Prevention of fetal growth restriction in placental insufficiency

The occurrence and development of such complications of pregnancy as preeclampsia, placental insufficiency, fetal growth restriction can be mediated by the systemic vascular damage. Understanding the pathophysiological mechanisms in the mother-placenta-fetus system contributes to the improvement of diagnostic methods and the selection of pathogenetically valid therapy for certain obstetric complications. In the systemic inflammatory response syndrome accompanying obstetric complications, the uncontrolled and excessive activation of proinflammatory mediators occurs, which leads to generalized tissue damage and development of multiple organ failure. The use of antiplatelet agents at a preventive dose in pregnant women with high risk of placental insufficiency and fetal growth restriction contributes to the reduction of systemic and placental blood flow disorders by affecting the vascular endothelium, increasing the synthesis of prostacyclin and nitric oxide, thereby implementing its angioprotective properties and increasing blood flow in the arteries and existing collaterals. The obtained data showed that adding of dipyridamole to the algorithm for managing pregnant women with high risk of placental insufficiency and fetal growth restriction, starting from the II trimester of gestation allows to reduce the risk of endotheliopathy and thrombophilia, improve obstetric and perinatal outcomes.