CLINICAL CHARACTERISTICS OF PREGNANT WOMEN WITH ISOLATED CONGENITAL HEART DEFECTS IN THE FETUS

Abstract

Relevance. Cardiovascular pathology today remains one of the main causes of morbidity, mortality and early disability in populations; occupies a leading place among developmental defects in children (up to 30 %). Received data from European and domestic studies indicate an increase in the frequency of the congenital heart defects, which is in the range of 8 -9 per 1,000 live births, depending on geographical differences. Despite significant progress in understanding the mechanisms that determine the formation and development of the heart, causes of the isolated congenital heart defects, in most cases, remain uncertain; they require study of the interaction of many factors, both in the prenatal and in the postnatal period. Objective.  Assessment of clinical diagnostic criteria of pregnant women with isolated congenital heart defects in the fetus for determination of the stages and multidisciplinary approach of their management.  Materials and methods. For the period 2020-2021, 30 pregnant women aged 17 to 39 years were examined on the basis of a hospital sample, with various forms of isolated congenital heart defects who were directed from different regions of Ukraine. The work was conducted on the basis of clinical prospective studies on the basis of an obstetric department CCE KCMH № 5. The selection criteria included: somatically healthy women in term 18-39 weeks of pregnancy, with unencumbered pregnancy, natural fertilization, the presence of an isolated heart defect in the fetus, the absence of a risk for chromosomal pathology in the fetus. Stages in the management of pregnant women using a multidisciplinary approach were determined. Common clinical, instrumental and statistical methods were used during the study. Results. The average age of women with heart defects in the fetus ranged 28.36±5.08. The weight of women with isolated heart defects in the fetus averaged 70.26±10.09, the height of pregnant women corresponded to 164.86±5.39 cm. In 73% of cases pregnant women were referred to the obstetric hospital by cardiologists, ultrasound specialists and in 27% by obstetricians-gynecologists on an outpatient basis. The average gestational age at which the fetus was first detected by ultrasound was isolated from 22.23±5.04 weeks. The total number of ultrasounds in pregnant women with congenital heart defects in the fetus was 4.80±0.92 times. In 54% of cases women had first pregnancy.  Conclusions. Congenital heart defects are not directly dependent on the age of the pregnant woman and her anthropometric data. For the first time, isolated congenital heart defects were determined in second trimester of pregnancy (22 weeks). Considering multifactorial etiology of congenital heart defects, there is a need in a further study of this problem using multidisciplinary approach in diagnosis.