• Miscarriage of pregnancy: modern approaches to diagnostics, prevention, and treatment

Miscarriage of pregnancy: modern approaches to diagnostics, prevention, and treatment

PERINATOLOGIYA I PEDIATRIYA. 2017.2(70):91-98; doi 10.15574/PP.2017.70.91

Zhivetskaya–Denisova A. A., Vorobyova I. I., Tkachenko V. B., Rudakova N. V.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv

Objective — to develop a complex of preventive and curative measures, targeted at preterm miscarriage rate reduction, decrease of a number of perinatal period complications and perinatal mortality.

Materials and methods. A total of 153 female patients were underwent an observed treatment of threatened miscarriage in the obstetrical clinics of the SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine» during the period of 2015–2016. All the patients had the higher risk factors of threatened miscarriage, who were performed a molecular genetic testing in the SI «Institute of Molecular Biology and Genetics of NASU» at early pregnancy according to the certain medical indications. Peculiarities of allelic polymorphism of the detoxification system genes, folate metabolism, blood-coagulation factors, interleukins, endothelium receptors and functions in women with recurrent miscarriage, and interaction patterns with hormonal, immune and biochemical homeostasis as well were studied. For the purposes of clinical evaluation of treatment given efficacy, the pregnants were divided into two groups: the 1st group comprised 74 female patients who were treated with standard (hormonal and symptomatic) therapy of threatened miscarriage; the 2nd group included 80 pregnant women who were provided with the recommended therapy. Statistical data processing was carried out by using the Fisher angular transformation. The degree of probability (P) between two comparative values was considered to be statistically valid with P<0.05. The average age of the examined women was 33.4±5.2 years old. The research results confirmed the multifactorial nature of miscarriage. Through the use of innovation technologies in the diagnosis and treatment of threatened miscarriage, it was possible to reduce the rate of preterm labour and spontaneous miscarriages by more than 11%. The application of the recommended pathogenetic therapy allowed to reduce the number of gestation course complications, improved its prolongation to the term at which the newborns viability is significantly higher.

Conclusions. The most effective method of pregnancy loss prevention is preconceptional preparation. Special attention should be paid to the early, prior to clinical manifestation detection of women with high risk of miscarriage.

Key words: miscarriage, multifactorial pathology, diagnostics, prophylactics, treatment.

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