РОЗВИТОК ПЛАЦЕНТАРНОЇ ДИСФУНКЦІЇ НА ТЛІ ГЕНІТАЛЬНИХ ІНФЕКЦІЙ

Complicated course of pregnancy by urogenital infections is noted, according to various authors, in 59-81 % of pregnant women. The structure of pregnancy complications is dominated by miscarriage (up to 24 %), intrauterine infection (up to 42 %), anemia (up to 15 %). The problems of placental dysfunction, the basis of which is a violation of compensatory and adaptive mechanisms and the influence of genial infections are relevant today, which is associated with a large number of complications in childbirth, high perinatal mortality. The main source of perinatal pathology is high-risk pregnant women, in whom the entire period of intrauterine development of the fetus continues against the background of genial infections. Intrauterine infections are a central pathological syndrome that leads to the development of perinatal lesions of the fetal CNS. The aim of our study was to study the development of placental dysfunction in pregnant women with genital infections. The course of pregnancy was studied and the state of the fetoplacental complex was assessed in 30 pregnant women with genital infections in the second half of pregnancy. In the examined group, the average age of women was 27.5+3.1 years. Among the examined pregnant women, there were 76 % of first-time mothers, 24 % of repeat mothers. Genital infections were detected in all pregnant women of the experimental group during the examination: chlamydia was detected in 16 pregnant women (53.3 %), ureaplasmosis in 8 (26.6 %), cytomegalovirus in 14 (46.6 %), herpes simplex virus in 11 (36.6 %). The first degree took place in 8 cases (26.6 %), the second degree in 4 (13.3 %). Thus, the volume, area and thickness of the placenta in pregnant women of the experimental group were significantly smaller than in pregnant women of the control group. Special changes were observed in the placentas of pregnant women with manifestations of ZVUR, which indicates manifestations of placental dysfunction in the presence of genital infections. Fetal retardation syndrome was diagnosed in 12 pregnant women (40 %). All cases were represented by a symmetrical form of ZVUR. The first degree occurred in 8 cases (26.6 %), the second degree in 4 (13.3 %). Thus, the volume, area and thickness of the placenta in pregnant women of the experimental group were significantly smaller than in pregnant women of the control group. Special changes were observed in the placentas of pregnant women with manifestations of ZVUR, which indicates manifestations of placental dysfunction in the presence of genital infections. Fetal retardation syndrome was diagnosed in 12 pregnant women (40 %). In the early neonatal period, there was impaired adaptation of newborns born to mothers with urogenital infection and clinical signs of hypoxia: mild-15 (50 %), moderate-5 (16.6 %), severe-3 (10 %). Depending on the severity of intrauterine infection, the main syndromes of central nervous system disorders were observed in newborn children in the early neonatal period. Hyperexcitability syndrome occurred in 18 (60 %) children. CNS depression syndrome was determined in 3 (10 %) children, which was complicated by a convulsive syndromeю. Hyperexcitability syndrome occurred in 18 (60 %) children. Central nervous system depression syndrome was identified in 3 (10 %) children, which was complicated by a convulsive syndrome. In pregnant women with genial infections, placental dysfunction develops in 73.4 % from 20 weeks of pregnancy due to disruption of trophoblast invasion. This leads to the development of primary dysfunction of the placenta, which further progresses and manifests itself after 32 weeks in the syndrome of fetal growth retardation.