FETOPLACENTAL BLOOD CIRCULATION IN PREGNANT WOMEN SUFFERING FROM CHRONIC VENOUS DISEASE
Objective. To investigate the placental blood circulation in the maternal-placental blood system and in the fetoplacental system in women with chronic venous insufficiency.
Materials and methods. We assessed parameters of Doppler velocimetry of umbilical and uterine arteries in a group of women with chronic venous disease (n=52). Healthy pregnant women made the control group (n=21).
Results. Chronic venous insufficiency is used to complicate the gestational period course due to threatening miscarriage and a premature childbirth (69.6 among women suffering from chronic venous disease vs. 42.8% in the control group), pre-eclampsia (33.3% and 17.3%, respectively). The severity of placental insufficiency was found to increase with the chronic venous disease severity. The placental insufficiency compensated form was identified in 69.6% of women with telangiectasia and the sub-compensated one in 30.4% of patients; in case of chronic venous insufficiency in 58.8% and 41.2% of women, respectively. The resistance index in the uterine arteries in patients with chronic venous disease was statistically different from that in the control group (t-test 23,8, p=0.0001). Circulatory disturbances in the venous plexus of broad ligaments and in the uterine veins appeared to be higher in women with severe and mild forms of CVD. The second and the third trimesters of pregnancy were characterized by the maximal blood flow rates (7.4 ± 3.5%, p> 0.05). The maximal transversal dimension of the vascular fascicle section was 4.7 cm±0.03 cm being 1.7 times higher than in the control group (p<0.05).
Conclusion. The hemodynamic system mother — fetus is closely associated with the period of the fetoplacental complex development. Its state makes possible identifying groups of risk for perinatal hypoxic disorders among the pregnant women especially among the women suffering from chronic venous disease. Doppler investigation of the pelvic venous blood flow in case of the pregnancy complicated course makes possible identify the venous hemodynamics disorders beginning from the pregnancy trimesters II and III.