Determining diagnostic markers of intrautering growth retardation in early pregnancy

Abstract

Intrauterine growth restriction is the cause of significant increases in perinatal mortality, morbidity and problems in the development of newborns and infants. The leading place of this pathology is not accidental, because according to various authors, the frequency of perinatal loss associated with it is from 19 to 287‰ and more, the level of perinatal morbidity - from 58.7 to 88.0%.The objective: To determine certain serum and ultrasound markers during the first trimester of pregnancy and to improve the perinatal morbidity and mortality rate in women with intrauterine growth restriction. Materials and methods. A prospective study of pregnant women in the gestation period of 11 weeks 0 days – 13 weeks 6 days, which was to determine the level of plasma protein A associated with pregnancy (PAPP-A), mean platelet volume (MPV), and ultrasound placenta examination. Pregnant women were divided into 2 groups: the main group (n1-52) and the control group (n2-50). The study group consisted of women with a low PAPP-A level and changes in the mean platelet volume towards their increase. It is this group of women that is more sensitive, in our opinion, for the development of placental disorders and the occurrence of fetal growth retardation.Results. In this study, PAPP-А levels in 39 pregnant women were <0.5 MoM, and WTO levels in 36 cases were> 10 fl, which, according to the literature, can be used as markers of early prediction of ZRP.Ultrasound type of disorders of the first stage of trophoblast invasion is described as intra- and / or periplacental pathological areas, which can be considered the causes of placental insufficiency, which results in a risk of ZRP. According to the study, high specificity and sensitivity of Doppler parameters with the determination of indices (PI and IR) in the uterine arteries were established. Conclusions. The results of the study showed that performing a screening based on a detailed history and determining PAPP-A, MPV, and ultrasound examination at first trimester of pregnancy in women with the risk of IUGR allows for prophylactic treatment and monitoring of pregnancy and thus reduces neonatal morbidity and mortality.