Clinical efficacy of pregravid preparation in induced pregnancy on a background of thyroid gland pathology

Abstract

The aim of study. To increase the efficiency of reproductive function restoration in women with infertility on the background of thyroid gland pathology, prevent miscarriage, reduce the incidence of gestational complications, improve perinatal outcomes and reduce neonatal morbidity.Study design. 221 women with infertility on the background of thyroid pathology were examined. Patients were divided into two clinical groups. The group I consisted of 92 women with induced pregnancies (IB) who received pregravid preparation: oral Ogestan® micronutrient complex (potassium iodide in a daily dose of 150 μg, folic acid 400 mg, vitamin D 5 μg, omega-3 fatty acids 200 mg docosahexaenoic acid, vitamin E 12 mg), micronized progesterone (Utrogestan®) 200 mg in the II phase of the menstrual cycle was intravaginal. Group II (129 women) with IB did not receive pregravid preparation.Results. In the group I 56 women (60.9%) became pregnant after induction of pregnancy, in the group II – 62 women (48.1%). The level of hormones in the serum showed the clinical effectiveness of pregravid preparation according to the method proposed by the authors. Thus, in pregnant women of group I low normal levels of TSH and high normal levels of free T4 were noted, which is a prognostically favorable index for the induction of ovulation. On the levels of progesterone and estradiol in pregnant women of group II, the stress of functioning of the mother-placenta-fetus system was noted, which led to a significantly high frequency of obstetric and perinatal complications. Analysis of the flow of pregnancy and childbirth in the group I showed a significantly lower frequency of a number of complications, which led to a significantly lower frequency of abdominal delivery (64.0%) and neonatal morbidity in the early neonatal period (14.8%).Conclusion. The inclusion of the Ogestan® complex in the schemes of pregravid preparation of women with infertility on the background of pathology of the thyroid gland is an effective way to replace the deficiency of the most important micronutrients and can be recommended for practical use.