Features of prevention of fetal growth retardation in pregnant women with chronic hypertension
Authors: Deinichenko O. V. , Krut Yu. Ya. , Izbytska N. G. , Slinko O. M. , Gaidai N. V. , Pavlyuchenko M. I. , Amro I. G. , Puchkov V. A. 
Published: October 2020

The lack of effective methods to prevent the development of fetal growth retardation in high-risk pregnant women remains a significant problem of modern obstetrics, which determines the relevance of the study. The aim of the study was to examine the effectiveness of monoprophylaxis of fetal growth retardation using aspirin at a dose of 150 mg, starting at 12-13 weeks of gestation, pregnant women with chronic hypertension. In order to apply and implement the proposed prevention of fetal growth retardation, all pregnant women with chronic hypertension were divided into two groups. The patients were divided into groups randomly. To prevent the development of fetal growth retardation, patients in group A received acetylsalicylic acid at 150 mg/day, patients in group B received acetylsalicylic acid at 100 mg/day. Primary examination of pregnant women in a prospective study was performed during pregnancy 11-12 weeks in all groups, which included: history taking, general clinical examination, blood pressure measurement, obstetric and gynecological examination according to clinical protocols of the Ministry of Health of Ukraine № 417 from 15.07.2011, № 676 dated 31.12.2004. Clinical and instrumental examination was performed: blood pressure and ECG monitoring, Doppler examination. Childbirth and initial assessment of the condition of newborns were performed in accordance with the current orders of the Ministry of Health of Ukraine with the assessment of the condition on the Apgar scale and the result of anthropometry (determination of mass and growth rate). It was found that the age characteristics of the group of pregnant women did not differ statistically significantly: the average age of patients in group A reached 27.3±1.6 years, group B – 28.1±1.8 years. According to the obstetric and gynecological history, the women did not differ. It should be noted that statistically significant differences between the main group and the comparison group by the degree of chronic hypertension (grade 1 and 2) were not detected: 30 % of women in group A and 35 % of group B had chronic hypertension grade 1, 70 % and 65 %, respectively – chronic arterial hypertension of 2 degrees. Among the concomitant lesions in pregnant women were determined: obesity 8 women of group A (26.7 %), 8 people (25.8 %) of group B; varicose veins in 3 women (10.0 %) of group A, 4 people (12.9 %) of group B; pathology of the urinary system – in 2 cases (6.6 %) in group A and in 2 people (6.45 %) of group B; pathology of the thyroid gland – 2 women (6.6 %) of group A, and 1 person (3.22 %) of group B, anemia of pregnant women – in 4 women (13.3 %) of group A, and 4 people (12.9 %) of group B; chronic viral hepatitis C in remission in 1 woman of group B (3.22 %). As a result of the analysis of pregnancies and complications of childbirth, we found that the appointment of acetylsalicylic acid in addition to standard treatment of chronic arterial hypertension in accordance with clinical protocols at a dose of 150 mg/day helped reduce the incidence of disorders of uteroplacental and fetal circulation by 2.7 times, fetal growth retardation – by 8,8 times and small to gestational age fetus – 4.8 times compared with the results of patients who received acetylsalicylic acid at a dose of 100 mg/day.