Shatylovytch K. Prediction of perinatal outcome based on assessment of fetal hemodynamics

The thesis is devoted to providing the reduction of perinatal morbidity and mortality by improving the accuracy of diagnostics of fetal condition by means of examining the peculiarities of fetal hemodynamics change in physiological and pathological course of pregnancy. The leading etiological factors and the consequences of circulatory disorders in the mother-placenta-fetus system have been elucidated on the basis of clinical and anamnestic characteristics, data of cardiotocography, ultrasound and Doppler ultrasound researches. Low diagnostic accuracy of the BPS parameters and blood flow resistance indices in the uterine, placental bed and umbilical cord vessels in predicting the adverse perinatal outcomes have been established. The research has revealed the dynamics of arterial, venous and intracardiac blood flow with the progression of fetal gestational age, and also normative parameters of blood flow through the vessels and heart valves have been established. The widespread introduction of the monitoring technology of the high-risk pregnancies allowed to improve perinatal outcomes for both mother and fetus, to reduce perinatal morbidity and mortality.