COURSE PREGNANCY AND ITS OUTCOME IN WOMEN AT THE HIGH RISK GROUP FOR PREECLAMPSIA

Introduction. Preeclampsia constitutes a significant proportion of maternal and prenatal morbidity and mortality. The rate of prenatal mortality in severe preeclampsia is 18-30 ‰, and for prenatal morbidity it is 640-780 ‰. The aim of the research was to study the clinical efficacy of early prognosis of preeclampsia and secondary prevention of this pathology. Materials and methods. Selection of the subjects at the risk group for the development of preeclampsia was performed on the basis of reduced blood flow in the spiral arteries of the uterus in the area of the placental site at 18-20 (+6 days) weeks of pregnancy. 30 healthy pregnant women and 91 pregnant women at risk for preeclampsia were examined; 32 pregnant women with the risk for preeclampsia refused advanced secondary prevention of preeclampsia, 59 pregnant women received the secondary prevention of preeclampsia (vitamin D3, metformin and corvitin) we proposed. We collected data on general and reproductive history, conducted objective clinical and laboratory examination, analyzed the course of the present pregnancy, the course and outcome of childbirth, their complications, the condition of the foetuses and newborns. Results. Reduced blood flow in the spiral arteries of the uterus located in the area of the placental site during the second ultrasound screening at 18-20 (+6 days) weeks of pregnancy is an informative prognostic sign of a high risk for preeclampsia. Pregnant women who consented to the secondary prevention of preeclampsia (vitamin D3, metformin, corvitin) as compared with the group of women who refused such prevention had fewer complications of pregnancy (preeclampsia, delayed foetal development, foetal distress and premature placental abruption, preterm birth) and childbirth (premature bursting of amniotic fluid was in 2.6 times less frequent, poor uterine contraction strength – in 1.8 times less, obstetric bleeding – in 2.8 times less, neonatal asphyxia – in 2.9 times less, no preterm infants with extremely low birth weight, intrauterine mortality occurred in 1.8 times less frequent).