Звичне невиношування: що необхідно робити і чого робити не слід (Огляд)

Abstract

The article presents an overview of domestic and foreign publications on pregravid preparation and early pregnancy in women with a history of habitual miscarriage (HM). Modern terminology is presented, questions about the causes of this pathology are considered and ways of its overcoming are determined. The views of specialists from leading institutions and obstetric and gynecological communities of the world on the issues of pregraved preparation and management of pregnancy in women with HM are presented. Among the main issues considered are the following: optimal timing for the next pregnancy; key recommendations on the management of women with HM (genetic examination, routine administration of progesterone preparations, correction of the «male factor», psychoemotional disorders, anatomical defects of female reproductive organs); the management of women with reproductive losses in the history on the background of antiphospholipid syndrome and congenital thrombophilia. It was noted the need to correct the infectious component of miscarriage. The role of vitamin and micronutrient supplementation in women with HM and their required quantity at the stage of pregravid preparation (folates, iron, iodine, vitamins D, B12) is defined. The evidence base on the use of sublingual and vaginal forms of micronized progesterone (luteina) for correction of the II phase of MC and early pregnancy in women with HM is presented. The emphasis is also on what should be avoided: unreasonable and unjustified prescriptions without special indications (additional examinations, medications, etc.). Key words: habitual miscarriage, pregravid preparation, key recommendations, micronutrient supplementation, micronized progesterone, gestalider, luteina.