Гинекология (Aug 2018)
Pregravid preparation as the main method of preventing undeveloped pregnancy
Abstract
How to make a pregravid women with the stood pregnancy in the anamnesis is the key to success in the fight against miscarriage. The testing outside of pregnancy, the identification of reasons for stopping a previous gestation, adherence to medical recommendations in the programme of preparation for future conception and implantation is a required step in the management of women who have had non-developing pregnancy. Periconceptional prevention is effective only at its beginning 3 months before conception and in the early stages of development of the embryo and fetus (12 weeks).The purpose of the study was improvement profilakticheskih activities based on identified pathogenetic mechanisms of occurrence of missed abortion. Aim of the study: to perfect the features of pregravid preparation for pregnant with undeveloping pregnancy in anamnesis on the basis of the educed nosotropic mechanisms of origin of this pathology, her intercommunication with a folats deficit. Materials and methods. Research was conducted in a few stages. On the first stage retrospectively on the basis of analysis 90 hospital charts are educed the supposed risk factors. On the second stage the exposure of reliable risk and development of algorithms of prognostication of undeveloping pregnancy (factors was conducted in 2 groups - basic (90 pregnant with stopping beating pregnancy) and control (30 pregnant with normally aleak pregnancy). The methods of prophylaxis of this pathology offered in high-risk of origin of stopping beating pregnancy groups. One of them was application of folates, namely vitamin-mineral complex before and after conception. Results. On the basis of undertaken studies multifactor genesis of missed miscarriage was confirmed, and the basic etiologic factors of origin of this pathology are educed. Stopping beating of pregnancy at anomalous karyotype takes place for certain before (6.2±0.8 weeks) what at normal karyotype (8.7±1.2 weeks). Cross-correlation connection was set between frequency of development of chromosomal anomalies and level of homocysteine from МТНFR677ТТ, level correlation of Spirmena equaled 0.84 - direct cross-correlation connection. As a result of undertaken a study one of methods of preparation application of folates offered in a kind vitamin-mineral complex for 16 weeks to conception and 12 weeks after conception. Conclusion. High-frequency of МТНFR677ТТ of heterogeneous or homozygous carriers educed for women with undeveloping pregnancy. Application of folates is in a vitamin-mineral complex, can be one of the most effective methods in the prophylaxis of early reproductive losses.
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