PREGRAVID PREPARATION IN WOMEN WITH OLIGOMENORRHEA AND CHRONIC HEPATITIS IS PREVENTION OF SUCCESSFUL REALIZATION OF REPRODUCTIVE FUNCTION

Abstract

The article presents the results of a study of the state of pregnant women with oligomenorrhea chronic hepatitis (CH). The aim of the study is to improve the diagnosis and treatment of oligomenorrhoea on the background of CH by developing adequate pathogenetically substantiated methods of treatment, to develop a program of pre-graduation training for women and to determine the effectiveness of pregravid preparation in womenwith this pathology.Material and methods of the study: 82 women with oligomenorrhea and non-viral CH were examined and intended to realize their reproductive function. Patients are divided into 3 groups: 1 group - 17 women, periodically treated with CHC, oligomenorrhea was not treated; Group 2 - 34 women who received standard therapy of CH and hormone therapy of oligomenorrhoea; Group 3 consisted of 31 women receiving CH and oligomenorrhea therapy and pregravid preparation, which included micronized progesterone in the 2nd phase of the menstrual cycle, folic acid and cyclodinone for 6 months before pregnancy. Control group - 30 pregnant women with oligomenorrhea without liver pathology. The anamnesis of menstrual, sexual, reproductive function is studied. Clinical examination, ultrasound of the genitals, liver, determination of liver function and the level of gonadotropic hormones and ovarian hormones are carried out. The results are presented in other publications. The level of indicators of liver function before pregnancy, in 1, 2 and 3 trimesters of pregnancy is determined. The course of pregnancy, the condi-tion of the fetus, the state of the newborn was assessed.Results of the study and their discussion A prospective analysis of the course of pregnancy in women of the 1st group was carried out. 9 (52.9%) patients had spontaneous miscarriages in the first trimester of pregnancy. In 5 (29,4%) infertility was observed from 2 to 4 years. In 6 (35.3%) pregnant women premature birth occurred in the period of 31-34 weeks, in all cases, the intrauterine growth retardation was diagnosed, the newborns were born asphyxiated. In 5 (29.4%) cases, urgent delivery was performed due to a high risk of perinatal loss and worsening of the condition of pregnant women. At 2 (11,7%) timely deliveries took place and healthy children were born. All pregnant women have dysfunction of the placenta. In group 2 spontaneous miscarriages occurred in 5 (14.7%), the threat of termination of pregnancy in 18 (52.9%), placental dysfunction in 26 (76.5%), intrauterine growth retardation in 9 (26.5%) pregnant, newborns were born in asphyxia. In women who received complex pregravid preparation, miscarriages occurred in 2 (6.7%), premature birth in 2 (6.7%), placental dysfunction in 5 (16.7%); delays in fetal growth and asphyxia of newborns in this group of pregnant women have not been revealed. Urgent delivery in 3 (9.7%) cases due to the increase in placental dysfunction.Conclusions: In women with oligomenorrhea and CH have infertility, miscarriage of pregnancy, a violation of the fetus. In women with oligomenorrhea and CH, who became pregnant spontaneously, termination of pregnancy in the first trimester in 52.9%, premature birth - in 35.3%. Women without prescriptive training have dysfunction of the placenta. In 35.3% of women without pre-treatment and pregravid preparations, intrauterine growth retardation and newborn asphyxia are delayed. With exacerbation of CH it is necessary urgent delivery due to the risk of perinatal losses, pregravid preparation reduces this need 3 times. The development of a program of pregravid preparation in women with CH is a weighty method to reduce the risks of perinatal loss: 8 times the number of spontaneous abortions and avoiding the delay in intrauterine growth of the fetus.