PREGNANCY COURSE AND PERINATAL OUTCOMES IN WOMEN WITH IMPAIRED FAT METABOLISM


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Abstract

Objective. to study the specific features of pregnancy course and perinatal outcomes in obese multigravidas and to provide a rationale for the expediency of pre-conception preparation, by focusing on body weight loss. Subjects and methods. Eighty overweight/obese multigravidas were followed up (from the first trimester of pregnancy). Circadian blood pressure (BP) rhythms during 24-hour BP ambulatory monitoring were analyzed. All the pregnant women were examined using ultrasound studies (fetometry, placentography, estimation of the amount of amniotic fluid, Doppler study of the fetal middle cerebral artery and aorta, both uterine arteries, both umbilical arteries, and their terminal branches). Peripheral hemodynamics was evaluated by an endothelium-dependent right brachial artery vasodilation test. Results. Analysis of the pattern of extragenital pathology showed the high frequency of and a close relationship between vascular tone regulation and fat metabolic disorders (FMD). Pregnancy complications more frequently occurred in pregnant women with FMD than in those with normal body mass index. A paradoxical brachial artery response to occlusion in patients with FMD and arterial hypertension should be considered as an additional poor prognostic factor for the development of gestosis and placental insufficiency. Conclusion. Complication rates during pregnancy and its perinatal outcomes are determined by the presence and degree of FMD and they increase in proportion to the rise of obesity, degree.

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About the authors

N. M PODZOLKOVA

Russian Medical Academy of Postgraduate Education

Email: podzolkova@gmail.com

M. I AGEEVA

Russian Medical Academy of Postgraduate Education

M. Yu SKVORTSOVA

Russian Medical Academy of Postgraduate Education

T. V PEROVA

Russian Medical Academy of Postgraduate Education

I. D NIKISHA

Russian Medical Academy of Postgraduate Education

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