Ultrasonographic peculiarities of fetoplacental complex in pregnancy complicated by intrauterine infection.

Introduction: the relevance of intrauterine infections is determined by significant peri- and postnatal loss as well as health impairment, which often results in disability and reduced quality of life. Ultrasonography is employed in order to provide a reliable assessment of the functional state of the fetoplacental system secondary to intrauterine fetal infection in the course of pregnancy. Ultrasound imaging is essential in diagnosis of various preclinical complications of pregnancy and detection of abnormalities in the developing fetus. The aim of the study was to perform ultrasonographic assessment of fetoplacental complex in pregnancy complicated by intrauterine infection.

Materials And Methods: the study involved 304 pregnant women who underwent ultrasonographic and bacteriological somatogenic examination. The women were divided into the following groups depending on the presence and nature of the diagnosed infection: Group 1 - 50 patients with normal pregnancy, who were not found to have signs of infection (control group), Group 2 - 50 pregnant women with viral infections (CMV and herpes simplex virus); Group 3 - 50 pregnant women with bacterial infections (chlamydia, ureaplasma, mycoplasma), Group 4 - 154 patients with mixed viral and bacterial infections. Clinical groups with intrauterine infections (IUI) were considered main ones.

Results: increased echogenicity of the endothelium of internal and provisional organs was considered to be the main ultrasonographic sign of intrauterine fetal infections as these changes were equally observed in pregnant women of the main group. Main symptoms of viral infections included ventriculomegaly, hypoplasia of the chest, echogenic fibrous inclusions in the papillary muscles and valve flaps, hepatomegaly, placental hypoplasia, oligohydramnios. Dolichocephalic skull, choroid plexus cysts, gastromegaly, placental calcifications, polyhydramnios were more common in bacterial infections. Pregnant women with mixed viral and bacterial infections were found to have those and other signs of infection in equal measure.

Conclusion: ultrasonographic somatogenic examination is of great diagnostic importance in preclinical diagnosis of intrauterine infection. Timely detection of changes in fetus and provisional organs provides a differentiated approach to administration of pathogenetically targeted treatment of this group of patients.