PERINATOLOGIYA I PEDIATRIYA.2015.1(61):32–35;doi10.15574/PP.2015.61.32

The features of the course of pregnancy, childbirth, fetus and newborn state in women after ART program during the functional disorders of the liver

Kaminskiy V. V., Zhdanovich A. I., Boychuk O. G., Kolomiychenko T. V.

P.L. Shupik National Medical Academy of Postgraduate Education, Kiev

State Institution «Institute of Pediatrics, Obstetrics and Gynecology NAMS of Ukraine», Kiev, Ukraine

Objective — to find out the role of disorders of the hepatobiliary system in appearance of obstetric and perinatal complications in pregnant women after application of ART.

Patients and methods. A total of 614 outpatient medical records, who have appealed for the treatment of infertility and for whom was an applied ART program (fertilization in vitro) is analyzed. The onset of pregnancy was marked in 147 (23.9%) of women from the 614 started cycles (study group). A total of 50 pregnant women without problems in the event of pregnancy in history consisted of the control group. For the determination of the role of the pathology of the hepatobiliary system in the development of disorders of pregnancy, we assigned 147 women whose pregnancy occurred after the application of ART (study group), they were divided into 2 subgroups: 1-a — 18 pregnant women with functional disorders of the hepatobiliary system and 2-a — 129 pregnant women after ART without signs of functional disorders of the hepatobiliary system. The functional disturbances we qualified as the presence of ultrasound signs of liver disorders and biochemical markers (transaminases, alkaline phosphatase, bilirubin).

Results. It has been established that pregnancy after ART in women with functional disorders of the liver has its own characteristics such as: significantly higher frequency of miscarriage and missed abortion, preterm labor, early gestosis, sever pre-eclampsia and growth retardation. In childbirth more often was marked bleeding, in the postpartum period — pyo-septic complications and late bleeding. Almost 40% of children were born in a state of asphyxia, moreover, in 11.1% of cases was marked it severe degree, a third of these children were underweight and 40.0% had signs of malnutrition, while in 66.7% had been violation of the course of early neonatal adaptation. Also was found more height perinatal mortality.

Conclusions. The presence of functional disorders of the liver in women with infertility play a certain role in carrying a pregnancy after ART, the appearance of its complications, the negative consequences for the woman and the newborn child, the specific mechanisms that require more detailed studies for the development of pathogenetically substantiated treatment and preventive measures.

Key words: infertility, assisted reproductive technologies, liver diseases, pregnancy, newborn.

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