docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2022-21-1-13-17docru-126Research ArticleАКУШЕРСТВО И ПЕРИНАТОЛОГИЯOBSTETRICS AND PERINATOLOGYПлацентометрия в прогнозировании ранней преэклампсииRole of Placentometry in Prediction of Early Preeclampsiahttps://orcid.org/0000-0001-9968-0744ЩеклеинаК. В.SchekleinaK. V.

Щеклеина Ксения Владимировна — врач акушер-гинеколог, врач ультразвуковой диагностики Центра антенатальной охраны плода; младший научный сотрудник лаборатории гемостаза

656038, г. Барнаул, пр-т Ленина, д. 40

40 Lenin Prospect, Barnaul, 656038

154 Fomin St., Barnaul, 656048

schekleinakv@gmail.comhttps://orcid.org/0000-0001-9459-5698НиколаеваМ. Г.NikolaevaM. G.

Николаева Мария Геннадьевна — д. м. н., профессор кафедры акушерства и гинекологии с курсом ДПО; старший научный сотрудник

656038, г. Барнаул, пр-т Ленина, д. 40

40 Lenin Prospect, Barnaul, 656038

51 Malakhov Str., Barnaul, 656050 

nikolmg@yandex.ruФГБОУ ВО «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации ; КГБУЗ «Алтайский краевой клинический перинатальный центр» ДАРРоссияAltai State Medical University (a Federal Government-funded Educational Institution of Higher Education), Russian Federation Ministry of Health ; DAR, Altai Territorial Perinatal Clinical Center (a Territorial Government-funded Healthcare Institution)Russian FederationФГБОУ ВО «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации ; Алтайский филиал ФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской ФедерацииРоссияAltai State Medical University (a Federal Government-funded Educational Institution of Higher Education), Russian Federation Ministry of Health ; Altay Branch of the National Medical Research Centre of Haematology of the Ministry of Health of the Russian FederationRussian Federation202217022025211ГИНЕКОЛОГИЯ1317Copyright © Щеклеина К.В., Николаева М.Г., 20252025Щеклеина К.В., Николаева М.Г.Schekleina K.V., Nikolaeva M.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/126Цель исследования

Цель исследования: определить предикторы развития ранней преэклампсии (ПЭ), по данным плацентометрии, при проведении ультразвукового скрининга в сроки гестации 19–21 неделя у женщин низкого риска ПЭ.

Дизайн

Дизайн: исследование типа «случай — контроль» (метод «копи-пара»).

Материалы и методы

Материалы и методы. В исследование вошли 80 беременных женщин. Основную группу составили 40 пациенток с реализовавшейся ранней ПЭ, сроки родоразрешения — 28–32 недели гестации. Контрольная группа — 40 женщин, родивших в срок детей без признаков гипотрофии. Проанализированы данные ультразвукового исследования, проведенного в сроки гестации 19–21 неделя, с целью расчета индекса плацентарного отношения (PRi).

Результаты

Результаты. Медиана PRi в контрольной группе составила 6,68 и была значимо меньше, чем аналогичный показатель в основной группе — 7,65 (р < 0,0001). Рассчитано пороговое значение показателя PRi, позволяющее прогнозировать раннюю ПЭ в группе низкого риска ее развития, — PRi ≥ 7 позволяет прогнозировать возникновение ранней ПЭ в 91,3% случаев, при этом чувствительность теста составляет 90%, специфичность — 87,5%.

Заключение

Заключение. Проведение плацентометрии в сроки гестации 19–21 неделя с расчетом PRi при длине (диаметре) плаценты 120–167 мм позволяет прогнозировать развитие ранней ПЭ у пациенток низкого риска и своевременно стратифицировать беременных для проведения дополнительных обследований и профилактических мероприятий.

Study Objective

Study Objective: To identify predictors of early preeclampsia (PE) according to placentometry results, when an ultrasound screening is performed at week 19–21 of pregnancy in women with low risk of PE.

Study Design

Study Design: Case–control study (paired comparison method).

Materials and Methods

Materials and Methods. The study enrolled 80 pregnant women. The study group included 40 patients with early PE, delivery time: week 28–32 of pregnancy. Controls were 40 women who delivered term infants without any signs of hypotrophy. We analysed ultrasound findings at week 19–21 of pregnancy in order to calculate the placental ratio score (PRi).

Study Results

Study Results. Median PRi in controls was 6.68, i.e., significantly lower than in the study group (7.65 (р < 0.0001)). We calculated the threshold value of PRi which allows forecasting early PE in the low-risk group: PRi of ≥ 7 makes it possible to forecast early PE in 91.3% of cases, with the sensitivity of 90% and specificity of 87.5%.

Conclusion

Conclusion. Placentometry at week 19–21 of pregnancy with PRi calculation, where the length (diameter) of placenta is 120–167 mm, allows forecasting early PE in low-risk patients and timely stratifying pregnant women for additional examinations and preventive measures.

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The authors declare that there are no conflicts of interest present.