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"code": "O43",
"name": "Плацентарные нарушения",
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"slug": "o43_placentarnye_narusheniya",
"lead": "Плацентарная недостаточность — синдром, обусловленный изменениями в плаценте.",
"description": "Плацентарная недостаточность — синдром, обусловленный морфофункциональными изменениями в плаценте, при прогрессировании которых развивается задержка развития плода, нередко сочетающаяся с гипоксией.",
"etiology": "",
"pathogenesis": "<p>Основную роль в патогенезе плацентарной недостаточности отводят нарушению маточноплацентарной перфузии, что приводит к снижению транспорта кислорода и питательных веществ через плаценту к плоду. </p>\r\n<p> </p>",
"diagnostics": "<p>Беременные группы риска по развитию плацентарных нарушений нуждаются в регулярном клиническом наблюдении. При акушерском осмотре следует обращать внимание на следующие признаки:<br />· рост и вес беременной;<br />· окружность живота, высоту дна матки;<br />· тонус матки (повышен при угрозе прерывания беременности);<br />· наличие кровянистых выделений из половых путей;<br />· число шевелений плода, характер сердцебиения при аускультации (глухость сердечных тонов и изменение частоты сердцебиения).</p>\r\n<p> </p>\r\n<p>Наиболее часто среди инструментальных методов для диагностики плацентарных нарушений используют УЗИ и КТГ. Ультразвуковые методы играют ведущую роль в диагностике плацентарных нарушений и задержке развития плода. Во II и III триметре беременности в сроки ультразвукового скрининга (20–24 нед и 30–34 нед), а также по дополнительным показаниям выполняют ультразвуковую фетометрию и допплерометрическое исследование кровотока в артериях и венах функциональной системы мать–плацента–плод.</p>\r\n<p> </p>\r\n<p> </p>\r\n<p> </p>",
"treatment": "<p>Терапия плацентарной недостаточности в большой мере определяется необходимостью устранения причин нарушения кровообращения в плаценте. У пациенток с угрозой прерывания важным компонентом лечения плацентарной недостаточности является снижение тонуса маточной мускулатуры; при гестозе.</p>\r\n<p>В комплексную патогенетическую терапию плацентарной недостаточности включают, прежде всего, препараты, обладающие вазоактивным действием. </p>\r\n<p>В последние годы широкое применение в акушерской практике для профилактики заболеваний, обусловливающих развитие плацентарной недостаточности и её лечения, применяют антиагреганты.</p>\r\n<p> </p>\r\n<p> </p>",
"prevention": "<p>ПРофилактика включает широкий спектр медикментозных и немедикаментозных мероприятий.<br />· Лечение акушерских и экстрагенитальных заболеваний, предрасполагающих к развитию плацентарной недостаточности.<br />· Регуляция тканевого обмена и окислительно-восстановительных процессов у беременных групп риска по развитию плацентарной недостаточности. С этой целью назначают антиоксиданты, гепатопротекторы.<br />· Нормализация процессов возбуждения и торможения в ЦНС у беременных с астенической конституцией и повышенным уровнем тревожности. Для этого используют ноотропы; глицин, оказывающий значительный антистрессовый эффект.<br />· При вегетососудистой дистонии по гипотоническому типу хороший эффект оказывают адаптогены.<br />· Для нормализации сна используют комплексные фитопрепараты, содержащие экстракты валерианы, боярышника, мелиссы, хмеля, перечной и лимонной мяты.</p>\r\n<p>Лечебно-профилактические мероприятия должны включать диетотерапию, витаминотерапию, продукты и пищевые добавки, стимулирующие функцию кишечника (кисломолочные продукты, хлеб из муки грубого помола, ламинолакт).</p>",
"clinical_picture": "<p>При хронической плацентарной недостаточности беременные предъявляют жалобы, характерные для акушерских и экстрагенитальных заболеваний, на фоне которых развивается хроническая или острая плацентарная недостаточность. Вместе с тем могут отмечать уменьшение числа шевелений плода. </p>",
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"code": "O29",
"name": "Осложнения, связанные с проведением анестезии в период беременности",
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3
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"slug": "o29_oslozhneniya_svyazannye_s_provedeniem_anestezii_v_period_beremennosti",
"lead": "",
"description": "",
"etiology": "",
"pathogenesis": "",
"diagnostics": "",
"treatment": "",
"prevention": "",
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"image": null,
"image_alt": null,
"standard_type": 3,
"danger": 1,
"published": 1,
"parent": null,
"block_rubric": 160,
"standards": []
}
]
}