Main Article Content
Abstract
Goal – to assess the effectiveness of pregravid preparation at women, taking into account the revealed risk factors for severe preeclampsia.
Material and methods. The research refers to 208 patients with risk factors for severe pre-eclampsia who were divided into two groups. The main group included 118 women who did not get pregravid preparation and were prematurely delivered (up to 33 weeks of gestation inclusive) due to severe preeclampsia. The comparison group consisted of 90 women who got pregravid preparation in view of risk factors, whose pregnancy was not complicated by severe preeclampsia and ended with delivery in time.
Results. Risk factors for severe pre-eclampsia determined during the clinic-laboratory investigation: pre-eclampsia in anamnesis, extragenital pathology (obesity, chronic pyelonephritis, chronic arterial hypertension), combinations of polymorphisms of hemostasis and folate cycle genes, hereditary hypertension, late reproductive age. The average number of risk factors per patient was 2.64. Women who got pregravid preparation in view of risk factors did not have severe preeclampsia, but moderate pre-eclampsia developed in 60 % of cases. It allowed to deliver in time, to reduce the frequency of Cesarean section by 3 times, to avoid perinatal losses and severe damages of newborns’ central nervous system.
Conclusion. Pregravid preparation of patients with risk factors for severe preeclampsia allows to reduce heaviness of its clinical manifestations, frequency of abdominal delivery and to avoid adverse perinatal outcomes.Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
Obstetrics. National leadership. Short edition /ed. Eilamazyan EK, Serov VN, Radzinsky VE, Savelyeva GM. M.: GEOTAR-Media, 2013. 608 p. Russian (Акушерство. Национальное руководство. Краткое издание /под ред. Айламазяна Э.К., Серова В.Н., Радзинского В.Е., Савельевой Г.М. М.: ГЭОТАР-Медиа, 2013. 608 с.)
Dolgushina VF, Vereina NK. Inherited and acquired thrombotic risk factors in women with a history of obstetric pathology. Obstetrics and gynecology. 2011; (3): 27-31. Russian (Долгушина В.Ф., Вереина Н.К. Генетические и приобретенные факторы риска тромбозов у женщин с акушерской патологией в анамнезе //Акушерство и гинекология. 2011. № 3. С. 27-31)
Igitova MB. High risk pregnancy (clinical and pathogenetic aspects): monograph of the territorial state institution «Regional informational center». Barnaul, 2013. 124 p. Russian (Игитова М.Б. Беременность высокого риска (клинико-патогенетические аспекты): монография – КГБУ «Краевой справочно-информационный центр», 2013. 124 с.)
Alanis MC, Johnson DD. Early initiation of severe preeclampsia induction of labor is versus elected cesarean delivery and newborn. Am J Obstetrics and Gynecology. 2008; 199(3): 262
Makarov OV, Tkacheva ON, Volkova EV. Preeclampsia and chronic hypertension. Clinical aspects. M.: GEOTAR-Media, 2010. 136 p. Russian (Макаров О.В., Ткачева О.Н., Волкова Е.В. Преэклампсия и хроническая артериальная гипертензия. Клинические аспекты. М.: ГЭОТАР-Медиа, 2010. 136 с.)
Pregravid preparation: clinical protocols /ed. by Radzinsky VE. M.: Editorial Board Status Praesens, 2016. 80 p. Russian (Прегравидарная подготовка: клинический протокол /под ред. В.Е. Радзинского. М.: Редакция журнала Status Praesens, 2016. 80 с.)
Kuznetsova IV, Konovalov VA. The value of vitamin and mineral complexes in the normal course of pregnancy and fetal development. Gynecology. 2015; (1): 60-64. Russian (Кузнецова И.В., Коновалов В.А. Значение витаминно-минеральных комплексов в обеспечении нормального течения беременности и развития плода //Гинекология. 2015. Т. 17, № 1. С. 60-64)
Makarov IO, Borovkova EI. Nutrition of women during pregnancy. Gynecology, Obstetrics and Perinatology. 2011; (4): 90-94. Russian (Макаров И.О., Боровкова Е.А. Питание женщин во время беременности //Вопросы гинекологии, акушерства и перинатологии. 2011. Т. 10, № 4. С. 90-94)
Putilova NV. Thrombophilia and pregnancy, prediction of perinatal complications and optimization of management tactics. Obstetrics and Gynecology. 2011; (4): 31-35. Russian (Путилова Н.В. Тромбофилии и беременность, прогнозирование неонатальных осложнений и оптимизация тактики ведения //Акушерство и гинекология. 2011. № 4. С. 31-35)
Momot AP, Molchanova IV, Batrak TA, Belozerov DE, Trukhina DA, Kudinova IIu et al. Reference values of hemostatic system parameters in normal pregnancy and after delivery Problems of reproduction. 2015; (1): 89-97. Russian (Момот А.П., Молчанова И.В., Батрак Т.А., Белозеров Д.Е., Трухина Д.А., Кудинова И.Ю. и др. Референсные значения показателей системы гемостаза при физиологической беремености и после родоразрешения //Проблемы репродукции. 2015. Т. 21. № 1. C. 89-97)
Greer IA. Low molecul weight heparin for pregnancy complications? Thromb Res. 2009; 123(3): 22-25