MODERN ASPECTS OF MULTIPLE PREGNANCY
DOI:
https://doi.org/10.11603/24116-4944.2017.1.7372Keywords:
multiple pregnancy, miscarriage, premature delivery, antenatal and perinatal loss, prevention of complications.Abstract
Literature data indicate that in recent years a worldwide increase in the number of multiple pregnancies, which resulted in implementing public health practice of assisted reproductive technology. Multiple pregnancy is accompanied by a large number of complications such as miscarriage, premature labor, anemia, preeclampsia, birth of children with low body weight, neurological complications and death antenatal fruit. Perinatal mortality in multiple pregnancy is more than 6 times higher than that in singleton pregnancies. The cause of perinatal loss is deep prematurity and low rates of weight and body length at birth. Next cause of perinatal morbidity and mortality in multiple pregnancy is placental insufficiency and intrauterine growth retardation. Of particular importance is the type of placentation. Approximately 80 % of the placenta in multiple pregnancies dichorial, and 20 % – monoсhorial. In monoсhorial placenta are placental vascular anastomoses between the circulatory systems of two fruits that can be the basis for serious complications of multiple pregnancy as a syndrome feto-fetal transfusion and reverse arterial perfusion. This fruit-donor small, delayed development, and fruit recipient of large defects often occur antenatal death of one of the fruit. Patients with multiple pregnancy up the group of high risk for the development of maternal and perinatal complications. By this time there is no single algorithm to properly monitor, treat, birth women with different versions of multiple pregnancy. For assessments of fetus carried ultrasound, Doppler is used, cardiotocography, fetal biophysical profile defining, exploring the one that agrees hormones photoplacet complex function and condition of genital tract microbiota. To prevent possible complications for mother and fetus in multiple pregnancies, drug use and drug-free methods. In recent years, in multiple pregnancies and istmicocervical insufficiency and to prevent it pessaries were used. Existing various methods of prevention of complications in multiple pregnancies are not always effective, and therefore there is a need to find new, more effective methods of preventing these complications.
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