CLINICAL AND MORPHOLOGICAL COMPARISON OF CHANGES IN THE SYSTEM "MOTHER-PLACENTA-FEUTUS-NEONATE" UNDER THE INFLUENCE OF COVID-19 DURING PREGNANCY

COVID-19 is a global medical and social problem for physicians of various specialties. SARS-COV-2 infection can have an impact on the course of pregnancy in women, on the prenatal condition of the fetus and on the postnatal adaptation of the newborn. The specific symptom complex of manifestations under the influence of the SARS-COV-2 virus on the body of a pregnant woman results in significant changes in the placental circulation and disrupts the steady development of the fetus and adaptation of the newborn. Aim of the study: To conduct a clinical and morphological study of changes in the "mother-placenta-fetus-newborn" system in mothers who had COVID-19 during pregnancy. Results and their discussion: On the basis of the "Ukrainian Center of Maternity and Childhood of the National Academy of Sciences of Ukraine", Kyiv, during 2021-2023 a retrospective-prospective study was conducted. A total of 141 pregnant women participated in the study: the main group consisted of 116 pregnant women who had COVID-19, depending on the trimester of pregnancy (subgroup I-III), the control group consisted of 25 healthy women. In accordance with the bioethical requirements of the Declaration of Helsinki, a morphological study of their placentas and newborns was performed. All women in the main group had some problems during pregnancy. These problems were relevant risk factors for the birth of their babies. Signs of placental dysfunction, premature maturation with hypo-/hyperplasia, fossilization, vascular destruction and thrombosis were diagnosed in the placentas of women with COVID-19, mainly in the 1st and 3rd trimesters of pregnancy. Impaired postnatal adaptation was found in the children, especially in the main subgroups I and III (p = 0.018). Children of these subgroups were more often born with moderate and severe asphyxia, p = 0.011. Respiratory disorders were 2.4 times more frequent in children of subgroup III and required intensive care, p = 0.015. In these subgroups, posthypoxic cardiopathy (p = 0.016) was diagnosed in 1 in 3 children. Hypoxic-ischemic encephalopathy, p = 0.005, subependymal and intraventricular hemorrhages on neurosonograms were 2.8 and 1.9 times more frequent in newborns of subgroups I and III, respectively. In children of the main group, inflammatory changes in internal organs were detected. Conclusion: Study of the mechanism of transmission of infection from mother to child, changes in the feto-placental barrier and characteristic disorders of the neonatal period in children from mothers who had COVID-19.