FEATURES OF PREGNANCY IN NULLIPAROUS WITH EARLY PREECLAMPSIA

Abstract

Objective - to study the characteristics of the course of pregnancy, maternal and perinatal outcomes in nulliparous with early preeclampsia. Methods. 127 nulliparas were included in the prospective case-control study. Two groups were formed: 1st (n = 27) - pregnant with early preeclampsia, 2nd (n = 100) - pregnant without preeclampsia. Mild preeclampsia occurred in 21 (77,8%) and severe in 6 (22,2%). Results. A significant difference was detected in the I trimester, which was expressed in differently directed changes in the indices of ß-hCG and PAPP-A. Violation of hemodynamic parameters was noted at 18-21 weeks which was observed in group 1st and was expressed by an increase in the systolic-diastolic ratio predominantly in the left uterine artery. In group 1st, shallow water, fetal growth retardation syndrome were more often detected, and antenatal death occurred in 2 cases. In total, 25 newborns were born alive in group 1st, 100 in group 2nd. Apgar score: less than 7 points in group 1st in 5 (18,5%), and in group 2nd - 8 (8%). Conclusions. The peculiarities of the course of pregnancy with early preeclampsia are a decrease in the level of PAPP-A in the period of 11-13 weeks and a violation of hemodynamics in the period of 18-21 weeks. The timely detection of pregnant women at risk of developing early preeclampsia will determine the criteria for more intensive monitoring and the use of prophylactic treatment methods.