PERINATAL MORTALITY RISK FACTORS FOR PREGNANT WOMEN WITH HYPERTENSIVE DISORDERS
Keywords:
risk factors, perinatal mortality, fetal distress, homocysteine, hypertensive disordersAbstract
The risk of perinatal morbidity and mortality for pregnant women with hypertension depends on the severity of preeclampsia, the age of pregnant women, the level of hyperhomocysteinemia, the incidence of delayed fetal development, the number of premature births and the increase of the rate of spontaneous oxidative modification of the protein. The purpose of the research was to identify and investigate the risk factors for mortality of newborn from pregnant women with hypertensive disoders. Materials and methods of research. It was studied the process of pregnancy, the condition of fetuses and newborns from 120 pregnant women with hypertensive disorders. The primary group consisted from pregnant women with moderate preeclampsia (n=30), who reported neonatal mortality (n=1). The comparison group consisted of pregnant women with chronic hypertension-grade I and mild preeclampsia, whose children survived after birth (n=60), control group was healthy pregnant women (n=30). Results of the research and their discussion. It was found that in the researched groups there was a significant difference in maternal age (p=0.019), terms of gestation at birth (p<0.001), fetal weight at birth (p<0.001), number of pregnancies (p=0.023), duration of the latent phase (p<0.001), as well as the difference in the condition of children at birth at the first (p<0.001) and fifth minutes (p<0.001) on the Apgar scale. Risk factors were identified using an adequate logistic regression model. There are three main risk factors for newborns’ mortality in case of hypertension disorders:1) mother’s age (HS=1.25; 95% CI 1.04–1.51 per year); 2) hyperhomocysteinemia (VH 36.3; 95% CI 3; 4–386.7); 3) premature infant (VS 95; 95% CI 3–2900); 4) increased spontaneous oxidation of protein (HS 1.65; 95% CI 1.8–457.5). Conclusions. Perinatal mortality of pregnant women with hypertension depends on gestational age and fetal weight at birth. The risk factors for newborns’s mortality and the data that must be taken into account for management of pregnancy and childbirth for women with hypertension (maternal age, conditions requiring the appointment of hypohomocystein therapy).
References
Kravchenko O. V. Features obstetric and gynecological history in pregnant women with fetal distress during pregnancy and birth hours. Materials conference. Healthy baby. Basics of nutrition. Chernivtsi, February 18, 2011. P. 53–54.
Haystruk N. A. Antenatal servive fetus in pregnant women with hipertenzivnie disorders (pathogenesis, diagnosis, prognosis and treatment): Dr. med. Sciences: 14.01.01 / N. A. Haystruk ; Donetsk State Medical University. M. Horkoho. Vinnitsya. 2007. 283 p.
Bart B. J. Hypertensive states of pregnancy (social and health aspects). Russian Journal of Cardiology 2010. № 3. P. 26–33.
Baskakov P. M., Dubovenko D. V. Clinical management of women with fetus and distress syndrome metabolichnit. Health of a woman. 2011. № 8 (64). P. 147–148.
Bartosz L. F., Dorogova I. V. Hypertension in pregnancy. Moscow SEC. 2007. 148 p.
Voronenka U. V., Мoskalenko V. F. Social Medicine and organization of the Health Protection. Тernopil: Ukrmеdbook, 2000. 680 p.
Boykо V. І., Buteykо О. І. Intrauterine Growth Restriction on the: prematurely born pregnancy: diagnostic and prevention of the perynathal patology. Women’s Health. 2017. № 1 (117). P. 124–126.
Venzkivska І. V., Vitovsky J. M., Zagorodnia О. S. New approaches to the estimate of the condition of the placental circulation on severe forms of the preeclampsiya. Сollection of scientific works of the Ukrainian obstetrics-gynecologists 2017. № 2 (40). Rivne: PP Еstero P. 40–44.
Venzkivska І. B. Modern view on the prognosis of the development of the preeclampsiya / І. B. Venzkivska, V. V. Belaia, U. О. Yarozkaia. Reproductive Health. Eath Europe: Internathional scientifical practical Journal. 2014. № 3 (33). P. 16–21.
Ivanuta S. О., Dindar О. А., Маkаrеnkо G. І., Кurochkа V. V. Меtabolic syndrom pandemia ХХI century, current problem of the Obstetrics. Сollection of scientific works of the Ukrainian obstetrics-gynecologists № 2 (40). Rivne: PP Еstero, 2017. P. 134–138.
Маlanchun І. М., Koptuch V. І., Franchuk О. А. The remote consequences of the postponed preeclampsiya. Аctual questions of the Pediatry, Obstetrics аnd Gynecology. 2014. № 2. P. 160–162.
The order of the Ministry of health protection of Ukraine from the of health protection of Ukraine from the 24. 03. 2014 № 205. Clinical protocol from the obstetric care “About improvement changes to the Ministry 29.12.2005. № 782 та від 31.12.2004 year № 676”.
The order of the Ministry of health protection of Ukraine № 782 from the 29.12.05. “About improvement of the Clinical protocol from the obstetric care “Intrauterine Growth Restriction”.
The order of the Ministry of health protection of Ukraine № 900 from the 27.12.2006 / About improvement of the Clinical protocol from the obstetric care “Fetal distress during pregnancy, delivery”.
Actions of the prevention of the Intrauterine Growth Restriction in pregnant of the risk groups / Тanko О. P. et al. Сollection of scientific works of the Ukrainian obstetrics-gynecologists № 2 (40). Rivne: PP Еstero, 2017. P. 248–254.
Aksornphusitaphong A., Phupong V. Risk factors of early and late onset preeclampsiya. J. Obstet. Gynaecol. Res. 2013. № 39 (3). P. 627–631.
Cotton D. B., Lee W., Huhta J. C., Dolman K. F. Hemodynamic profile in severe pregnancy induced hypertension. American Journal of Obstetrics and Gynecology 1988. Vol. 158: 523–529.
Early onset fetalgrows restriction / A. Dall’Asta et al. Med. 2010. Vol. 30 (2). P. 412–417.
Kinzler W. L., Vintzileos A. M. Fetal growth restriction: a modern approach. Curr. Opin. Obstet. 2008. 20 (2). P. 125–131.
