Comparative assessment of fetal blood flow and cardiac system status of pregnant women with mitral valve pathology


  • A.P. Dnistryanska National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • Yu. Konovalenko National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • N.A. Godlevskaya National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • N.G. Burtyak National Pirogov Memorial Medical University, Vinnytsya, Ukraine
  • L.S. Baida National Pirogov Memorial Medical University, Vinnytsya, Ukraine
Keywords: ultrasound, Doppler ultrasound, mitral valve prolapse, mitral valve insufficiency.

Abstract

Annotation. The aim of this work is to analyze the course of pregnancy in women with mitral pathology, the task is to identify preclinical criteria for worsening cardiovascular pathology that can lead to the development of complications of pregnancy and functioning of the fetal CVS, to evaluate the effectiveness of preventive measures. The article presents the analysis of changes in ultrasound characteristics of fetoplacental blood flow in women with mitral valve prolapse and mitral valve insufficiency, as well as cardiovascular status in these women. Statistical processing was performed by calculating Student coefficients (+) using the Microsoft Excel PC program. Doppler examination of fetal umbilical cord blood flow during pregnancy was studied. The correlation between the level of maternal blood flow compensation and pathological changes in the fetoplacental complex was established. As a result of our work, the prevalence of the disease was estimated. As of 2018, it was found that of the total number of extragenital pathology in 1676 pregnant women with CVSD; respectively for 2017 — 1699, for 2016 — 1925, 2015 — 1857 in the region. Of these, 331 (2018), 313 (2017), 326 (2016), 306 (2015) had mitral valve defects, including prolapse. A retrospective assessment of pregnancy and childbirth indicates the possibility of complications of pregnancy and childbirth. In the group of patients with mitral valve prolapse and mitral valve insufficiency, compared to the control group, they did not show significant changes in the dynamics of the Doppler metrics of cardiovascular pathology, which indicates the compensation of the cardiovascular system against the background of changes in the valve. At the same time, the tendency to decrease of CF in women with mitral valve prolapse and insufficiency of the mitral valve against the background of increasing pregnancy is revealed, indicates a violation of CVD adaptation to changes inherent in pregnancy, which provoke hemic and hemodynamic changes in the body, which will cause pregnancy and fetal status. FPC status in women with mitral valve prolapse and mitral valve insufficiency worsens in the third trimester of pregnancy, especially indicators such as the ratio of systolic volume ratio (SVR) to diastolic volume ratio (DVR) and IR. The administration of 40 mg of ƅ-blockers for a 2-week period improved the FPC, was safe and effective.

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Published
2019-12-30
How to Cite
Dnistryanska, A., Konovalenko, Y., Godlevskaya, N., Burtyak, N., & Baida, L. (2019). Comparative assessment of fetal blood flow and cardiac system status of pregnant women with mitral valve pathology. Reports of Vinnytsia National Medical University, 23(4), 645-651. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2019-23(4)-15