Клінічна ефективність профілактики акушерських та перинатальних ускладнень у вагітних із первинною артеріальною гіпертензією на тлі йододефіциту

Abstract

The objective: reduction in the incidence of obstetric and perinatal complications in pregnant women with primary hypertension in conditions of endemic iodine deficiency based on the study of pregnancy and childbirth course, fetal and newborn conditions after the introduction of the developed complex of preventive and therapeutic measures. Materials and methods. A clinical analysis of 100 pregnant women has been conducted: – control group (KG) – 30 healthy pregnant women living in conditions of endemic iodine deficiency, give birth to the first time, without somatic pathology, had vaginal delivery; – And the group – 30 pregnant women with primary hypertension, who live in conditions of endemic iodine deficiency and received the usual medical and preventive measures; – II group – 40 pregnant women with primary hypertension who live in conditions of endemic iodine deficiency and received the method of prevention of obstetric and perinatal complications developed by us. Clinical and statistical analysis of the course of pregnancy, childbirth and condition of the fetus and the newborn after the introduction of the developed complex of treatment and preventive measures has been carried out. The obtained data are processed by the statistical method using the Microsoft Excel computer program. Results. Due to the use of proposed by us method, we managed to reliably reduce the frequency of gestational anemia (I group – 43.3% vs. 22.5% in group II, p<0.05), development of gestational diabetes (I group – 13.3% vs. 5.0% in the 2nd group, p<0.05), the threat of preterm labor (I group – 16.6% vs. 7.5% in the second group, p<0.05), placental dysfunction (group I – 63.3% vs. 22.5% in the second group, p<0.05); violation of microbiocenosis of the genital tract (group I – 53.3% vs. 17.5% in group ІІ, p<0.05). In addition, a significant reduction in the level of combined preeclampsia (group I – 40.0% vs. 20.0% in group II, p<0.05) and change in the incidence of FGR syndrome (group I – 40.0% vs. 22.5% in the second group, p <0.05). Significant decline in the incidence of developmental delivery complications: premature rupture of fetal membranes (I group – 26.7% vs. 15.0% in group II, p<0.05); preterm labor (group I – 13.3% vs. 5.0% in group II, p<0.05); Fetal distress (group I – 36.6% versus 15.0% in group II, p<0.05). It should be noted that the absence of PDNLP in pregnant group II versus 6.7% incidence of pregnant in group I. Reduction in the level of various forms of newborn asphyxiation: from 26.7% in group I to 15.0% in group II, p<0.05 against the background of the use of the proposed method, severe asphyxia was absent in newborns from pregnancy group II versus 3.3% cases in group І. The total incidence of newborns in the early neonatal period has significantly decreased by 1.7 times (60.0% in group I versus 35.0% in group II, p<0.05). There is no perinatal loss in group II, which also confirms the effectiveness of our proposed method. Conclusions. The proposed therapeutic and prophylactic technique for the prevention of obstetric and perinatal complications in pregnant women with primary hypertension in the background of natural iodine deficiency has made it possible to reliably reduce the frequency of obstetric and perinatal complications. This makes it possible for the proposed method to be recommended for use in therapeutic practice. Key words: course of pregnancy, childbirth, condition of newborn, obstetric and perinatal complications, primary arterial hypertension, iodine deficiency.