Dopplerometric Features of Blood Flow Changes in the Utero-Placental System in Women With Related Pregnancy Mission

Abstract

This article discusses the problem of recurrent miscarriage, which is one of the urgent problems in the field of obstetrics and gynecology, and analyzes the problem of its prevention by identifying Doppler markers that predict this pathology in the early stages. To do this, we widely used ultrasound research methods and drew attention to their relationship with the level of disorders in the uteroplacental system.

Relevance. The great medical and social significance of the problem of placental insufficiency in primiparous re-pregnant women lies in the fact that the severe consequences it causes for the mother and child cannot always be prevented in the proper amount using only pharmacological therapy to prevent miscarriage [1,2,5]. That is why, considering the leading mechanisms of the pathogenesis of chronic placental insufficiency, it strongly emphasizes the need to find new medical technologies for the prevention of placental circulation disorders [3,6,7,9]. The antenatal therapeutic measures carried out at the present stage turn out to be ineffective, and often useless, due to their implementation only in the first trimester of pregnancy, against the background of placental insufficiency.

The study of risk factors in physiological pregnancy, their timely treatment and exclusion leads to the normal course of pregnancy [4,8,10]. It is known that the rheological properties of blood are manifested in its dynamics. The manifested hyperfibrinemia and a sharp increase in D-dimer in the blood leads to a deterioration in hemodynamic properties in the uterus-fetus-placenta system. At the same time, an increase in acute inflammation proteins leads to destructive consequences in the placenta and contributes to a change in the structure-functional properties of the placenta, which leads to a decrease in hormone production. To determine these data, we used Doppler ultrasound.The Doppler ultrasound method gives us information about changes in the uterus-placenta and placenta-fetus system, with the help of which complications can be predicted. It is known that, for dynamic observation in order to prevent complications, Doppler monitoring should be carried out. Dopplerometry performed at 4-11 weeks indicates the processes of implantation and the development of the chorion, at 20-24 weeks of pregnancy it shows the state of blood flow in the uterus-placenta and fetus-placenta system, in addition, it can be used to predict possible complications from the mother and fetus, which manifests itself in the form of structural and functional changes in the placenta. Doppler ultrasound at 30-34 weeks provides information about possible premature birth and fetal development. That is why we decided to make a step-by-step study of Doppler indicators depending on the weeks of gestation.