Method of assessment of the fetal condition during tocolytic therapy

Aim: To study the Doppler patterns of fetal condition at threat of premature delivery.

Materials and methods: Parameters of blood flow (S/D ratio) in middle cerebral arteries of 180 women with physiological pregnancy and 326 women with complicated pregnancy were investigated in II-III trimesters. All women were divided into 3 groups: 1-st group –180 women with uncomplicated pregnancies, 2-d –163 women with pregnancies complicated by threat of preterm deliveries without tocolytic therapy 3-d –163 women with pregnancies complicated by threat of preterm deliveries with tocolytic therapy. Our study was followed by breath-holding test.

Results: Three types of the fetus reaction were discovered: with breath-holding test: I type – dilatation of middle cerebral artery; II type – spasm of middle cerebral artery; III type – absence of any reaction of middle cerebral artery during breath-holding.

During analysis of the fetus condition the first type of reaction was followed by adequate fetal condition. The second type always was followed by signs of development delay. The clinical significance of the III type of reactions was related to the type of pregnancy. In the second clinical group the absence of reaction to breath-holding was accompanied lower rate of growth of fetus and worsening of biophysiological profiles of the fetus. In the group of pregnant women receiving gynipral the absence of reactions of the fetus did not indicate any pathological conditions.

Conclusion: The breath-holding test can be effectively utilized for assessment of the condition and adaptive reserves of fetuses during tocolytic therapy.