Профилактика плацента-ассоциированной патологии во втором триместре у беременных группы риска

Abstract

Objective. To justify drug-based preventive treatment in the second trimester of pregnancy in women at risk of developing placental pathology in order to reduce the incidence of adverse perinatal outcomes. Patients and methods. A comprehensive analysis of the course and outcomes of pregnancies in 598 women was carried out. Each pregnant woman at 11-13 weeks was assigned to a low-, moderate- or high-risk group of developing placental pathology with the use of designed scale. In the main group, 299 pregnant women did not receive medications in the second trimester, and 299 patients in the comparison group, who were selected by matching method (copy-pasted pairs), if there was a risk in the second trimester, received treatment including micronized progesterone, vitamin D, omega-3 polyunsaturated fatty acids, magnesium citrate and in case of medical indications – antiplatelet agents and anticoagulants. In risk groups, dynamic cardiotocography (CTG) was performed at 16 and 20 weeks on the General Meditech device. Results and conclusion. Administration of the recommended set of medicines in the second trimester made it possible to achieve a decrease in the incidence of pre-eclampsia by 2.9 times, gestational hypertension – by 2.4 times, disorders of the placental circulation – by 3.6 times, fetal growth restriction – by 2.4 times, neonatal morbidity – by 2.9 times. Carrying out a full complex of drug-based preventive measures in the second trimester of pregnancy had an effect on the CTG parameters, statistically significantly reducing the frequency of unfavorable prognostic factors at 20 weeks compared with the results at 16 weeks. Key words: vitamin D, fetal growth restriction, cardiotocography, placental pathology, pre-eclampsia, progesterone