• Risk factors of fetal growth restriction in pregnant women with arterial hypertension
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Risk factors of fetal growth restriction in pregnant women with arterial hypertension

HEALTH OF WOMAN. 2019.1(137):88–91; doi 10.15574/HW.2019.137.88

Krut Yu. Ya., Deinichenko O. V.
Zaporozhye state medical University

The problem of fetal growth restriction (FGR) is an actual problem of modern obstetrics. Nowadays, the existing various criteria for FGR do not allow to diagnose it in the early stages of pregnancy. This leads to late treatment and preventive measures. Thus, there is a need to improve the methods of diagnosing FGR.

The objective: determine the risk factors of FGR in pregnant women with arterial hypertension using anamnestic and clinical-instrumental standard methods.

Materials and methods. A retrospective analysis of 117 cases of histories of pregnant patients with arterial hypertension, which were treated in the Zaporizhia regional perinatal center in 2017–2018 was carried out. A «case-control» study has been completed. Women were observed in gestational age of 26–36 weeks. Pregnant women were divided into 2 groups. Group 1 included 14 pregnant women with chronic arterial hypertension (CAH) who had FGR. Group 2 (comparison group) consisted of 103 women with CAH, who did not have FGR. Pregnant women were treated according to the current clinical protocols. Statistical analysis was performed using the program «STATISTICA® for Windows 6.0» (Stat Soft Inc., № AXXR712D833214FAN5).

Results. Significant differences between groups of patients in the structure of associated diseases have not been established, р˃0.05. It should be noted that grade 2 of CAH was determined in the majority of women in group 1 (78.6%), whereas in the majority of patients in group 2, grade 1 was determined (52.4%), р>0.05. The systolic blood pressure exceeded 140 mmHg (78.6%), and the diastolic blood pressure exceeded 90 mmHg (85.7%) in the overwhelming majority of patients in the main group, p>0.01. Disturbance of the utero-placental circulation (DUPC) occurred in 92.9% of patients in group 1 and in 20.4% of women in the comparison group, p>0.001. At the same time, grade 3 of DUPC was in 35.9% of women in the 1st group and in 1% of the comparison group patients, р>0.05. All pregnant women received treatment according to the standards of the Ministry of Health of Ukraine. The amount of prescribed therapy had no effect on the formation of FGR, p>0.05. Physiological labors were performed in the majority of pregnant women.

Conclusions. The following risk factors for fetal growth restriction were identified after analyzing the anamnestic and standard clinical and instrumental indices: CAH of grade 2, excess blood pressure values greater than 140 and 90 mmHg, presence of DUPC of 2 and grade 3. The appointment of standard treatment regimens did not affect the occurrence of FGR.

Key words: risk factors, delayed fetal development.

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