Maternal factors of preconceptual and early gestation periods in women with high prenatal diagnostic risks

Cover Page

Cite item

Full Text

Abstract

Objective — evaluate maternal factors in preconception and early gestation periods in women with a high risk of prenatal diagnosis.

Methods and patients. Features of the development of preconception and early gestation periods were studied, including the first prenatal screening (PS), in 443 women with singleton pregnancy. Women were divided into 2 clinical groups: group 1 (n = 235) with a high risk (HR) of complications; subgroups: 1A (n = 69) — fetal chromosomal abnormalities (after exclusion confirmed cases); 1B (n = 66) — the development of preeclampsia; 1C (n = 48) — fetal growth restriction; 1D (n = 52) — preterm birth (PB). 2nd control group (n = 208) — women with low risk of complications.

Results. A high PS risk in the 1st group, especially in subgroups 1A, 1B, were in patients with hypertonic disease of 1-2 degrees (p < 0.05). Chronic kidney disease was leading in 1A, 1C (p < 0.05). Varicose veins of the lower extremities in the 1st group prevailed in the 1A, 1B, 1C (p < 0.05). A history of ovarian tumors and uterine myoma during pregnancy prevailed in 1A, 1B, cycle dysfunction in 1B, 1D (p < 0.05). GR was observed in nulliparous women with a history of miscarriages in 1B, 1C, 1D and artificial abortions in 1A (p < 0.05). PB in the anamnesis were significantly increased in the 1st gr. (p < 0.001). In the 1st trimester, the threatened miscarriage, bleeding and progesterone were frequent in the 1st group (p < 0.05).

Conclusion. Based on the obtain results a high risk of PS calculated according to the Astraia program using standard markers was noted in patients with somatic pathology, ovarian tumors, miscarriages, medical abortions and PB in the anamnesis, myoma during pregnancy, threatened miscarriage, bleeding, progesterone intake during 1st trimester. These factors should be considered when preparing for pregnancy.

About the authors

Petr M. Samchuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: dr_samchuk@mail.ru
ORCID iD: 0000-0001-7882-8922

MD, PhD, DSci. in medicine, professor at the chair Obstetrics and Gynecology No. 1, I.M. Sechenov First Moscow State Medical University (Sechenov University)

Russian Federation, Moscow

Evelina L. Azoyeva

V.V. Veresayev City Clinical Hospital

Email: azoeva@yandex.ru
ORCID iD: 0000-0002-3711-2423
Russian Federation, Moscow

Anatoliy I. Ishchenko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: 7205502@mail.ru
ORCID iD: 0000-0003-3338-1113

MD, PhD, DSc, Professor

Russian Federation, Moscow

References

  1. Cuckle H., Platt L.D., Thornburg L.L., Bromley B., Fuchs K., Abuhamad A. et al. Nuchal Translucency Quality Review Program of the Perinatal Quality Foundation. Nuchal Translucency Quality Review (NTQR) program: first one and half million results. Ultrasound Obstet. Gynecol. 2015;45(2):199‐204. doi: https://doi.org/10.1002/uog.13390
  2. Sung K.U., Roh J.A., Eoh K.J., Kim E.H. Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study. Obstet. Gynecol. Sci. 2017;60(2):154‐62. doi: https://doi.org/10.5468/ogs.2017.60.2.154
  3. Livrinova V., Petrov I., Samardziski I., Jovanovska V., Boshku A.A., Todorovska I. et al. Clinical importance of low level of PAPP-A in first trimester of pregnancy - an obstetrical dilemma in chromosomally normal fetus. Open Access Maced J. Med. Sci. 2019;7(9):1475‐9. doi: https://doi.org/10.3889/oamjms.2019.384
  4. O’Gorman N., Wright D., Syngelaki A., Akolekar R., Wright A., Poon L.C., Nicolaides K.H. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 11-13 weeks gestation. Am. J. Obstet. Gynecol. 2016;214(1):103.e1‐103.e12. doi: https://doi.org/10.1016/j.ajog.2015.08.034
  5. Preconception care: Maximizing the gains for maternal and child health. Geneva: World Health Organization (WHO); 2013.
  6. Dean S.V., Imam A.M., Lassi Z.S., Bhutta Z.A. Importance of intervening in the preconception period to impact pregnancy outcomes. Nestle Nutr. Inst. Workshop Ser. 2013;74:63‐73. doi: https://doi.org/10.1159/000348402
  7. Dean S.V., Lassi Z.S., Imam A.M., Bhutta Z.A. Preconception care: closing the gap in the continuum of care to accelerate improvements in maternal, newborn and child health. Reprod. Health. 2014; 11(Suppl. 3):S1. doi: https://doi.org/10.1186/1742-4755-11-S3-S1
  8. Aylamazyan A.K., Kulakov V.I., Radzinskiy V.E., Savel’yeva G.M., eds. Obstetrics: National guidance. Moscow: GEOTAR-Media; 2007. (In Russ.).
  9. Radzinskiy V.E. Obstetric aggression. [Akusherskaya agressiya]. Moscow: StatusPraesens; 2011. (In Russ.)
  10. Usta I.M., Zoorob D., Abu-Musa A., Naassan G., Nassar A.H. Obstetric outcome of teenage pregnancies compared with adult pregnancies. Acta Obstet. Gynecol. Scand. 2008;87(2):178‐83. doi: https://doi.org/10.1080/00016340701803282
  11. Ciancimino L., Laganà A.S., Chiofalo B., Granese R., Grasso R., Triolo O. Would it be too late? A retrospective case-control analysis to evaluate maternal-fetal outcomes in advanced maternal age. Arch. Gynecol. Obstet. 2014;290(6):1109‐14. doi: https://doi.org/10.1007/s00404-014-3367-5
  12. Langley S. A nutrition screening form for female infertility patients. Can. J. Diet. Pract. Res. 2014;75(4):195‐201. doi: https://doi.org/10.3148/cjdpr-2014-024
  13. Committee of experts of the Russian Cardiological Society. Diagnostics and treatment of cardiovascular diseases during pregnancy: Russian recommendations. Rossiyskiy kardiologicheskiy zhurnal. 2013;(4s1):4-40. (In Russ.)
  14. Tikhomirov A.L., Sarsaniya S.I. Iron deficiency anemia in women: solutions to the problem. Russkiy meditsinskiy zhurnal. Mat’ i ditya. 2020;3(1):44-50. (In Russ.) doi: https://doi.org/10.32364/2618-8430-2020-3-1-44-50
  15. Stuklov N.I. Iron-deficiency anemia in the practice of a gynecologist. Algorithms for diagnosis, prevention, and treatment. Akusherstvo i ginekologiya. 2016;7:99-104. (In Russ.) doi: http://doi.org/10.18565/aig.2016.7.99-104
  16. Dedov I.I., Krasnopol’skiy V.I., Sukhikh G.T. Russian National Consensus Statement on gestational diabetes: diagnostics, treatment and postnatal care. Diabetes Mellitus. 2012;(4):4-10. (In Russ.)
  17. Stagnaro-Green A., Abalovich M., Alexander E., Azizi F., Mestman J., Negro R., et al. American Thyroid Association Taskforce on Thyroid Disease During Pregnancy and Postpartum. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21(10):1081‐25. doi: https://doi.org/10.1089/thy.2011.0087
  18. Lassi Z.S., Imam A.M., Dean S.V., Bhutta Z.A. Preconception care: screening and management of chronic disease and promoting psychological health. Reprod. Health. 2014;11(Suppl 3):S3-S5. doi: https://doi.org/10.1186/1742-4755-11-S3-S5
  19. Dedov I.I., Mel’nichenko G.A., eds. Endocrinology: Russian clinical recommendations. [Endokrinologiya: Rossiyskiye klinicheskiye rekomendatsii]. Moscow: GEOTAR-Media; 2016. (In Russ.)
  20. Platonova N.M. Hypothyroidism and pregnancy. Poliklinika. 2014; 2:1-5. (In Russ.).
  21. Farkash E., Weintraub A.Y., Sergienko R., Wiznitzer A., Zlotnik A., Sheiner E. Acute antepartum pyelonephritis in pregnancy: a critical analysis of risk factors and outcomes. Eur. J. Obstet. Gynecol. Reprod. Biol. 2012;162(1):24‐7. doi: https://doi.org/10.1016/j.ejogrb.2012.01.024
  22. Matuszkiewicz-Rowińska J., Małyszko J., Wieliczko M. Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. Arch. Med. Sci. 2015;11(1):67‐77. doi: https://doi.org/10.5114/aoms.2013.39202
  23. Christiansen O.B. Recurrent pregnancy loss. Causes, controversies and treatment. New-York: CRC Press by Taylor & Francis Group; 2014:1-16.
  24. About improvement of the organization of prenatal (prenatal) diagnostics of disorders of development of the fetus/child: Order Of the Department of health of Moscow of 14.06.2013 No. 600. [O sovershenstvovanii organizatsii prenatal’noy (dorodovoy) diagnostiki narusheniy razvitiya ploda/rebenka: Prikaz Departamenta zdravookhraneniya g. Moskvy ot 14.06.2013 № 600]. Moscow; 2013. (In Russ.)
  25. About the approval of the Order of rendering medical care in the profile “obstetrics and gynecology (except for the use of assisted reproductive technologies)”: Order of the Ministry of Health of the Russian Federation of November 1, 2012 No. 572n. [Ob utverzhdenii Poryadka okazaniya meditsinskoy pomoshchi po profilyu “akusherstvo i ginekologiya (za isklyucheniem ispol’zovaniya vspomogatel’nykh reproduktivnykh tekhnologiy)”: Prikaz Ministerstva zdravookhraneniya Rossiyskoy Federatsii ot 1 noyabrya 2012 g. № 572n]. Moscow: 2012 (In Russ.)

Copyright (c) 2020 Eco-Vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies