Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC16010.15690/vramn.v68i7.704OBSTETRICS AND GYNAECOLOGY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ АКУШЕРСТВА И ГИНЕКОЛОГИИPROGNOSTIC VALUE OF UTEROPLACENTAL CIRCULATION IMPAIRMENT IN 1ST TRIMESTER OF PREGNANCY IN PATIENTS WITH COMPLICATED OBSTETRIC HISTORYПРОГНОСТИЧЕСКАЯ ЗНАЧИМОСТЬ НАРУШЕНИЯ МАТОЧНО-ПЛАЦЕНТАРНОГО КРОВООБРАЩЕНИЯ В I ТРИМЕСТРЕ БЕРЕМЕННОСТИ У ПАЦИЕНТОК С ОТЯГОЩЕННЫМ АКУШЕРСКИМ АНАМНЕЗОМSavel'evaG. M.СавельеваГ. М.
Russian Federation

RAMS academician, Head of the Department of Obstetrics and Gynecology, Department f Pediatrics, N.I. Pirogov Russian National Research Medical University Address: 117997, Moscow, street Ostrovityanova, 1; tel.: (495) 718-34-72

gms@cfp.ruBugerenkoE. Yu.БугеренкоЕ. Ю.
Russian Federation

PhD, obstetrician-gynecologist, Center of Family Planning and Reproductive Moscow Health Department Address: 113209, Moscow, Sevastopol`sky avenue, 24-A; tel.: (499) 794-43-73

bugerenko@yandex.ruPaninaO. B.ПанинаО. Б.
Russian Federation

PhD, Professor, Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine Lomonosov Moscow State University Address: 119192, Moscow Lomonosov Ave, on 31/5; tel.: (495) 331-91-81

olgapanina@yandex.ruRussian National Research Medical University, Moscow, Russian FederationРоссийский национальный исследовательский медицинский университет им. Н.И. Пирогова, Москва, Российская ФедерацияCenter for Family Planning and Reproduction Department of Health in Moscow, Russian FederationЦентр планирования семьи и репродукции департамента здравоохранения г. Москвы, Российская ФедерацияMoscow State University, Russian FederationМосковский государственный университет им. М.В. Ломоносова, Российская Федерация19072013687Vestnik Rossiiskoi akademii medetsinskikh nauk / Annals of the Russian academy of medical sciencesВестник Российской академии медицинских наук4807082015Copyright ©; 1970, "Paediatrician" Publishers LLCCopyright ©; 1970, Издательство "Педиатръ"1970"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/160

One of the urgent problems of modern obstetrics is the early detection of irregularities in the development of the uteroplacental vessels system in patients with severe disorders in the history. Aim: to evaluate the predictive value of re-development of obstetric pathology on the basis of the uterine artery Doppler on 11–14 weeks of pregnancy. Patients and methods. 410 patients in I trimester of pregnancy were examined with fetal growth restriction, preeclampsia and/or fetal death and/or a history of preterm delivery were. The influence of physical factors and obstetric history on the state of uterine blood flow in the I trimester of pregnancy was studied. Results. The optimal Doppler indexes was calculated; a high predictive ability of the pulsation index in the uterine arteries with respect to pregnancy complications with early clinical manifestation, severe preeclampsia and combined obstetric complications was detected. Conclusions. Our data support the possibility of preclinical diagnosis of obstetrical complications in patients with complicated obstetric history.

Одной из актуальных проблем современного акушерства является ранняя диагностика нарушений в формировании маточно-плацентарной системы у пациенток с отягощенным акушерским анамнезом. Цель исследования: оценить возможность прогнозирования повторного развития акушерской патологии на основании данных допплерометрии в маточных артериях в 11–13 недель беременности. Пациенты и методы. Обследовано 410 пациенток в I триместре беременности с наличием задержки роста плода, гестоза и/или антенатальной гибели плода и/или преждевременных родов в анамнезе. Изучено влияние факторов соматического и акушерского анамнеза на состояние маточного кровообращения в I триместре беременности. Результаты. Рассчитаны оптимальные пороговые значения допплерометрических индексов. Определена высокая прогностическая способность пульсационного индекса в маточных артериях в 11-13 недель в отношении осложнений беременности с ранней клинической манифестацией, тяжелым гестозом и сочетанными акушерскими осложнениями. Выводы. Полученные нами данные подтверждают возможность доклинической диагностики акушерских осложнений второй половины беременности у пациенток с отягощенным акушерским анамнезом.

doppleruterine arterycomplicated pregnancyдопплерометрияматочные артерииосложнения беременности1. Strizhakov A.N., Ignatko I.V. Poterya beremennosti [Pregnancy loss]. Moscow, MIA, 2007.2. Capucci R, Pivato E, Carboni S, Mossuto E, Castellino G, Padovan M, Govoni M, Marci R, Patella A. The use of uterine artery doppler as a predictive tool for adverse gestational outcomes in pregnant patients with autoimmune and thrombophilic disease. J. Prenat. Med. 2011; 5 (2): 54–58.3. Gómez O, Figueras F, Fernández S, Bennasar M, Martínez JM, Puerto B, Gratacós E. Reference ranges for uterine artery mean pulsatility index at 11–41 weeks of gestation. Ultrasound Obstet. Gynecol. 2008; 32 (2): 128–132.4. Panina O.B. Razvitie plodnogo yaitsa v I trimestre beremennosti: diagnostika i prognozirovanie prenatal'noi patologii. Avtoref. diss. … dokt. med. nauk [The development of the ovum in the I trimester of pregnancy: prenatal diagnosis and prognosis pathology. Author’s abstract]. Moscow, 2000. 32 p.5. Konovalova O. V. Tyazhelye formy gestoza. Prognozirovanie i profilaktika. Avtoref. diss. … kand. med. nauk [Severe preeclampsia. Prediction and prevention. Author’s abstract]. Moscow, 2012. 22 p.6. Pilalis A, Souka AP, Antsaklis P, Daskalakis G, Papantoniou N, Mesogitis S, Antsaklis A. Screening for pre-eclampsia and fetal growth restriction by uterine artery Doppler and PAPP-A at 11–14 weeks' gestation. Ultrasound Obstet. Gynecol. 2007; 29 (2): 135–140.7. Dugoff L., Lynch A.M. First trimester uterine artery Doppler abnormalities predict subsequent intrauterine growth restriction. Am. J. Obstet. Gynecol. 2005; 193: 1208–1212.8. Costa Fda. S., Murthi P., Keogh R., Woodrow N. Early screening for preeclampsia. Rev. Bras. Ginecol. Obstet. 2011; 33 (11): 367–375.9. Herraiz I., Escribano D., Gómez-Arriaga P.I. Predictive value of sequential models of the uterine artery Doppler in pregnancy at high risk for preeclampsia. Ultrasound Obstet. Gynecol. 2012; 40 (1): 68–74.10. Cetin I., Huppertz B., Burton G. Pregenesys pre-eclampsia markers consensus meeting: What do we require from markers, risk assessment and model systems to tailor preventive strategies? Placenta. 2011; 32 (Suppl.): 4–16.11. Khalil A, Cowans NJ, Spencer K, Goichman S, Meiri H, Harrington K. First-trimester markers for the prediction of pre-eclampsia in women with a-priori high risk. Ultrasound Obstet. Gynecol. 2010; 35 (6): 671–679.12. Rasmussen S, Irgens LM, Albrechtsen S, Dalaker K. Predicting preeclampsia in the second pregnancy from low birth weight in the first pregnancy. Obstet. Gynecol. 2000; 96: 696–700.13. Plasencia W., Maiz N., Poon L., Yu C., Nicolaides K. H. Uterine artery Doppler at 11 + 0 to 13 + 6 weeks and 21 + 0 to 24 + 6 weeks in the prediction of pre-eclampsia. Ultrasound Obstet. Gynecol. 2008; 32: 138–146.14. Martin A.M., Bindra R, Curcio P, Cicero S, Nicolaides K. Screening for pre-eclampsia and fetal growth restriction by uterine artery Doppler at 11–14 weeks of gestation. Ultrasound Obstet. Gynecol 2001; 18: 583–586.15. Melchiorre K., Leslie K, Prefumo F, Bhide A, Thilaganathan B. First-trimester uterine artery Doppler indices in the prediction of small-for-gestational age pregnancy and intrauterine growth restriction. Ultrasound Obstet. Gynecol. 2009; 33 (5): 524–529.