ECHOGRAPHIC SIGNS OF PLACENTAL INSUFFICIENCY IN PREGNANT WOMEN WITH HELMINTH-PROTOZOAL INFESTATION

Rzakuliyeva L. M., Babashova F. M.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Goal. The study of the nature and frequency of sonographic signs of placental insufficiency in pregnant women with helminth-protozoan invasion in Baku. Methods. As the optimal design study conducted to identify risk factors and prognostic factors selected cohort retrospective study “case-control”. Based on the developed clinical and laboratory criteria, for the period from 2015 to 2017 were examined in 152 women in the age group from 18 to 38 years (average age 27,98±5,3) with parasitic infestation in pregnancy 16-40 weeks. In the course of retrospective studies depending on the nature of pregnancy and its outcome formed the following groups: 1 primary group – 84 women (55,3±4,0%) whose pregnancy proceeded against the background of monenvasia worms and resulted in the birth of live infants; the 2nd main group of 68 women (44,7±4,0%), whose pregnancy was complicated with mixed helminth-protozoan invasion and ended with the birth of a living newborn. The comparison group (3rd) consisted of 42 women whose pregnancy proceeded without helminth-protozoan infestation and resulted in the birth of live full-term babies. Examination of all women was carried out at the timing 16-22, 23-29, 30-36 and 37-40 weeks of pregnancy. A comprehensive ultrasound examination included fetometry, plantography, evaluation of the quality and quantity of amniotic fluid. During the examination of pregnant women at 10-14 weeks was determined the average inner diameter of the ovum, kopcikparietal size, the thickness of the nuchal translucency and the place of attachment of the chorion. Special attention was paid to the hypertonicity of the myometrium in the area of attachment of the ovum, the deformation of the ovum and the presence of a retrochorial hematoma, which was assessed as sonographic signs of primary placental insufficiency. If fotometrii measured biparietal head size, the average diameter of the thorax and abdomen, the length of the thigh. Reliable signs of delayed fetal growth was considered a mismatch in 2 weeks the biparietal head size to the actual period of pregnancy, a violation of the relationship between the size of the head and torso of the fetus. Placentally conducted to determine the location and thickness of the placenta, level of maturity and features of its structure, quantity and quality of amniotic fluid. Results. It was found that in pregnant women with helminth-protozoan invasion sonographic signs of primary placental insufficiency visualized from 55,9±6,0% of pregnant women with mixed infection, with monenvasia – 66,7±5.1% of pregnant women in the comparison group by 7.1%. Characteristically, in pregnant women in the comparison group the predominant symptom of placental insufficiency – the placenta thickening, hypoplasia of the placenta is rare (4,8%, 2 cases). In pregnant women with monenvasia, there is a combination of several ultrasonographic signs. Secondary placental insufficiency in 21-24 weeks in the form of changes in the structure and thickening of the placenta: in pregnant women with monenvasia observed at 49.1±5.5%, and thickening of the placenta and changes its structure at 30.9±5,0%, in pregnant women with a mixed invasion marked thickening of the placenta at 32.4±5.6% of cases and changes its structure at 35.3±5.8% of cases. Conclusion. The discrepancy between stage of maturation of the placenta gestational age is prevalent in pregnant women with mixed infection. In uncomplicated pregnancy the stage of maturation of the placenta corresponds to the period of gestation.

helmintho-protozoal infestation, ultrasound, placental insufficiency, pregnancy

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 213-218 pages, index UDK 618.36-008.64-06:619.9

10.29254/2077–4214–2017–4–3–141–213-218