METHOD OF SELECTING RISK MANAGEMENT STRATEGY FOR PREGNANT WOMEN AT 28^TH WEEK OF PREGNANCY

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to ultrasonic diagnostics and can be used to select a management approach to pregnant women at risk from 28^th week of pregnancy. Performing Doppler examination of cerebral vasculature of fetus of anterior cerebral artery (ACA), posterior cerebral artery (PCA), middle cerebral artery (MCA) with determination of resistance indices (RI), and uterine arteries and umbilical vessels to determine utero-placental-fetus blood flow disturbances (UPFD). If observing normal values of RI in all three cerebral arteries of the fetus: ACA, PCA, MCA and absence of Doppler pathological disturbances of blood flow from the side of UPFD, dynamic control by an obstetrician-gynecologist in maternity welfare center is considered to be shown. If observing normal values of RI in all three cerebral arteries of the fetus: ACA, PCA, MCA and UPFD degree I disorder are considered dynamic control every 2 weeks by obstetrician-gynecologist and doctor of ultrasonic diagnostics with emphasis on assessment of blood flow in cerebral arteries. If observing the degree I-II degree of UPFD disorder and reducing the RI less than 5th percentile from the RI value in the case of the physiological pregnancy course of at least one of the three cerebral arteries of the fetus: ACA, PCA, MCA, hospital admission of pregnant woman is considered to be shown. If observing the II-III degree of UPFD and the normal RI values in all three cerebral arteries of the fetus: ACA, PCA, MCA, hospital admission of pregnant woman is considered to be shown. If observing degree 2 UPFD disorder and reducing the RI less than 5th percentile from the RI value in the case of the physiological pregnancy course of at least one of the three fetal cerebral arteries: ACA, PCA, MCA, hospital admission of pregnant woman is indicated, with daily monitoring of fetus state and decision on expediency of further prolongation of pregnancy. If observing a degree III UPFD inhibitor and reducing the RI less than 5th percentile of the RI value in the case of the physiological pregnancy course of at least one of the three cerebral arteries of the fetus: ACA, PCA, MCA, hospitalization of the pregnant woman is considered to solve the issue of early delivery.;EFFECT: method provides selecting a management approach to pregnant women at risk from 28th week of pregnancy, reducing perinatal loss and infant morbidity.;1 cl, 3 tbl, 6 ex