Abstract
Background. Preparation for pregnancy in patients with extragenital pathology is an important problem of current obstetrics. Purpose. To perform comparative assessment of the course and outcomes of pregnancy in patients with undifferentiated connective tissue dysplasia (UCTD) after using conventional and personalized preconception preparation. Material and methods. A total of 262 patients were examined, including 159 with UCTD. Group I (the main group) included 125 patients with minor heart abnormalities and at least 4 signs of undifferentiated connective tissue dysplasia, who underwent the generally accepted preconception preparation: folic acid – 400 μg/day, potassium iodide – 200 μg/day orally for 3 months. Group II (the intervention group) consisted of 34 patients who received personalized preconception preparation: folic acid – 400 μg/day orally, potassium iodide – 200 μg/day orally for 3 months, Mg2+ preparations at a dose of 300 mg/day, glycine –400 mg/day, multivitamin complex containing vitamin B1 (10 mg/day), vitamin B2 (10 mg/day), vitamin B6 (10 mg/day), vitamin E (400 mg/day) for 3 months. Group III (the control group) included 103 patients without signs of UCTD who received a standard amount of preconception preparation. The evaluation of the effectiveness of personalized preconception preparation was carried out according to the criteria of evidence-based medicine. Relative risk (RR), relative risk reduction (RRR), absolute risk reduction (ARR), the number of patients who needed treatment to prevent 1 adverse outcome (NNT), the odds ratio (OR) for a particular outcome were calculated. Results of the study. In the intervention group, statistically significant results were obtained in terms of reducing the risk of developing a threatened miscarriage and preterm birth in patients with undifferentiated connective tissue dysplasia, as well as reducing the absolute risk of developing isthmic-cervical isufficiency. Conclusions. Identification of signs of UCTD at the preconception stage and the use of personalized preconception preparation in this group of patients contributes to the improvement of perinatal outcomes.
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