MODERN VIEWS ON THE PROBLEM OF INTRAUTERINE GROWTH RETARDATION AS A COVID-19 COMPLICATION

Abstract

Relevance: Child growth retardation in utero most often occurs against insufficient intake or absorption of nutrients and oxygen. Such disorders are mainly caused by pathological changes in the fetoplacental system, maternal and fetal organisms, and fetal membranes. Various factors can lead to fetal growth retardation (FGR). Acute infections, gynecological pathologies, endocrine diseases, and malnutrition in women increase the risk of FGR. FGR frequency varies in the population from 3-5% in practically healthy pregnant women to 10-25% with a burdened obstetric-gynecological diagnosis. Morphological and functional disorders in the chorion/placenta in pregnant women against post-covid endotheliitis are the main pathogenetic factors in the development of preeclampsia, FGR, antenatal fetal death, and impaired state of the fetus and newborns. The study aimed to increase the clinical awareness of the medical community regarding the problem of fetal growth retardation against the background of the coronavirus disease transmitted during pregnancy. Methods: Special literature on the pathogenesis, diagnosis, impact on the life and health of a newborn UGR fetus in women after COVID-19, and the possibilities of medical correction of placental dysfunction during pregnancy were analyzed. Results: The article presents current literature data on the impact of COVID-19 (SARS-CoV-2) on the course of pregnancy and perinatal consequences, particularly on the vascular endothelium and the development of placental dysfunction and FGR; it reflects modern views on potential ways for drug prevention of vascular and metabolic disorders in pregnant women against the backdrop of a coronavirus disease; substantiates using an L-arginine-based drug and a sorbitol-based hyperosmolar crystalloid solution to improve microcirculation. Conclusion: Placental dysfunction and FGR after a coronavirus infection during pregnancy often threaten the child’s further development. Sufficient saturation of the gravida’s body with L-arginine as a nitric oxide donor, along with microcirculation improvement and the correction of hypovolemic disorders in the fetoplacental blood flow, can prevent FGR in post-COVID women.