HEALTH OF WOMAN. 2019.3(139): 65–71; doi 10.15574/HW.2019.139.65

Tkachuk R. R.
Shupyk National Medical Academy of Postgraduate Education, Kiev
Kyiv City Center for Reproductive and Perinatal Medicine

The objective: is to analyze the frequency of gestational complications and labor abnormalities in pregnant women with different types of vegetative regulation disorders.

Materials and methods. 129 women were examined. The type of vegetative regulation was determined by recording the time and spectral parameters of heart rate variability by computer cardiointervalography with use of CardioLab Bebicard diagnostic system. The main group consisted of 66 pregnant women with established vegetative regulation disorders. 63 patients with a normal vegetative state, a balanced level of sympathetic and parasympathetic activity formed a control group.

To assess the status of the mother–placenta–fetus, an ultrasound examination with doplerometry was performed.

Results. A significant increase of the central regulatory circuit activity in pregnant women with vegetative dysfunction was established. The cardiointervalography indicate a balanced activity of the vegetative nervous system in the control group. The gestational complications were significantly more frequent in women of the main group in the context of detected vegetative dysfunction than in the control group. Labor anomalies were more common in pregnant women of the main group. Women with high parasympathetic astivity noted an increased frequency of labor dystocia. In patients with a superiority of sympathetic and humoral regulation, an increased frequency of weakness of labour activity was observed.  The fast deliveries often determined in pregnant women with decreased activity of both departments of autonomic nervous system. The incidence of urgent caesarian deliveries was significantly higher in the main group, including due to the ineffectiveness of the medical correction of labor abnormalities.

Conclusions. The cardiointervalography is informative for the diagnosis of vegetative regulation and adaptive disorders, which may be the prerequisites for the gestational complications and labor abnormalities development. Using the heart rate variability analysis in pregnant women will improve the early prediction of gestational pathology and pathological birth process, reduce the risk of obstetric and perinatal complications.

Key words: heart rate variability, vegetative regulation, gestational complications, labor activity abnormalities.

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