HEALTH OF WOMAN. 2019.1(137):28–31; doi 10.15574/HW.2019.137.28

Kravchenko O. V.
HSSIU «Bukovinian state medical University», Chernivtsi

The objective: development of a differentiated approach to the appointment of hormone therapy in the second trimester of gestation in pregnant women after IVF.

Materials and methods. Under the supervision there were 28 women whose pregnancy was due to ART. The exclusion criteria for the study were: multiple pregnancy, abnormal development of the female genital organs, severe extragenital pathology in matter, and congenital abnormalities of the fetus.

All pregnant women were comprehensively examined and conducted in the first trimester according to the programs of reproduction centers where IVF occurred. Additionally, transvaginal ultrasound was performed using a special three-dimensional VOCAL program.

Results. The vast majority of women (73.1%) had chorionic hypoplasia. The chorion vascularization index was also lower in 76.9% of pregnant women after IVF. 23.1% of pregnant women after IVF, in which the growth of the chorion and its vascularization corresponded to the gestational rate, and also there were no signs of a threatened miscarriage, hormone therapy was gradually canceled. 76.9% of patients with induced pregnancy and impaired chorion development continued to receive micronized progesterone Lutein until 18–20 weeks of gestation, as well as venotonic Normoven and Architol metabolic agent (from 14 to 18 weeks gestation).

The effectiveness of the proposed therapy was evaluated according to the nature of blood flow in the myometrium. Thus, analysis of blood flow in the uterine and spiral arteries at the end of the first half of pregnancy showed that in 85% of pregnant women the average resistance index (IR) in both the spiral arteries and the uterine arteries did not differ from the average population indicators.

Conclusion. The proposed complex of drugs (Lutein, Normen, Architol), in the vast majority of patients with induced pregnancy (80–85%), provides a full-fledged increase in uteroplacental blood flow, due to the adequate passage of the second wave of cytotrophoblast invasion into the myometral segments of the spiral arteries, and creates optimal conditions for the normal course of pregnancy and fetal development.

Key words: in vitro fertilization, hormone therapy, gestation II trimester.

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