PREVENTION OF FETOPLACENTAL INSUFFICIENCY IN HIGH-RISK PREGNANT WOMEN

Abstract

Background: Fetoplacental insufficiency (FPI) remains a leading cause of perinatal morbidity and mortality. Women with somatic pathologies (chronic hypertension, anemia, kidney disease) or a history of obstetric complications constitute a high-risk group for developing FPI. This study aims to evaluate the efficacy of a comprehensive prophylactic regimen initiated in the first trimester for preventing placental dysfunction in high-risk pregnancies. Methods: A prospective randomized controlled trial was conducted involving 240 high-risk pregnant women. Participants were divided into two groups: the Control Group (n=120) received standard antenatal care, while the Main Group (n=120) received a targeted prophylactic complex including low-dose aspirin (150 mg), micronutrient supplementation, and metabolic support (L-arginine) starting from 12-14 weeks. Placental function was monitored via Doppler velocimetry and biochemical markers. Results: The incidence of decompensated FPI was significantly lower in the Main Group (4.2%) compared to the Control Group (18.3%, p < 0.01). Women in the prophylactic group showed better uterine artery flow dynamics and higher birth weight neonates (mean difference +350g). The rate of preterm births associated with placental failure was reduced by 50%. Conclusion: Early initiation of pathogenetically oriented prophylaxis in high-risk women effectively preserves placental function, reduces the severity of hemodynamic disturbances, and improves perinatal outcomes.