Evaluation of clinical efficacy of preventive therapy in pregnant women with ulcerative colitis

Abstract

Annotation. “Voluntary childlessness” as a consequence of fear of infertility, doubts about the ability to cope with pregnancy in the presence of the disease, the hereditary nature of the disease and adverse effects on the fetus; improper medication; self-modification or discontinuation of therapy in patients with CIBD (chronic inflammatory bowel disease) are significant not only medical but also social problems that currently remain unresolved. The aim of this work is to provide up-to-date evidence for the optimal diagnosis and treatment of chronic inflammatory bowel disease before conception, during pregnancy and in the postpartum period. A detailed analysis of the social, somatic, gynecological and obstetric history of women with inflammatory bowel disease was performed. The examined patients were divided into the main group (ulcerative colitis) (n=40) and control groups (almost healthy women) (n=30). The first main clinical group underwent prophylactic therapy using a drug containing active folate of the 4th generation "Quatrefolic" (equivalent to 400 μg of folic acid), potassium iodide 1 table. per day and vitamin D 1000 IU per day, starting from the planning stage of pregnancy). The second major clinical group received, in addition to Quatrefolic and potassium iodide, vitamin D 4,000 IU per day during the pre-pregnancy phase and 2,000 IU per day during pregnancy and 1,000 IU per day in cases of placental dysfunction and anemia. The formation of observation groups was carried out by methods of continuous and selective analysis. Statistical processing of research results was performed using the software package Statistica 6.0. The obtained indicators were processed statistically with the determination of the arithmetic mean (M) and the error of the standard deviation (±m), at p<0,05. Risk ratio (RR) and confidence interval (CI) were determined with a given reliable probability p=95%. Comparison of groups by case frequency was performed using the exact Fisher test (two-way criterion). Pregnant women with ulcerative colitis have a better clinical efficacy of preventive therapy using the 4th generation active folate “Quatrefolic” (equivalent to 400 mcg of folic acid) and vitamin D 4000 IU at the pre-pregnancy stage and 2000 IU after pregnancy verification compared with active folate 4th generation “Quatrefolic” (equivalent to 400 mcg of folic acid) and vitamin D 1000 IU.