MODERN APPROACHES TO TREATMENT ANEMIA OF PREGNANCY WITH USE ENZYMES

Abstract

Introduction. The progressive increase in the frequency of anemia in pregnant women over the last decade (for WHO data from 20% to 80%) causes the urgency of this pathology. Anemia is a factor in the high risk of gestosis, obstetric hemorrhages, miscarriage, perinatal morbidity and mortality, postpartum septic complications. Studies of recent years have demonstrated the pathogenetic role the Coagulation Disorder of the blood in the development of such complications and the need for correction of hemostasis for their prevention and treatment.Aim. To investigate the effectiveness of the proposed complex of ferrotherapy in combination with enzymes in pregnant women with anemia living in the Chernivtsi region on the basis of previously revealed changes in the hemostasis system.Materials and methods. Efficacy of the proposed complex method for the treatment of anemia in pregnant women was analyzed in 103 female residents of the Chernivtsi region with anemia of pregnant women, which was not caused by severe extragenital or obstetric pathology (main group). Among those surveyed were women with a moderate to severe anemia. The control group consisted of 65 women with gestational anemia who received the standard complex therapy. The groups were statistically homogeneous. To assess the effectiveness of the proposed therapy, primary and secondary hemostasis, fibrinolytic activity of blood, markers of Coagulation Disorder were studied.Research results. The paper presents the results of the clinical use of phlogenzime in the complex therapy of anemia of pregnant women, which testifies to the high efficiency of enzymes that contribute to the relief of the chronic Coagulation Disorder of the blood in the above pathology. After the proposed treatment in pregnant women with anemia of varying severity, the recalcification time (by 1.3 times), activated partial thromboplastin time (by a factor of 1.5) significantly increased. Prothrombin time in mild and moderate severity of anemia significantly exceeded the data of women with traditional ferrotherapy, respectively, by 1.56 and 1.57 times (p <0.05). In pregnant women with a medium-severe course of the disease, an arithmetic progression of an increase in the activity of antithrombin III was observed. The concentration of soluble complexes of fibrin-monomer in the blood of pregnant women with anemia of the I degree decreased 4.2 times, in case of anemia of the 2nd degree - 4 times, and in case of anemia of the third degree - by 4.5 times. The level of degradation products of fibrin-fibrinogen decreased by 8.7-10.2 times, while the activity of the Laki-Laurent factor increased by 12.89%, 14.36% and 15.63%, respectively. As a result of treatment, the incidence of obstetric complications significantly decreased. The duration of treatment of the experimental group was 24-26% (5-7 days) less than the duration of the pregnant control group. The number of women with a severe form of the disease also decreased.Conclusions. The results of the use of enzymes in the complex therapy of anemia of pregnant women testify to their high clinical efficacy, contributing to the relief of the Coagulation Disorder of the blood and the reduction in the frequency of obstetric anesthesia with the above pathology.