ASSESSMENT OF THE INTRAUTERINE STATE OF THE SURVIVING FETUS IN MULTIPLE PREGNANCIES WITH ANTENATAL DEATH OF ONE FETUS
Keywords:
multiple pregnancies, chorionality, amnionality, intrauterine fetal death, cardiotocography, Doppler sonographyAbstract
Over the past decades, due to the widespread use of assisted reproductive technologies, the frequency of multiple pregnancies in the population has doubled, reaching an average of 2%. The probability of death of one fetus among all twins varies from 3.7 to 6.8%. The death of one fetus with multiple pregnancies can occur at any stage of pregnancy, which in turn is combined with an increase in morbidity and mortality among surviving fetuses. Intrauterine fetal death in twins is 4 times higher than in singleton pregnancies, and is associated with high neonatal and infant morbidity for surviving children. Management of pregnancy with this complication of multiple pregnancies requires a multidisciplinary approach, comprehensive dynamic monitoring of the condition of the surviving fetus. The purpose of research. To assess the intrauterine state of the surviving fetus in multiple pregnancies with antenatal death of one fetus. Materials and methods of research. The study was conducted on the basis of the Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology. Prospectively, 11 patients with multiple pregnancies complicated with antenatal death of one fetus were examined. The analysis of anamnestic data of pregnant women, the features of the course of this pregnancy was carried out; general clinical, biochemical blood tests, hemostasiogram; ultrasound; Doppler method; cardiotocography.Results and discussion. In the course of the study, the features of utero-fetal-placental blood flow and the condition of the surviving fetus in pregnant women with multiple pregnancies complicated by intrauterine death of one fetus were revealed. Changes in the intrauterine state of the surviving fetus were more often observed in antenatal death of one fetus after 22 weeks of gestation.Conclusions. Multiple pregnancies remain an urgent problem to this day. In order to prevent antenatal fetal death in multiple pregnancies, early diagnosis and adequate treatment of utero-fetal-placental blood flow disorders are necessary.
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