Analysis of predictors of the development of premature detachment of a normally located placenta

Vinogradova Olga Pavlovna, Rakhmatullov Fagim Kosymovich, Ostanin Maxim Alexandrovich, Bocharnikov Denis Yurievich

The purpose of the study. To analyze the predictors leading to premature detachment of a normally located placenta. Materials and methods. This study was conducted from 2016 to 2020 on the basis of the Penza City Maternity Hospital - a hospital of the second group (medium risk), according to the Order of the Ministry of Health of the Russian Federation dated 20.10.2020 No. 1130n "On approval of the Procedure for providing medical care in the profile "obstetrics and gynecology (except for the use of assisted reproductive technologies)". Retrospectively, 250 birth histories of women in the gestation period of 28-41 weeks of pregnancy were analyzed. For the analysis, 2 groups were formed: group 1 included 120 pregnant women with a complication in the form of PPRP, group 2 consisted of 130 women with a normal pregnancy outcome, but the presence of risk factors for PPRP (arterial/gestational hypertension, placental insufficiency, preeclampsia, hereditary and acquired thrombophilia, cardiac arrhythmias). Results. During the period from 2016 to 2020, 24316 births took place in the Penza City Maternity Hospital. There has been a decrease in the number of births every year. The frequency of pregnancies complicated by PPRP averaged 0.48%. The data obtained during the retrospective analysis indicate the importance of predictors of PPRP in the course of pregnancy development. This retrospective analysis demonstrates the importance of early diagnosis of predictors of PPRP for the further formation of risk groups. The formed groups will require closer attention, since the detection and early diagnosis of this pathology will be able to prevent the formation of PPRP, which will entail a more favorable outcome of pregnancy for both the pregnant woman and the fetus. The results obtained show the need for further study and expansion of predictors of complications of PPRP, timely diagnosis and reduction of perinatal losses. Conclusion. 1. Assessment of the pathology of the vascular system will make it possible to predict the development of unfavorable outcomes in preeclampsia and fetoplacental insufficiency, which are predictors of the development of the PPRP condition. 2. When identifying patients with OCD, it is necessary to optimize pre-gravidar preparation, timely diagnosis of manifestations of AFN in the early stages in order to timely correction, which will reduce the risk of developing OCD and improve perinatal outcomes. 3. Statistically significant differences were identified according to the following criteria: violation of blood flow I-II (p=0,014); initial and pronounced fetal disorders according to CTG (p=0,022); CPR (p=0,041); cardiac arrhythmia (p=0,01). 4. Further study of the adaptive capabilities of the vascular system will help to more accurately predict the outcomes of pregnancy, with a further decrease both infant and maternal mortality.

Keywords:pregnancy, PPRP, fetoplacental insufficiency, cardiac arrhythmias, childbirth, pregnancy outcomes, pregnancy complications.