THE STATE OF THE FETAL CIRCULATION IN CONGENITAL FETAL MALFORMATIONS DEPENDING ON THE NOSOLOGIC STRUCTURE OF THE MALFORMATION

A normal pregnancy and fetal development depend on the blood flow in the mother-placenta-fetus system. The study of the blood flow using Doppler in this system is carried out both in obstetric pathologies and diseases of the fetus in utero. There are few such studies in congenital fetal malformation (CFM) and they are based on a very small number of studies.

The aim of the investigation was to evaluate the dopplerometric indices of the circulation in CFM depending on the nosologic structure of the malformation.

Materials and methods. The analysis of dopplerometric studies was made in 100 pregnant women aged 18 to 43 years in the third trimester of pregnancy who were diagnosed CFM. This group was divided into 7 groups according to ICD 10.The control group (CG) comprised 25 pregnant women who gave birth to healthy children.

The greatest changes were observed in multiple CFM of the fetus. Blood flow disorders were observed in the utero-placental complex in the fallopian artery (FA) and the placental-fetal blood flow. In the fetal-placental blood flow there were observed disturbances in the umbilical artery (UA) and middle cerebral artery (MCA).

The analysis of CVS in CFM showed no abnormalities in the utero-placental blood flow. In the fetal-placental blood flow there was observed a significant increase in Doppler indices in UA. Indices in MCA and fetal aorta had no significant difference.

The blood flow disturbance in Dopplerometry was also observed in fetuses with CFM of the pulmonary system. There was established that the pulse index in UA was significantly lower, and CMA was significantly higher than in CG. There was observed a significant increase in the resistance index (RI) in the fetal aorta compared with the control group.

Conclusions. The major disturbances in the feto-placental complex were observed in multiple CFM, CVS and CFM of the pulmonary system. In multiple CFM both utero-placental and fetal-placental complex are disturbed. In CFM of CVS and pulmonary system disturbances occur only in the fetal-placental complex.