Features of formation of the activity-dormancy cycle in fetuses with growth restriction and developmental delay
- Authors: Pavlova N.G.1, Dyusembinova S.D.1
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Affiliations:
- Acad. I.P. Pavlov First Saint Petersburg State Medical University Ministry of Health of Russia
- Issue: No 1 (2020)
- Pages: 104-109
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/248679
- DOI: https://doi.org/10.18565/aig.2020.1.104-109
- ID: 248679
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Abstract
Objective. To study and compare the parameters of the activity-dormancy cycle in fetuses having various degrees of growth restriction in the presence and absence of disorders of placental circulation in the third trimester of pregnancy. Subjects and methods. The presence and components of the activity-dormancy cycle were assessed in the fetuses of 43 women with singleton pregnancy at 34/35 weeks and at fetometric values below the 10th percentile. All the women underwent great artery Doppler studies in the mother-placenta-fetus functional system. According to the presence and absence of impaired placental hemodynamics, the pregnant women were divided into 2 groups. Groups 1 and 2 contained 33 and 10 fetuses, respectively. The newborn infants were divided according to the severity of hypotrophy, by using the tables proposed by G.M. Dementieva et al. (1984). Results. The activity-dormancy cycle was formed only in 33% of the fetuses in Group 1 and in 40% of those in Group 2. Half of these fetuses were found to have grades 2 and 3 hypotrophy; the remaining fetuses had grade 1 hypotrophy. The duration of dormancy in the cycle was reduced equally by 40%, and the amplitude of the heart rate and motor-cardiac reflex decreased by 50% and 19% in the fetuses of Groups 1 and 2 women, respectively, as compared with in the fetuses of healthy women during physiological pregnancy. There was an inverse correlation between the duration of dormancy in the activity-dormancy cycle and the severity of neonatal hypotrophy (r = -0.35; p = 0.05). It was found that the more severe disorders of placental circulation were observed, the less frequently the fetal activity-dormancy cycle was formed (r = -0.39; p = 0.021). Conclusion. The activity-dormancy cycle and its parameters can serve as qualitative and quantitative criteria for growth restriction and developmental delay in fetuses having prenatal fetometric values between the 5th and 10th percentiles. The integrated approach to prenatal diagnosis of growth restriction and developmental delay will be able to adequately assess fetal adaptive capabilities when planning the timing and mode of delivery.
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About the authors
Nataliya G. Pavlova
Acad. I.P. Pavlov First Saint Petersburg State Medical University Ministry of Health of Russia
Email: ngp05@yandex.ru
MD, professor of the Department of Obstetrics, Gynecology and Reproductology 197022 Russia, St. Petersburg, ul. Leo Tolstoy, d. 6-8
Sholpan D. Dyusembinova
Acad. I.P. Pavlov First Saint Petersburg State Medical University Ministry of Health of Russia
Email: sholpan8-d@mail.ru
doctor of ultrasound diagnostics, St. Petersburg GBUZ “Maternity hospital number 6 prof. V.F. Snegireva “ 197022 Russia, St. Petersburg, ul. Leo Tolstoy, d. 6-8
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