• Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)
en To content

Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)

HEALTH OF WOMAN. 2018.5(132):122–126; doi 10.15574/HW.2018.132.122

Zhabchenko I. A. , Sudmak O. R.
SI «Institute of Pediatrics, Obstetrics and Gynecology acad. O.M. Lukyanovaya NAMS of Ukraine», Kyiv

The objective: to study the structure and frequency of complications of pregnancy, deliveries and perinatal outcomes in three groups of women: women with infertility and obesity, treated by application of in vitro fertilization (hereinafter IVF), pregnant women after IVF application with normal body weight, and pregnant women on the background of obesity which did not have an infertility in past history.

Materials and methods. A retrospective analysis of 221 case histories of pregnancies and labors in women who were treated and gave birth in the Pregnancy and delivery pathology Department of SI «Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova of NAMS of Ukraine» for 2012 – 2016 years was carried out.

Results. The overwhelming majority of pregnant women after IVF on the background of obesity are primaparas, who have a complicated obstetric history, hormonal changes in the form of progesterone deficiency predominantly and chronic inflammatory processes. Pregnancy with a combination of infertility, treated by the means of IVF application, and obesity, in most cases is accompanied by a long-term threat of termination of pregnancy (48.8%), threatening preterm deliveries (56%), placental dysfunction (41.5%), premature rupture of the amniotic membranes (41.5%), other problems during pregnancy, at the same time, every second woman (58.5%) had a combination of several complications, and required a long-term and repeated inpatient treatment (53.7%). The specific gravity of surgical delivery was 90%, and 16.2% of such deliveries were complicated by pathological blood loss. The number of preterm deliveries was 17.1%, with perinatal losses up to 11.3‰. Among full-term newborns 21.3% of newborns had malnutrition of the I degree and 17% of them had hypoxic-ischemic lesion of CNS.

Conclusion. The course of pregnancy, delivery and the postpartum period in the studied contingent of women has a significant frequency of complications, mainly the coinciding ones, which affects on the consequences of perinatal outcomes and requires further study of this problem and the development of differentiated algorithms for antenatal observation.

Key words: pregnancy, obesity, in vitro fertilization, complications, delivery, newborn.

REFERENCES

1. Ahmetov AS. 2002. Ozhirenie – epidemiya HHI veka. Terapevt. arh. 74;10:5–7.

2. Bayramova MA. 2012. Optimizatsiya taktiki vedeniya beremennyih s ozhireniem. Dis. kand. med. nauk. – 14.01.01. M:132.

3. Veropotvelyan PN, Tsehmistrenko IS, Veropotvelyan NP. 2017. Vliyanie ozhireniya na reproduktivnuyu funktsiyu: novyiy vzglyad na reshenie staryih problem. Zhinochyi likar 1(69):56–59.

4. Vyhivska LM, Nykoniuk TR. 2017. Etiopatohenetychni aspekty perebihu I trymestra vahitnosti u zhinok pislia zastosuvannia dopomizhnykh reproduktyvnykh tekhnolohii. Zdorove zhenshchiny 4(120):98–101.

5. Vyhivska LM, Beniuk VO. 2015. Profilaktyka perynatalnykh uskladnen pislia dopomizhnykh reproduktyvnykh tekhnolohii. Zbirnyk naukovykh prats asotsiatsii akusheriv-ginekologiv Ukrainy 2(36):30–33.

6. Honcharuk NP, Kovyda NR. 2017. Optymizatsiia pidkhodiv do rozrodzhennia zhinok, yaki zavahitnily pislia zastosuvannia likuvalnykh prohram dopomizhnykh reproduktyvnykh tekhnolohii. Zdorove zhenshchіnу 4(120):123–125.

7. Zhabchenko IA, Chernenko TS, Nevyshna YuV, Pokhytun MV. 2011. Osoblyvosti vahinalnoho mikrobiotsenozu u vahitnykh ta yoho korektsiia v razi dysbiotychnykh zsuviv. Zdorove zhenshchіnу 4:87–89.

8. Kovaleva YuV. 2014. Rol ozhireniya v razvitii narusheniy menstrualnoy i reproduktivnoy funktsii. Rossiyskiy vestnik akushera-ginekologa 14;2:43–51.

9. Kuzin AI, Lengin YuA. 2011. Metabolicheskiy sindrom: klinicheskie i populyatsionnyie aspektyi. Chelyabinsk, Izdatelstvo «ZAO «Chelyabinskaya mezhrayonnaya tipografiya»:120.

10. Kulakov VI, Korneeva IE. 2002. Sovremennyie podhodyi k diagnostike i lecheniyu zhenskogo besplodiya. Akusherstvo i ginekologiya 2:56–59.

11. Chu SY, Callaghan WM, Kim SY, Schmid CH et al. 2007. Maternal obesity and risk of gestational diabetes mellitus: A meta-analysis. Diabetes Care. 6. https://doi.org/10.2337/dc06-2559a

12. Dietl J. 2005. Maternal obesity and complications during pregnancy. J. Perinatal. Med. 33;2:100–105. https://doi.org/10.1515/JPM.2005.018

13. Jevitt C. 2009, Nov.– Dec. Pregnancy complicated by obesity: midwifery management. J. Midwifery Womens Health 54(6):445–451. https://doi.org/10.1016/j.jmwh.2009.02.002; PMid:19879516

14. Norman JE. 2010. The adverse effects of obesity on reproduction. Reproduction. 140(3):343-345. https://doi.org/10.1530/REP-10-0297; PMid:20802106

15. Péter Fedorcsák Per, Olav Dale Ritsa Storeng Gudvor, Ertzeid Sverre, BjerckeNan, Oldereid Anne K, Omland Thomas, Åbyholm Tom Tanbo. 2004, November. Impact of overweight and underweight on assisted reproduction treatment. Human Reproduction 19; 11:2523–2528. https://doi.org/10.1093/humrep/deh485; PMid:15319380