PERINATOLOGIYA AND PEDIATRIYA.2019.2(78):27-31; doi 10.15574/PP.2019.78.27

Krut Yu. Ya., Shevchenko A. О., Syusyuka V. G., Belenichev I. F.
Zaporozhye State Medical University, Ukraine

Introduction. One of the important problems in preserving reproductive potential is the prevention of miscarriage of pregnancy, which requires more detailed study in order to prevent spontaneous miscarriages, premature births and the birth of children with low birthrate.

Purpose — to evaluate the effect of combined treatment of pregnant women with the threatened preterm labor on the stress-resistance of their organism, obstetric and perinatal effects of delivery.

Patients and methods. The study involved 85 pregnant women at 22–34 weeks of pregnancy. The main group included 43 women with threatened preterm labor receiving natural progesterone and Dalmaksin (thiotriasolini). Conduction of 42 pregnancies of women from comparative group (women with preterm labor) was according with the current MOH Order No. 624 dated November 3, 2008. For pregnant women a comprehensive psychological examination and an assessment of the level of insulin and cortisol in serum using the immunoassay method were conducted.

Results. Describing the dynamics of anxiety levels after 7 and 10 days of therapy, women in the study group experienced a decrease in the level of SA, which is a marker of emotional stress response. However, later, a statistically significant decrease only in the main group after 2 weeks of treatment was established (p<0.05). The mean serum cortisol levels did not have a statistically significant (p>0.05) difference in treatment dynamics. But average insulin level was 15.9 μM/ml, and after one week of treatment statistically significantly increased to 34.7 μMe/ml (p<0.05). There were no such changes among pregnant women in the comparison group. Also, an increase in insulin / cortisol index in the dynamics of treatment in pregnant women in the main group with 0,027 U.M. to 0,066 UM was established. A similar growth occurred in the comparison group (0.027 U and 0.033 U.M., respectively) too, but its increase was not significant. The analysis of obstetric and perinatal consequences of delivery shows that the preterm labor birth rate was 23.8% in comparison group and significantly exceeded the indicator of the main group (14.0%). The percentage of perinatal morbidity in the comparison group was significantly (p>0.05) higher and was 40.5% in comparison with the main group (14.0%).

Conclusions. The results of the study allowed to establish the positive effect of the proposed comprehensive treatment of pregnant women with the threat of premature birth on the hormonal balance, which helps to increase the stress-resistance of the organism of pregnant women. The use of natural progesterone and Dalmaxin complex in pregnant women with a threat of preterm labor contributed to a decrease in their frequency (14.0% vs. 23.8%), and a positive effect on the percentage of perinatal pathology (14.0% vs. 40.5%), which gives every reason to recommend the proposed scheme of treatment.

Key words: pregnancy, threat of preterm labor, hormones, stress-resistance, treatment, progesterone, Dalmaxin.

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Article received: Feb 13, 2019. Accepted for publication: Jun 20, 2019.