The obtained results created a theoretical basis for optimizing the tactics of pregnancy management in such patients by applying a pathogenetically sound set of treatment and prevention measures. The proposed complex includes assessment of risk factors, additional examinations, monitoring of the condition of the pregnant woman and fetus, treatment measures to prevent placental insufficiency and reduce the negative effects of hyperimmune response (aspirin, dipyridamole, progestogens, intravenous immunoglobulin, vitamin D).To test the effectiveness of the proposed set of treatment and prevention measures, 80 pregnant women were selected after influenza, transmitted in early pregnancy, with a high risk of placental dysfunction. Patients were randomly divided into 2 groups: 40 women whose pregnancies were performed according to optimized tactics (main group) and 40 women (comparison group) whose pregnancies were managed according to the clinical protocols of the Ministry of Health.Testing the effectiveness of the proposed set of measures showed its positive effect on hormonal function of the placenta (normalization of progesterone and estradiol levels), immune status (reduction of NK-cytotoxicity, balance of cytokine profile), elimination of vitamin D deficiency and reduction of procoagulation potential of the hemostasis system.Creating favorable conditions for the development of gestation has reduced the incidence of placental insufficiency by almost 2 times to 35.0% vs. 62.5%. Against the background of the recommended tactics of pregnancy after influenza, the frequency of complications of pregnancy, disorders of the fetus and newborn has decreased significantly.
The purpose of the study: to evaluate the effectiveness of the proposed set of preventive measures for pregnant women after ART with a high risk of preeclampsia. Material and methods. To test the effectiveness of the proposed set of prophylactic measures, 60 pregnant women after ART were selected, which were randomly divided into 2 groups: 30 women who received the recommended complex (main group) and 30 women (comparison group), whose preeclampsia was prevented by order of the Ministry of Health. № 417 "Guidelines for the provision of outpatient obstetric and gynecological care." Results. The use of the recommended measures improves lipid metabolism (significant reduction of triglycerides and low density cholesterol), eliminates vitamin D deficiency, balances the cytokine profile (reduction of proinflammatory focus), reduces the prothrombotic potential of the hemostasis system (reduction of D-dimer and background marker damage). Improving the general condition and the use of psychotherapy can reduce the manifestations of vegetative-vascular dystonia, anxiety and improve quality of life. Such changes provide a more favorable background for the development of gestation. The incidence of preeclampsia decreased by 43.8% (from 26.7 to 15.0%), and mainly due to early preeclampsia, the incidence of which decreased by 78%, no cases of severe preeclampsia were reported. The frequency of placental insufficiency, fetal distress and growth retardation is reduced. The frequency of birth of children in a state of asphyxia is reduced by 2 times (up to 20.0 vs. 46.7%), severe asphyxia is not observed. Significantly lower and the frequency of violations of the period of neonatal adaptation (30.0 vs. 53.3%). Conclusions. The use of treatment and prophylactic complex to prevent preeclampsia in pregnant women after ART can improve a woman's homeostasis, balance vegetative-vascular regulation, reduce the incidence of preeclampsia by 43.8% (from 26.7 to 15.0%) and other complications of pregnancy and childbirth, improve perinatal outcomes. Proven medical, social and economic efficiency of the developed complex allows to recommend it for implementation in medical practice.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.