Early ultrasound signs of gestational complications in pregnant women with sleep disorders

The objective: to investigate the condition of the fetus and fetoplacental complex according to ultrasound examination (USE) with color Doppler imaging (CDI) in pregnant women with sleep disorders.Materials and methods. At the clinical bases of the Department of Obstetrics and Gynecology No. 1 Shupyk National Healthcare University of Ukraine during 2022–2024 a prospective study of 125 pregnant women aged 18–35 years at 22–30 weeks, with singleton pregnancy was carried out. Pregnant women were divided into the main group (n = 55) with signs of insomnia and the control group (n = 70) – without sleep disorders. The Pittsburgh Sleep Quality Index was used to diagnose sleep disorders.USE was performed on the IMAGIC Agile (BK Medical, USA) device using transabdominal (3.5–5 MHz) and transvaginal (5–9 MHz) sensors. The main fetometric indicators were measured and a CDI was performed with the determination of pulse index (PI) in the uterine arteries (UA) and umbilical cord and fetal vessels, as well as placentography and the amniotic index (AI) were determined. We used the reference norms for the indicated ultrasound indicators according to Fetal Medicine Foundation, Royal College of Obstetricians and Gynaecologists. Statistical processing was performed using MedCalc (MedCalc Software Ltd, Belgium) and Microsoft Excel 365, using the Student’s test, considering the results significant at p < 0.05.Results. Pregnant women with sleep disorders had significantly more frequent ultrasound signs of impaired uterine and placental blood flow: increased PI in UA (p < 0.05), decreased cerebroplacental ratio (CPR) (p < 0.01), asymmetric fetal growth retardation (17.2% vs 6.5%), as well as signs of early maturity and thickening of the placenta in the II trimester of pregnancy.Conclusions. Sleep disorders in pregnant women are associated with early signs of fetoplacental insufficiency, which can be detected according to USE and indices determined during CDI. The most informative markers are increased PI in UA and decreased CPR. Early detection of these changes in the II trimester is important for the prediction and prevention of perinatal complications in the III trimester of pregnancy.