INFLUENCE OF PROLONGATION OF PRETERM PREGNANCY COMPLICATED BY PREMATURE RUPTURE OF FETIC MEMBRANES ON THE FUNCTIONAL STATE OF THE FETOPLACENTAL COMPLEX

Abstract

At present, in obstetric hospitals of the Russian Federation, in accordance with a number of guidance documents, in preterm pregnancy complicated by premature rupture of the membranes, expectant management is recommended, i.e. prolongation of gestation, the main purpose of which is to achieve a more morphofunctionally mature fetus. However, this tactic is associated with a high risk of developing a systemic inflammatory response and critical conditions in the mother and fetus, requiring emergency delivery. At the same time, it is of scientific interest to assess dynamic changes in the mother-placenta-fetus system in the process of pregnancy prolongation. Establishing patterns of changes in the functional state of the fetus may allow you to determine the optimal timing of the completion of gestation and reduce the percentage of urgent situations. For this purpose, on the basis of the “Perinatal Center of the Saratov Region”, an assessment was made of the functional state of the fetoplacental complex in 147 patients whose premature pregnancy was complicated by premature rupture of the membranes, with prolongation of gestation in the periods: admission to the hospital, on days 5-7 of prolongation and the moment of completion of gestation . The indicators of cardiotocography, dopplerometry (resistance indices of the uterine arteries, umbilical artery, fetal middle cerebral artery), placental thickness and amniotic fluid index were assessed. The comparison group consisted of 140 patients with a physiological pregnancy with similar gestation periods, in whom similar studies were performed. It was established that this pathology of gestation develops against the background of feto-placental insufficiency, as evidenced by a decrease in fetal rhythm variability, a decrease in the thickness of the placenta compared to the control group. In the process of pregnancy prolongation, the most significant indicators for assessing the functional state of the fetus were cardiotocography data, resistance indices of the uterine and umbilical arteries, and the amniotic fluid index.