Pathogenetic therapeutic and preventive measures in women of risk group of isthmicocervical incompetence

Abstract

The article considers the problem of isthmicocervical incompetence (ICI) as one of the leading factors in the genesis of premature termination of pregnancy. As noted, the frequency of this pathology in the population among pregnant women reaches 15%. The results of the study are presented, the purpose of which was to study the clinical effectiveness of the use of the drug Biolectra Magnesium Fortissimum in preconception prevention of ICI in women with undifferentiated connective tissue dysplasia on the background of a magnesium deficiency. The study involved 50 women at risk of ICI (hypomagnesemia, decrease in the index of resistance in the small arteries of cervix uteri (CU), ultrasound signs of connective tissue dysplasia). The age of women ranged from 20 to 40 years. Most subjects had clinical symptoms of magnesium deficiency: tachycardia occurred in 28%, sleep disorders in 24%, general fatigue in 20%, constipation in 18%, paresthesia in 36%, muscle spasms in 18% of cases. The mean magnesium concentration in the blood plasma of the patients was 0.74 ± 0.03 mmol/l. The conducted studies showed a significant decrease in the index of resistance in small arteries of CU in 86% of women, which indicated the presence of morphofunctional deficiency of CU. Also, in 78% of women, echographic examination revealed the presence of collagenopathy. To correct the magnesium deficiency in the pregestation period, women were prescribed the drug Biolectra Magnesium Fortissimum (Hermes Arzneimittel GmbH, Germany) for 1 effervescent tablet once a day for 10 days with a break of 2 weeks for 3–4 months. After completion of the course of treatment, in most cases there was a lack or decrease in the frequency and intensity of symptoms of magnesium deficiency symptoms. The gradient of magnesium level increase after a 3-month therapy was 0.14 ± 0.03 mmol/l. Residual phenomena of paresthesia occurred only in 10% of women, muscle cramps – in 8%. In 60% of women, there was an approximation of the blood flow resistance in the small arteries of CU (RI 0.63 ± 0.03) and in 64% of cases the ultrasonic examination of CU revealed an increase in the reflectivity of the organ, which indicating stabilization of collagen structures, changes in the morphofunctional state of CU, normalization of hemodynamic processes in the organ. Thus, the use of drug Biolectra Magnesium Fortissimum in magnesium deficiency provided an effective correction of hypomagnesemia, positively influenced the morphofunctional state of CU, which helped prevent the complication of pregnancy in 80% of cases.

Keywords

• isthmicocervical incompetence
• magnesium deficiency
• connective tissue dysplasia