Analysis of frequency of placental insufficiency occurrence using ultrasound in patients after IVF and in women with spontaneous onset of pregnancy.

Nagaytseva E. A., Serova N. S.

Рurpose. The aim of the study was to compare the incidence of placental insufficiency by ultrasound in patients after in vitro fertilization and replanting of an embryo (IVF and PE) and in women with spontaneous onset of pregnancy. Materials and methods. We conducted a retrospective cohort analysis of pregnancy and birth outcomes have 169 pregnant women in the period from 2013 to 2015, with various pathological changes in the placenta detected by ultrasound in the period from 22 to 40 weeks Age of pregnant women was from 17 to 50 years. Patients were divided into two groups according to the method of pregnancy (IVF or naturally). The first group consisted of 81 wom-en whose pregnancy has come through IVF. The second comparison group consisted of 88 patients with spontaneously occurring pregnancy. In patients of group I in 68 pregnancies were singleton and 13 – twins. In group II all the women were with singleton pregnancies. Ultrasonography was performed according to standard methods recommended for pregnant women, advanced Protocol, taking into account sonographic features of placenta (prevalence vysokoudoynyh inclusions cysts, enlarged majorsince spaces of varying severity), with evaluation of major geometricheskih parameters and their compliance with the stated gestational age, degree of maturity of the placenta, its thickness and location, the amount of water. Results. The analysis of the frequency of occurrence of various variants of echostruc-ture of the placenta showed pathological changes in the placenta is rarely met in patients after IVF and PE (n =61;64,8%) than among women with spontaneous onset of pregnancy (n =78;88,6%). There was a high percentage of delayed maturation of the placenta in both groups in 96 cases (52,7%). Significantly the most frequent of the pathological variants was option 2 delayed maturation of the placenta in the form of a uniformly heterogeneous echo-structure in 54 cases (29,7%). Compliance with the physiological norm, the level of maturity of the placenta (II or III) was 35,2% of the patients after IVF and PE (n=33) and 11,4% among women with spontaneous onset of pregnancy. In a comparative analysis of changes in the thickness of the placenta and amount of amniotic fluid revealed statistically significant differences. Significantly less (p<0.05) changes in thickness of the placenta were detected in patients of group I (after IVF) (n=13;13,8%) than women of group II (spontaneous pregnancy) (n=40; 45,5%) cases. Also oligohydramnios was determined significantly less (p<0,003) in group I (n=32; 34%), compared to the II group (n=40;45,5%). A small amount of water was combined with growth retardation and was a reliable sign of placental insufficiency in both groups. In group I patients (after IVF and PE) were significantly less likely to have babies with growth retardation (n=33; 35,2%) than in group II (n=49;55,7%). In a comparative analysis of blood flow disorders in the system "mother – placenta – fetus" significantly fewer were detected in patients after IVF and PE (n=26;27,7%), compared with women with spontaneous onset of pregnancy (n=45; 51,1%). Conclusion. A comparative analysis of the results of the study, the significantly lower frequency of placental insufficiency were found in patients after in vitro fertilization com-pared with women with spontaneous onset of pregnancy.

I. M. Sechenov First Moscow medical state medical university (Sechenov University) Moscow, Russia.

 

 

 

 

 

Keywords: ultrasound placental insufficiency, placenta, in vitro fertilization (IVF), pathological types of the placenta, growth retardation of the fetus, Doppler.

 

Corresponding author:Nagaytseva E.A., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Nagaytseva E. A., Serova N. S. Analysis of frequency of placental insufficiency occurrence using ultrasound in patients after IVF and in women with spontaneous onset of pregnancy. REJR. 2017; 7 (3):117-126. DOI:10.21569/2222-7415-2017-7-3-117-126.

Received: 24.05.2017 Accepted:04.09.2017