PAPP-A LEVEL OF PRIMIPAROUS WOMEN IN I TRIMESTER AND PREGNANCY OUTCOME
The aim of the examination is to compare the results of labor depending on the level of RAPP-A in the first trimester of pregnancy of primiparous. Methods: an observational study was conducted in 50 primiparous women. Anamnesis, a clinical blood test and biochemical markers, ultrasound were evaluated in the first trimester of all pregnant women by the case-control method. Two groups were formed: I (n=20) - pregnant women with level of PAPP-A<3 IU/l, II (n=30) - level of РАРР-А>3 IU/l. Results: Pregnant women with higher education prevailed in the I group (0R=2,042 [0,618, 6,748]), working (0R=5,783 [0,653;51,239]) who were married (OR = 0,688 [0,176;2,684]). The size of the fetus is significantly small in group in the I group than in the 2 group. The hemodynamic index: the systolic-diastolic ratio at the left was significantly higher in group I than in II. Violation of the parameters of hemodynamics was only observed in group I. Fetal growth retardation syndrome was more reliably detected in I than in II (OR = 19.333 [2.174;171.893]). In group I, antenatal fetal death occurred in one observation at a gestation period of 26-27 weeks, fetal hypotrophy occurred in one observation. In the I group independently 60% gave birth, in II - 83.3%. In group I, 40% (emergency) was delivery by cesarean section, in II - 16.7%, of which emergency caesarean section - 6.7% and planned - 10%. Totally 19 were born alive in group I, in group II - 30 of newborns. The Apgar score: 7-10 points to the I group around 15 (75%), in II - 30 (100%), less than 7 points was found only in the I group around 4 (20%). Conclusions: A decrease in the level of PAPP-A of primiparous is less than 3 IU/l and should be considered as an unfavorable prognostic sign of the formation of complications of pregnancy.