DYSFUNCTION OF THE PLACENTA IN PREGNANT WOMEN WITH POST-TRAUMATIC STRESS DISORDER
DOI:
https://doi.org/10.11603/24116-4944.2023.1.13939Keywords:
pregnancy, placental dysfunction, post-traumatic stress disorderAbstract
The aim of the study – to assess the prevalence of post-traumatic stress disorder (pTSD) among pregnant women with signs of placental dysfunction.
Material and Methods. The study was conducted on the basis of the clinical units of the Department of Obstetrics and Gynecology of the Odessa National Medical University (Odesa) in 2022. 35 pregnant women aged 20–35 with signs of placental dysfunction (main group) and 30 pregnant women of the same age with the physiological course of pregnancy (control group) were examined. The following criteria were used to verify placental dysfunction: the presence of changes in fetoplacental blood flow, the presence of symmetric or asymmetric fetal hypotrophy, signs of fetal distress, hormonal imbalance (increased blood concentration of placental hormones with a simultaneous decrease in fetal hormones, including high levels of placental lactogen, chorionic gonadotropin, low levels of estrogens, progesterone, alpha-fetoprotein), changes in the activity of enzymes (alkaline phosphatase, oxytocinase). A structured clinical diagnostic interview and the CAPS-5 clinical diagnostic scale were used to determine the signs of PTSD. Statistical processing was carried out by methods of dispersion and correlation analysis using Statistica 14.0 software (TIBCO, USA)
Results and Discussion. The average age of pregnant women in the main group was 28.1±0.3 years, the control group was 27.3±0.4 years old (p>0.05). In both groups, first-time pregnant women predominated (54.3 % and 63.3 %, respectively). Signs of ZVUR were identified in 91.4 % of cases in pregnant women of the main group, violations of fetoplacental blood flow – in 100 % of cases, changes in cerebral blood flow of the fetus after the 32nd week of gestation – in 17.1 % of cases.In all cases of PD, changes in the hormonal profile were noted. When assessing the prevalence of PTSD in women of both clinical groups, a significant prevalence of such cases was determined in the main group (8 or 25.7 % versus 2 (6.7 %) in the control group, χ2=4.17 df=1 p=0.04). In all pregnant women, the manifestations of post-traumatic stress disorder lasted more than a month, their intensity corresponded to 62.2±1.1 points in the main group and 63.5±5.8 points in the control group. The most frequent causes of PTSD in pregnant women are the presence of obstetric or perinatal complications during previous pregnancies, the status of a refugee/displaced person from temporarily occupied territories, and the loss of a loved one (husband, brother, father, mother, etc.) as a result of military operations or for other reasons.
Conclusions. The frequency of detection of PTSD symptoms in pregnant women with compensated placental dysfunction is 3.5 times higher than during the physiological course of pregnancy. The most frequent causes of PTSD in pregnant women are the presence of obstetric or perinatal complications during previous pregnancies, the status of a refugee/displaced person from temporarily occupied territories and the loss of a loved one (husband, brother, father, mother, etc.) as a result of military operations or for other reasons
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