Эхографические особенности и биофизический профиль плода при беременности, осложненной резус-иммунизацией

Abstract

Background: High perinatal morbidity and mortality at newborn hemolytic disease needs new effective diagnostics and prophylactic methods development. Material and methods: 115 pregnant women with Rh-immunization, complicated with fetal anemia development as a main group and 50 pregnant Rh-negative women without antibodies as a control group were examined using ultrasound (Philips HD-11), doppler (100 mHz filter, 3.5-5.0 mHz probe) methods, fetal biophysical profile in real time mode (11AM-2PM). According to immunization severity grade the main group was divided into three groups due to diagnostic cordocentesis results. Results: Most informative non-invasive criterion of fetal anemia diagnostics is the bloodstream maximum systolic speed in medium brain artery increase. These changes accurately correlate with an average or a heavy degree of newborn anemia presence. Sensitivity for the average degree anaemia makes 94%, and specificity – 98%, and the heavy degree anaemia 100% and 99% respectively. Ductus venosus bloodstream change at heavy form hemolytic disease reflects fetal condition deterioration developing on heavy anemia background. Reversed values occurrence speaks about fetal circulatory dynamics decompensation and considerably worsens the forecast for a newborn. The characteristics of the light, average, severe and edematous hemolytic disease forms are described. Conclusions: The obtained results are necessary for perinatal pathology forecasting and early diagnostics at pregnancy, complicated by Rh-factor immunization.