Marshalov DV, Salov IA, Shifman EM, Petrenko AP
Introduction: Given in the literature, there is a possible link between perinatal pathology and intra-abdominal pressure (IAP) in pregnant women. Since intra-abdominal hypertension (IAH) is the companion of obesity, we can assume that there is a casual relation of perinatal complications of high frequency which obese patients with a level of IAP have.
Methods: A pilot study involving 407 patients: 135 of those were patients with the spontaneous labor, 273 were patients with the abdominal delivery. Patients, depending on their body mass index (BMI) were divided into four groups: group I - control (n=117), group II - patients with I degree of obesity (n=158), group III - with II degree of obesity (n=84), group IV - with III degree of obesity (n=48). The groups were divided into subgroups according to the neurological status of a newborn. IAP research was carried out using the indirect method through the bladder. The assessment of mental status of the newborn was performed with the help of NACS scale.
Results: The frequency and severity of the neurological deficit in newborns depended on the level of IAP before delivery and IAP in delivery. The correlational analysis of the degree of asphyxia and neonatal neurologic status is the presence of an average bond strength (r=-0.66, p<0.001). In subgroups where the epidural analgesia was introduced during labor, the overall score on NACS scale was significantly higher (p<0.001). In the groups of patients with severe obesity, the total score on the NACS scale was significantly lower (p<0.05) compared with other methods of anesthesia.
Conclusion: The results of the limited pilot study indicate the impact of the level of IAP of parturient women with obesity on the severity of asphyxia and the neurological status of the newborn in the early neonatal period.
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