THE IMPACT OF MATERNAL CHRONIC DISEASES (ANEMIA, HYPERTENSION, DIABETES) ON FETOPLACENTAL INSUFFICIENCY

Abstract

Background: Fetoplacental insufficiency (FPI) is a major complication of pregnancy leading to intrauterine growth restriction (IUGR) and perinatal hypoxia. Maternal chronic extragenital pathologies, specifically iron-deficiency anemia (IDA), chronic hypertension, and diabetes mellitus, are hypothesized to be primary drivers of placental dysfunction in the Fergana Valley region. This study aims to evaluate the specific impact of these conditions on the development and severity of FPI. Methods: A prospective comparative study was conducted involving 200 pregnant women in the third trimester. Participants were divided into four groups: Group I (n=60) with moderate/severe anemia, Group II (n=50) with chronic hypertension, Group III (n=40) with pre-gestational diabetes, and Group IV (Control, n=50) with uncomplicated pregnancies. FPI was assessed using Doppler ultrasonography (umbilical and uterine arteries) and placental morphometry. Results: Signs of FPI were diagnosed in 65% of women in Group II (Hypertension) and 55% in Group I (Anemia), compared to only 8% in the Control Group (p < 0.001). Hypertension was strongly associated with hemodynamic disturbances (elevated Resistance Index), while anemia was linked to placental hypoplasia. Diabetes showed a mixed pattern of placentomegaly and functional insufficiency. Conclusion: Chronic maternal diseases significantly impair placental function through distinct pathophysiological mechanisms. Early screening and aggressive management of anemia and hypertension are crucial for preventing FPI-related perinatal morbidity.