В.Н. Сидоренко, И.С. Кухта, Е.О. Барановская, Я.Б. Станкевич, А.В. Годяева, А.А. Будкина
УО «Белорусский государственный медицинский университет, УЗ «5-я городская клиническая больница
В статье представлены собственные данные и обобщены данные литературы, касающиеся причин, методов диагностики и лечения задержки роста плода. Хроническая фетоплацентарная недостаточность и задержка роста плода являются актуальными акушерскими проблемами, требующими тщательного подхода к диагностике, динамике наблюдения, лечению и принятию коллегиального решения для выбора стратегии о методе и сроке родоразрешения. Согласно мнению отечественных и зарубежных исследователей, ЗРП диагностируют на основании снижения массы тела конкретного плода по сравнению со среднестатистической массой, соответствующей данному сроку беременности. Проведен сравнительный анализ достоверности диагнозов хронической фетоплацентарной недостаточности и задержки роста плода на амбулаторном и стационарном этапах. Показано, что внедрение в клиническую практику шкалы INTERGROWTH-21st позволяет не только своевременно диагностировать задержку развития плода, но и в определенной степени снизить частоту необоснованного выставления диагноза ЗРП и связанного с ним досрочного оперативного родоразрешения.
ключевые слова: беременность, задержка роста плода, хроническая фетоплацетарная недостаточность, шкала INTERGROWTH-21st
Insufficient growth of the fetus: modern possibilities of prenatal diagnostics in the practice of an obstetrician-gynecologist
V.N. Sidorenko, I.S. Kuchta, E.O. Baranovskaya, Y.B. Stankevich, A.V. Godyaeva, A.A. Budkina
The article presents its own data and summarizes the literature data concerning the causes, methods of diagnosis and treatment of fetal growth restriction. Chronic placental insufficiency and fetal growth restriction are relevant obstetric problems that require a careful approach to diagnosis, follow-up dynamics, treatment and collegial resolution for choosing a strategy for the method and timing of delivery. According to the opinion of researchers, IGR is diagnosed on the basis of a decrease in the body weight of a particular fetus in comparison to the average weight corresponding to the gestational age. A comparative analysis of the reliability of diagnoses of chronic placental insufficiency and fetal growth restriction at the outpatient and inpatient clinics was carried out. It has been shown that the introduction of the INTERGROWTH-21st scale into the clinical practice allows not only to punctually diagnose fetal growth restriction, but also to a certain extent reduce the frequency of unjustified diagnosis of IGR and associated with it early operative delivery.
keywords: pregnancy, fetal growth restriction, chronic placental insufficiency, INTERGROWTH-21st scale
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Поступила 21.01.2022 г.
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