The endpoint of the negative impact of adverse processes in the mother’s body with influenza is the formation of placental insufficiency, the basis of which is a violation of the uteroplacental blood flow. The objective: to study the features of the course of pregnancy, the state of the fetus and the newborn after the influenza in the first trimester of pregnancy. Materials and methods. 120 women who had the influenza in the first trimester of pregnancy were examined. In 68 (56.7%) pregnant women signs of feto-placental dysfunction were observed, 2 groups were distinguished: the main group - 68 patients with feto-placental dysfunction, the comparison group – 52 pregnant women without signs of feto-placental insufficiency. Results. 3 times more often than women without manifestations of placental insufficiency (42.6% versus 15.4%; p<0.05) a severe course of influenza was observed, it accompanied by a high frequency of clinical manifestations, including in almost all patients (95.6% versus 67.3%; p<0.05), body temperature rose to 38 °C and higher, and in 61.7% of women it stayed for 4–6 days (versus 11.5%; p<0.05). Among the complications of influenza: bronchitis (25.0% versus 9.3%; p<0.05), pneumonia (17.6% versus 5.7%; p<0.05), sinusitis (17.6% versus 7.7%; p<0.05). The threat of abortion was noted in 57.4% of cases, the threat of preterm birth was observed in 39.7% of women. Most often, placental dysfunction was associated with fetal distress (76.5% versus 13.5%; p<0.05) and growth retardation (54.4% versus 3.8%; p<0.05). 32.4% versus 13.5% of women had preeclampsia (p<0.05). The frequency of both polyhydramnios (17.6%) and low water (10.3%) is significantly higher. By cesarean section, 35.3% women were delivered (versus 15.4%, (p<0.05). Delivery was preterm in 17.6% of women versus 7.7% (p<0.05). Premature discharge of amniotic fluid (17.6%) and pathological blood loss during childbirth (16.2%), fetal distress during childbirth (48.5% versus 9.6%; p<0.05) were noted. Maternal placental dysfunction, fetal distress, prematurity (17.6%) and malnutrition (22.1%) led to a high incidence of birth asphyxia (46.5% versus 19.2%, p <0.05). Half (51.5%) of children had disadaptation syndromes, most often neurological disorders (32.4% versus 11.5%; p<0.05) and respiratory disorders (27.9% versus 7.7%; p<0.05). Conclusion. Influenza in early pregnancy with a severe course and a high frequency of complications is associated with a high frequency of feto-placental dysfunction and other obstetric and perinatal complications, which requires a more detailed study to determine risk factors and develop tactics for managing this category of pregnant women. Keywords: pregnancy, influenza, feto-placental dysfunction, obstetric and perinatal complications, newborn.
The objective: to study the changes in the procoagulant link of the hemostasis system, the course of pregnancy and parturition peculiarities in HIV-infected women, depending on the clinical stage and the onset of haart. Materials and methods. In 150 HIV-infected pregnant women and parturients, a procoagulant link of hemostasis was evaluated by meanings of total fibrinogen, prothrombin, activated fractional thromboplastin time, as well as the status of the mother-placenta-fetus system and periportal blood loss amount. Results. Study of the procoagulant link in women with II and III clinical stages of HIV-infection in the second trimester showed a tendency to a hypercoagulative conditions, with increased levels of fibrinogen, prothrombin and short activated fractional thromboplastin time. In the third trimester, these patients already had a significant difference in these parameters compared to the control group (p<0.05). Laboratory changes in the 3rd trimester correlate with impairment of the «mother–placenta–fetus» system discovered by ultrasound and doplerometry in the vast majority of pregnant women with II and III clinical stages (p<0.05). A state of hypocoagulation is observed during parturirion in women with the III clinical stage of HIV-infection and in parturients who started taking HAART during this pregnancy (p<0.05). Conclusions. The pregnancy course in women with II and III clinical stages of HIV-infection is characterized by the presence of gestational and perinatal complications caused by hypercoagulation. During parturirion in HIV-infected patients with the III clinical stage and in parturients who started taking HAART during this pregnancy, there is a tendency to periportal haemorrages, which confirmes by coagulogram changes. Key words: HIV-infected pregnant women, HIV-infected parturient, procoagulant link of hemostasis system, mother-placenta-fetus system, periportal blood loss.
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