TREATMENT RESULTS OF WOMEN WITH FETOPLACENTAL INSUFFICIENCY DUE TO SARS-CoV-2 INFECTION

Abstract

Objective: to determine the role of fetoplacental insufficiency (FPI) in perinatal outcomes in pregnant women with SARS-CoV-2 infection. Material and methods. The study included 160 pregnant patients hospitalized in RSD Zangiota-1. Evaluation of uteroplacental and fetal-placental blood flow was carried out by Doppler fetal method. For the diagnosis of FPI, the classification of A.N. Strizhakov. For a comparative analysis of the effectiveness of the protocols developed during the study period, pregnant women with FPI against the background of COVID-19 were divided into two study groups. Results. The main predictors of the development of FPI in pregnant women infected with SARS-CoV-2 were: preeclampsia (70.0%); the threat of abortion during pregnancy (36.25%); burdened obstetric and gynaecological history (40.0%). Only 19.4% of cases were diagnosed with FPI grades 1-A and 1-B, while the remaining 80.6% were diagnosed with grades 2 and 3 FPI. Delivery by caesarean section was used in 77.5% of cases, 100% in severe and extremely severe cases of COVID-19, and 61.7% in moderate cases (p<0.001), with 95.6% favourable outcomes for mothers, and 92 .5% for children. The frequency of cesarean section was reduced from 85.0% to 70.0% (p=0.023), total maternal mortality from 7.5% to 1.25% (p=0.043), perinatal mortality from 12.5% to 2.5 % (p=0.013), the average duration of treatment decreased from 26.4±3.4 to 18.1±2.2 days (p=0.042). Conclusion. A low incidence of complications accompanies early detection of FPI in women infected with SARS-CoV-2 and, as a result, can significantly affect the favourable course and outcome of the entire pregnancy.