


Рубрика: 14.00.00 МЕДИЦИНСКИЕ НАУКИ

Библиографическая ссылка на статью:
Сарасвати Р., Клычева О.И. Clinical and anamnestic characteristics of women with fetal growth retardation syndrome // Современные научные исследования и инновации. 2022. № 5 [Электронный ресурс]. URL: https://web.snauka.ru/issues/2022/05/98334 (дата обращения: 14.03.2024).

Relevance. The problem of fetal growth retardation syndrome has not lost its relevance for many years, since it occupies a leading place in the structure of the causes of perinatal morbidity and mortality. The frequency of fetal growth retardation syndrome varies from 5 to 15%, perinatal losses are 17‰ among term newborns and 94.4‰ among premature newborns [1, 4]. Despite a number of major achievements in obstetrics and perinatology, the main of which is the reduction of maternal and perinatal morbidity and mortality, there is a constant trend towards an increase in the number of congenital diseases determined by morphological and functional disorders in the fetoplacental system. In this regard, the urgent task is to identify risk factors for the development of fetal growth retardation syndrome, develop methods for predicting, early diagnosis of placental insufficiency, management of pregnancy and childbirth with this complication of gestation [2, 3].

The purpose of the study was to study the clinical and anamnestic characteristics of women with a confirmed diagnosis of fetal growth retardation syndrome.

Materials and methods. The study involved 40 women. All patients were divided into 2 groups: the main group included 20 pregnant women who were hospitalized in the pregnancy pathology department with a diagnosis of chronic fetoplacental insufficiency, fetal growth retardation syndrome. The control group consisted of 20 women with normal pregnancy.

Criteria for inclusion of patients in the study:

1. Women who are hospitalized with a diagnosis of fetal growth retardation syndrome (main group);

2. Women with normal pregnancy (control group);

3. The consent of the woman to take part in the study.

With the help of an individual card developed by us, clinical and anamnestic data were collected. Statistical processing of the obtained data was carried out using standard software packages for applied statistical analysis MS Excel 2013 and STATISTICA 10.0 for Windows. To assess the statistical significance of differences between the compared indicators, Student’s t-test was used. Differences at p<0.05 were considered statistically significant.

Results of the study.The mean age of patients in the main group was slightly higher (28.4±0.9 years) than in the control group (24.5±0.8 years) (p<0.05). The majority of women in both the main (54.5%) and control groups (74.2%) were married. All surveyed had a satisfactory financial situation. Education in most patients was predominantly higher.

Family history is aggravated only in pregnant women of the main group. 42.3% of women in the main group among first-line relatives had cases of thrombotic complications under the age of 55 years (deep vein thrombosis – 48.1%, strokes – 27.7%, heart attacks – 24.2%).

The study showed that extragenital diseases in a significant number of cases occurred in women of the main group 72.9%, compared with the control group (p <0.05). Completely somatically healthy were 19.1% patients of the main group and 100% of the control group. In the structure of extragenital pathology of women in the main group, the following were identified: diseases of the cardiovascular system in 63.4% cases (varicose disease – 35.3%, vegetative-vascular dystonia of the hypertensive type – 21.3%, arterial hypotension – 12.2%, sinus arrhythmia – 11.4%, heart disease (mitral valve prolapse II degree, atrial septal aneurysm) – 7.7%). Urinary system diseases occurred in 36.1% women. Chronic pyelonephritis was observed in 49%, chronic cystitis in 31.1%, urolithiasis  in7.7% pregnant woman. Pathology of the gastrointestinal tract was diagnosed in 17.1% women: chronic gastroduodenitis – 51%, biliary dyskinesia – 49% women. Pathology of the endocrine system was detected in 13.3% pregnant women: 62.1% women suffer from type 2 diabetes mellitus, 37.9% suffers from hypothyroidism.

Indicators of menstrual function of women in the main and control groups had no statistically significant differences (p>0.05).

Of all the examined, 9 pregnant women of the main group had gynecological diseases, and no gynecological pathology was detected in the control group. When analyzing the structure of gynecological morbidity, 27.1% women had chronic cervicitis, 17.1% had chronic salpingo-oophoritis, and 7.7% had chronic endometritis.

When comparing the parity of the control and main groups, it was found that the main group was dominated by multi-pregnant women 69.7% compared with the control 41.3% (p > 0.05). There were primiparas in the main group67.1%, in the control group 57.3%; multiparous 32.9% and 42.7% women, respectively.

Complicated obstetric history found only in pregnant women of the main group. At 10 women of the main group had a history of fetal loss in the 1st and 2nd half of pregnancy they have 7 non-developing pregnancy before 12 weeks and  4 antenatal death fetus in the second half of pregnancy at 28 and 31 weeks. The frequency of complications of previous pregnancies amounted to 87.7%. In structure complications were identified: in 10 women fetoplacental insufficiency was diagnosed, in 6 preeclampsia, in 3 premature abruption of a normally located placenta.

The first trimester of this pregnancy against the background of complications proceeded in 17 patients of the main group (mild toxicosis – 10, threatened miscarriage – 5, mild anemia – 5) and in 7 women of the control group (mild toxicosis – 4, anemia mild degree – 3). Complications in the first trimester of the main group were significantly more frequent than in the control group (p <0.05).

Second trimester complications were observed in 14 pregnant women group and in 7 women in the control group. Signs of intrauterine infection had 3 women of the main group. Anemia mild degree was detected in 4 pregnant women of the main group and in 3 control group, moderate in 2 women of the main group. Against the backdrop of a threat termination of pregnancy, the second trimester proceeded in 4 women of the main group. Preeclampsia complicates pregnancy 3 women of the main group, and 8 pregnant women of the main group were diagnosed with chronic fetoplacental insufficiency. Compared with the control group, complications in the second trimester were more common in the main group (p<0.05).

Complications in the third trimester occurred only in women of the main group. In the structure of complications, the following were noted: the threat of abortion in 4 women, anemia in 4 pregnant women, of which mild anemia was detected in 2 women, moderate anemia in 2 of patients, intrauterine infection in 2 pregnant women, premature maturation of the placenta in one patient. In 14 patients I degree fetal growth retardation syndrome was diagnosed, in 6 II degree and in 2 III degree. The third trimester passed without visible complications in 21 (100%) women of the control group.

Conclusion: we have identified the following most significant clinical and anamnestic risk factors for the development of fetal growth retardation syndrome: complicated somatic and family history, early reproductive losses in history, complications of previous pregnancies (fetoplacental insufficiency, preeclampsia), aggravated current pregnancy (threat of abortion on various timing, preeclampsia, intrauterine infection, premature maturation of the placenta).

In order to increase the effectiveness of identifying women who are at high risk of developing fetal development delay syndrome, it is advisable to carefully collect anamnesis at the stage of pregnancy planning. When identifying such patients, it is necessary to optimize pregravidar preparation, timely diagnosis of manifestations of fetoplacental insufficiency in the early stages in order to timely correction, which will reduce the risk of developing fetal growth retardation syndrome and improve perinatal outcomes.


References
  1. Fetal Growth Restriction: ACOG Practice Bulletin, Number 227 / Obstetrics & Gynecology. 2021. 137 (2): e16–e28. doi:10.1097/AOG.0000000000004251
  2. Kesavan, K.; Devaskar, S. U. Intrauterine Growth Restriction: Postnatal Monitoring and Outcomes / Pediatric Clinics of North America. 2019. 66 (2): 403–423.  doi:10.1016/j.pcl.2018.12.009
  3. Sharma, Deepak; Shastri, Sweta; Sharma, Pradeep. Intrauterine Growth Restriction: Antenatal and Postnatal Aspects / Clinical Medicine Insights. Pediatrics. 2020. 10: 67-83. doi:10.4137/CMPed.S40070
  4. White, Cynthia D. Intrauterine growth restriction / MedlinePlus Medical Encyclopedia . 2018. 15: 77–93.


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