Zavadska O. Placental insufficiency in multiple pregnancy.

The goal of this scientific research is to optimize prevention of perinatal complications in women with multiple pregnancy by the development of diagnostic and prognostic criteria for fetal hypoxia using clinical laboratory and functional diagnostics methods. For the first time correlation of blood flow in the placenta bed central spiral arteries and terminal branches of umbilical arteries, serum placental protein levels to parameters of antenatal cardiotocography, ultrasound biometry and results of histological study of placenta is analyzed. Criteria for deterioration in fetal well-being are determined on the basis of comparison of antenatal cardiotocography and ultrasound biometry parameters and pregnancy outcome with blood flow indices in "mother - placenta- fetus" system. The importance of comprehensive antenatal screening for diagnosis of fetal compromise is demonstrated in multiple pregnancy. Comparative clinical aspects of obstetrical and perinatal complications are studied in multiple pregnancy. Demonstrated diagnostic value of utero-placental blood flow indices provides robust basis for prediction and early diagnosis of placental insufficiency, optimization of obstetrical management strategy and choosing the best management plan for delivery.