Прием прогестагенов во время беременности и частота тяжелой преэклампсии: сравнительный анализ

Abstract

Objective. To study the effect of progestogen administration during pregnancy, particularly of dydrogesterone, on the incidence of severe pre-eclampsia (PE) and its efficacy in preventing PE depending on dosage. Patients and methods. A retrospective comparative study included three groups of pregnant women at risk for severe PE who received dydrogesterone as indicated at a dose of 30 mg (n = 19), 20 mg (n = 24) from 6 to 20 weeks’ gestation, and who did not receive progestogens (n = 98). Results. It was found that the group of pregnant women at risk for severe PE who received dydrogesterone at a dose of 30 mg/day from 6 to 20 weeks’ gestation developed an early-onset PE (before 34 weeks), which is the most adverse form of PE, significantly less frequently and had fewer cases of fetal growth restriction (FGR) and placental insufficiency (sub- and decompensated) compared to similar complications in the comparison group (without dydrogesterone). In the group of pregnant women at risk for severe PE who received dydrogesterone at a dose of 20 mg/day from early pregnancy, there were no statistically significant differences in the onset of PE, the incidence of preterm birth, FGR, and severe placental insufficiency compared to similar complications in the comparison group. Conclusion. The use of dydrogesterone at a dose of 30 mg from early pregnancy until 20 weeks is pathogenetically grounded and effective for preventing PE, reducing the incidence of early-onset PE and, accordingly, preventing adverse obstetric and perinatal outcomes. Key words: pregnancy, pre-eclampsia, prevention, gestagens, dydrogesterone