HEALTH OF WOMAN. 2019.5(141): 63–68;  doi 10.15574/HW.2019.141.63

Vdovichenko Yu. P., Firsova N. O., Maximova V. V.
Shupyk National Medical Academy of Postgraduate Education, Kiev
MC «Isida-IVF», Kiev

The objective: was to reduce the obstetric and perinatal complications in women with the usual miscarriage of pregnancy and the acquired form of thrombophilia by developing, implementing and evaluating the effectiveness of the complex of diagnostic, treatment and preventive measures at the stage of pre-bladder training.

Materials and methods. A survey was conducted on 377 patients with a normal pregnancy incontinence. In 140 (37.1%) women, the pathological level of antiphospholipid antibodies was detected. Depending on the type of pre-bladder preparation, women were divided into two groups: the main (I; n = 80) patients were trained according to the proposed method, and the comparison group (II; n = 60), whose patients were trained according to the protocol. The control group included 30 somatically healthy women without disturbing the generative function.

The examination included: determination of hormonal, immune status, homocysteine ​​level, infectious profile, determination of antiphospholipid antibodies, hemostasis studies of all stages of hemostasis, consultations of adjacent specialists.

Results. The pathophysiological level of antiphospholipid antibodies was found in 37.1% of women with a history of fatal pregnancy. In women of the studied groups, the mild degree of activity of the antiphospholipid syndrome by the level of detected antibodies (10-20 U/D) was 65%, the average degree (20-60 U / D) was recorded at 20%, and in 10% of patients a severe degree was detected (> 60 U.D.). In the group where the developed complex of pre-glare preparation was carried out, the level of antiphospholipid antibodies decreased to normal, the hemostatic potential was normalized, sanation of the secondary infection centers was performed, and the indices of immune and hormonal status were normalized. In patients of Group II, an increased antibody level (> 10 U.D.) was recorded in almost 40% of patients.

The algorithm of pre-glare preparation developed by us allowed to reduce the frequency of involuntary abortions and dead pregnancies by up to 22 weeks by 25% and reduce the frequency of preterm births by almost 25%.

Conclusion. The developed and implemented program of treatment and rehabilitation measures in the pregravidder period allows to reduce perinatal morbidity and mortality in women with the usual miscarriage of pregnancy against the background of antiphospholipid syndrome.

Key words: habitual miscarriage of pregnancy, antiphospholipid syndrome, pregravidar preparation, plasmapheresis, intravenous immunoglobulin.

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