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[Placental insufficiency in pregnancy with gestosis: pathogenesis, diagnosis, evaluation, and obstetric care strategy].

Pathogenesis of placental insufficiency during pregnancy with gestosis was investigated by high-tech methods including ultrasonography, dopplerometry, echocardiography, and measurement of placental and endothelial growth factors. Their utility for the evaluation of the severity of placental insufficiency was demonstrated. Diagnostic criteria for compensated and uncompensated placental insufficiency were proposed along with an algorithm for the examination of pregnant women with gestosis and obstetric strategies at different severity of this disorder. Also, criteria for prolongation of pregnancy with uncompensated placental insufficiency, indications for planned and emergency delivery by cesarean section were developed. The importance of differential approach to the choice of obstetric strategy to reduce perinatal and maternal morbidity and mortality in case of gestosis and placental insufficiency is emphasized.