FETAL GROWTH RETARDATION: DIAGNOSIS AND AN OPTIMAL DELIVERY METHOD


Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

Objective. To evaluate the efficiency of current diagnostic methods and to choose a delivery mode in relation to the degree of intrauterine growth retardation (IUGR). Subjects and methods. Four hundred and ten cases of full-term pregnancy were retrospectively studied according to medical records including medical history data, the results of follow-ups, ultrasonography (USG), and Doppler study, and neonatal information. Three study groups (310 women) were identified according to the degree of IUGR. A comparison group comprised 50 women with constitutional hypotrophy and a fetal weight of less than 2800 g. A control group consisted of 50 women with a fetal weight of more than 2800 g. Each group was divided into subgroups depending on the mode of delivery: a vaginal delivery and a cesarean section. Results. Fetal hypotrophy was diagnosed by USG in 74.44% of cases. In IUGR, the expected fetal mass was below the 10th percentile in 187 (60.32%) cases; abdominal circumference in 51.61%; femur length in 50.32%; biparietal diameter in 48.0%, and head circumference in 41.61%. The progressive pathological process was found to be paralleled by increases in resistance and pulsatility indices, which occurred in 83.8% of cases of third-degree IUGR. In 168 (54.2%) cases of IUGR, Doppler abnormal indices could identify fetal distress, which necessitated an emergence cesarean section. The perinatal mortality rates during a vaginal delivery were 48.8% (8 deaths). No neonatal deaths were recorded after cesarean section. There were differences in morbidity rates among the babies born by vaginal delivery or cesarean section (86.7 and 44.7%, respectively (p<0.05). Conclusion. USG with dynamic Doppler study makes it possible to timely diagnose IUGR and the degree of fetal distress and to make a decision on the time and mode of delivery. Cesarean section is the most sparing mode of delivery.

Texto integral

Acesso é fechado

Sobre autores

G. PALADI

N. Testemitsanu Kishinev State University of Medicine and Pharmacy, Republic of Moldova

K. ILIADI-TULBURE

N. Testemitsanu Kishinev State University of Medicine and Pharmacy, Republic of Moldova

U. TABUIKA

N. Testemitsanu Kishinev State University of Medicine and Pharmacy, Republic of Moldova

Email: tabuca@yandex.ru

Bibliografia

  1. Демидов В.Н., Розенфельд Б.Е., Сигизбаева И.К. Значение одновременного использования автоматизированной кардиотокографии и ультразвуковой допплерометрии для оценки состояния плода во время беременности// SonoAce-Ultrasound. - 2001. — № 9. — С. 73—80.
  2. Миколайович Я. Затримка розвитку плода (Патогенез, прогнозування, профшактика i лжування): Автореф. дис..д-ра. мед. наук. — Ктв, 2002.
  3. Пчелинцев В.В., Сидоров А.В. Особенности состояния здоровья женщин, родоразрешившихся плодом с внутриутробной задержкой развития // Материалы V Рос. форума «Мать и дитя»: Тезисы докл. — М., 2003. — С. 179—180.
  4. Стрижаков А.Н. Внутриутробная задержка развития плода (СЗРП) //Материалы V Рос. форума «Мать и дитя»: Тезисы докл. — М., 2003. - С. 44—45
  5. Brodsky H. Current concepts in intrauterine growth restriction //Obstet. and Gynec. ACOG. - 2000. - Vol. 19, № 6. — P. 307.
  6. Carbillon L. Diagnostic du retard de croissance intra-uterine// J.Réalit. Gynécol. Obstét. — 2006. - Vol. 92. — P. 32—38.
  7. Carbonne В., Cynober E. Indications et résultats du Doppler cérébral foetal // J. Réalit. Gynéc.-Obstét. — 2006. - Vol. 107. — P. 11—14.
  8. Cuttini M., Cortinovis I., Bossi A. et al. Proportionality of small for gestational age babies as a predictor of neonatal mortality and morbidity// Paediatr. Perinat. Epidemiol. - 2001. — Vol. 5. — P. 56—63.
  9. Daikoku N.H., Johnson J.W., GrafG. et al. patterns of intrauterine growth retardation// Obstet. and Gynecol. ACOG. — 2005. — Vol. 54, № 2. — P. 211.
  10. Divon M.Y., Hsu H.W. Maternal and fetal blood flow velocity waveforms in intrauterine growth retardation// Clin. Obstet. Gynecol. - 2002. — Vol. 35. — P. 156—171.
  11. Fraser A.M., Broken J.E., Ward R.H. Association of young maternal age with adverse reproductive outcomes //N. Engl. J. Med. - 1995. — Vol. 332. — P. 1113—1117.
  12. Lin C.C., Santolaya-Forgas J. Current concepts of fetal growth restriction: Causes, classification, and pathophysiology//Obstet. and Gynecol. ACOG. - 2000. - Vol. 19, № 6. — P. 310.
  13. Ott W.J., Doyle S. Ultrasonic diagnosis of altered fetal growth by use of a normal ultrasonic fetal weight curve// Obstet. and Gynecol. - 2002. — Vol. 78. — P. 582.
  14. Seeds J.W. Impaired fetal growth: ultrasonic evaluation and clinical management// Obstet. and Gynecol. ACOG. -2005. — Vol. 64, № 4. — P. 577.
  15. Uzan M. Examen Doppler en cas du retard de croissance intrauterine// J.Réalit. en Gynécol.-Obstét. - 2006. — Vol. 9. — P. 83—96.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML

Declaração de direitos autorais © Bionika Media, 2011

Este site utiliza cookies

Ao continuar usando nosso site, você concorda com o procedimento de cookies que mantêm o site funcionando normalmente.

Informação sobre cookies