- Pathogenetic approach of preterm labour treatment in the background of chronic infection source
Pathogenetic approach of preterm labour treatment in the background of chronic infection source
HEALTH OF WOMAN. 2017.3(119):54–58; doi 10.15574/HW.2017.119.54
Heryak S. N., Petrenko N. V., Dobryanskа V. Yu., Yakimchuk O. A.
SHEI «Ternopil state medical University Horbachevsky of the MH of Ukraine»
The objective was to study the effectiveness of the application of the sublingual form of micronized progesterone for the treatment and prevention of premature birth in women with concomitant risk factors against the background of the infectious inflammatory component in the anamnesis.
Materials and methods. The study was conducted in two stages. At the first stage, 100 stories of pregnant women with preterm labor were analyzed at a period of 22-36 weeks, which were inpatient treatment in the Ternopil Regional Clinical Perinatal Center «Mother and Child». A comprehensive assessment of risk factors for the development of preterm labor and the effectiveness of their management was carried out. At the second stage of the study, 27 pregnant women (group 1) who were hospitalized with a threat of premature birth and had an anamnesis history, were treated with natural micronized progesterone Lutein in a dose of 100 mg sublingually twice a day. The comparison group (group 2) included 30 pregnant women, who before traditional hospitalization began traditional tocolytic therapy with calcium channel blockers. The control group included 20 pregnant women with a physiological pregnancy.
Results. As a result of the proposed therapy, a decrease in the intensity of the pain syndrome in patients taking micronized progesterone was observed at 25 min faster (p <0.05) than after conventional therapy (85.2 ± 7.4 min in the 1st group and 110.6 ± 9.8 min – in the second group). At the same time, anxiety level was 16.1 ± 1.8 points in patients of the 1st group, which corresponded to its absence, while the patients of the 2nd group continued to be in a state of moderate anxiety (19.3 ± 1.4 points). Pregnant women with a threat of preterm birth who had an inflammatory process of any localization in the past had a significant increase in the level of proinflammatory cytokines (IL-2, IL-6, TNF-?) and a decrease in the level of anti-inflammatory cytokines (IL-4, IL- 10) in comparison with the indicators of healthy pregnant women. The use of micronized progesterone and conventional therapy positively affects these indicators.
Conclusion. The use of the sublingual form of micronized progesterone in the preparation of Lutein at a dose of 200 mg per day is pathogenetically grounded and provides a rapid arrest of the manifestations of premature birth in women with miscarriage in the background of chronic foci of infection.
Key words: premature birth, inflammation, micronized progesterone.
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