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616-053.1-091.8 (1) |
Patologie. Medicină clinică (6963) |
SM ISO690:2012 PETROV, Victor, BURSACOVSCHI, Natalia, OPALCO, Igor, BOTNARI-GUȚU, Mihaela, COJOCARI, Victoria. Influența maladiilor non-transmisive asupra mortinatalității. In: Buletin de Perinatologie, 2022, nr. 1(93), pp. 195-200. ISSN 1810-5289. |
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Buletin de Perinatologie | |||||||
Numărul 1(93) / 2022 / ISSN 1810-5289 | |||||||
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CZU: 616-053.1-091.8 | |||||||
Pag. 195-200 | |||||||
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The purpose of the study. To reduce ante- and intranatal mortality by identifying modifiable risk factors that lead to the chronic pathology of a pregnant woman that complicates the course of pregnancy up to intrauterine fetal death. Material and methods. The retrospective case-control study was carried out within the Scientific Laboratory of Obstetrics of Institute of Mother and Child (IMC), Chisinau, Moldova. The research included 5322 births within the Perinatal Center of level III (Obstetrical ward no. 1 and 2) that took place in 2019. After excluding cases of twin pregnancy, pregnancy term less than 26 weeks and child weight less than 500 gr - in the final research, 5098 births with a single fetus were taken, including 43 cases of stillbirth. Results. In 2019, 237 births with a single fetus were assisted in IMС with a gestational age between 26+0 and 33+6 weeks, of which 26 were stillborn. Of the non-transmissible extragenital pathology, the major impact on the rate of premature fetal death was pre-existing diabetes mellitus, including in non-obese patient (OR 4,46; CI1,04-19,03). In the group of births 34+0-36+6 weeks, the research did not determine the influence of non-communicable diseases on the rate of intrauterine death of the fetus. In the group of term births, 4602 births with a single fetus were included in the research, with 11 cases of intrauterine death. The ratio of the probability of termination of pregnancy with intrauterine death of the fetus was higher in women whose pregnancy was complicated by preeclampsia on the background of pregnancy-induced hypertension (OR 16.3, CI 2.02-131.62). Gestational diabetes had the same negative impact (OR 9.88, CI 2.11-46.31). Conclusions. Within the non-transmissible pathology, hypertensive conditions and diabetes have the major negative impact for the unfavourable outcome of the pregnancy, such as intrauterine death of the fetus. For patients with type I and II pre-existing diabetes in pregnancy, adequate prenatal preparation is necessary with the achievement of adequate blood glucose levels. For people in the risk group, the glucose tolerance test at 24-28 weeks and the active detection of gestational diabetes with the assessment of the need to resolve the pregnancy at 37-39 s. can reduce the stillbirth rate due to this serious maternal pathology. In the case of the development of severe preeclampsia in pregnancy in order to prevent the case of stillbirth or maternal complications - the termination of the pregnancy is reasonable regardless of the term. Even so expectation tactic is admissible for 48 hours necessary to finish the prophylaxis of respiratory distress in the fetus with term less than 34 weeks. |
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Cuvinte-cheie non-communicable diseases, hypertension, diabetes, stillbirth, нетрансмиссивные заболевания, гипертония, диабет, мертворождение |
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