THE FEATURES OF PREGNANCY IN NULLIPAROUS WOMEN WITH PREECLAMPSIA
The purpose of research is to study the features of the course of pregnancy in nulliparous women with preeclampsia to identify risk factors. Methods: The authors conducted an observational study of 46 nulliparous women at low risk for preeclampsia to reveal a possible prediction. History, clinical analysis of blood and biochemical markers, as well as ultrasonography were assessed in the first trimester of pregnancy based on case control in 25 women with preeclampsia and 21 patients in the control group. Results: In group I the pregnant women with a higher education and have jobs predominated (odds ratio = 4.179 [1.209, 14.441]). The authors found a significant decrease in the level of PAPP-A in the 1st group. Indicators of hemodynamics: the right of resistance index and systolic-diastolic ratio of the left were significantly higher in group the 1st than in the 2nd group. Violation of hemodynamic parameters was observed only in the 1st group, usually in the right uterine artery (52%). In the 1st group, 64% of women gave birth by yourself, of which term births - 48%, premature - 16%, cesarean section - 36%, including an emergency cesarean section - 32%, planned childbirth - 4%. In the 2nd group, 90,5% of women gave birth by yourself, of which urgent deliveries - 85,7% and preterm - 4,8%, an emergency cesarean-section - 9,5%. In the 1st and the 2nd groups there were 2 fetal deaths during pregnancy on 26-27 and 29-30 weeks, fetal malnutrition was observed in the three cases. In total, 23 children were born alive in the 1st group, in the 2nd - 21 newborn. According to Apgar score the data were - less than 7 points in 3 newborn (12%) in the 1st group and in 1 (4, 8%) in the 2nd group. Conclusions: the reduction of PAPP-A levels at week 11 and hemodynamic instability in the uterine artery in the period 18-21 weeks should be considered important predictors of the development of preeclampsia in nulliparous women.