Fetoplacental insufficiency and terms of its management in pregnant women with influenza
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01.01.2018 |
Romanovskaya A.
Davydov A.
Khvorostukhina N.
Novichkov D.
Trushina O.
Stepanova N.
Plekhanov A.
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Voprosy Ginekologii, Akusherstva i Perinatologii |
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1 |
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© 2018 Dynasty Publishing House. All rights reserved. The objective: To establish the character of haemodynamic disorders in the fetoplacental complex taking into account blood rheological properties, severity of systemic inflammatory response syndrome and to offer a pathogenetic rationale for terms that would be optimal for treatment of placental dysfunction in pregnant women with influenza. Patients and methods: 114 pregnant women with influenza were examined, of them 35 with moderate, 79 with severe flu. In order to rule out the variability of parameters reflecting the state of the fetoplacental complex all women were at comparable terms of gestation (20-30 wks). Results: We have found a relation between the severity of influenza, increased blood viscosity and the development of haemodynamic disorders in the fetoplacental complex. In moderate flu, fetoplacental blood circulation practically does not suffer. Resistivity index (RI), pulsatility index (PI) and systolic/diastolic (S/D) ratio remain within control values. In severe influenza, blood viscosity significantly increases and uteroplacental blood flow exhibits significant impairment. Against the background of increased blood viscosity on the average by 15-20%, taking into account the shear rate, RI, PI and S/D ratio values increase by 25-30%, which is indicative of the signs of impaired blood circulation. In increased blood viscosity at low shear rates it is uteroplacental blood flow that suffers predominantly, without involving fetoplacental one. Conclusion: In severe influenza, the contingency of placental hemodynamics on the maternal and fetal sides is impaired, and increased blood viscosity is to a great extent the cause of these disorders.
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