Placental dysfunction as a predictor of miscarriage

Т. Г. Романенко

Abstract


The article considers the possibilities of influence on the formation of the placenta in order to further prevent the occurrence of irreversible placental dysfunction and prevention of pregnancy loss.

Status of the endometrium before fertilization is progesterone-dependent. Progesterone, with all its defence mechanisms, refers to one of the major hormones that participate in the process of trophoblast invasion. The course of pregnancy depends of this process, because it predicts the conceiving and clearly regulates the development of pregnancy. Achievement an adequate functioning of the placenta is possible only when female organism is sufficient saturated of progestin to ensure the success of pregnancy until delivery on time. To do this, it is advisable to conduct primary prevention – administration of progesterone for 2–3 months before planned pregnancy. With this purpose in clinical practice using micronized progesterone (Utrogestan), which has the most sufficient evidence base and used in all developed countries.

Appointment Utrogestan in the step of pregravid preparation, in the early stages of gestation, and the possibility of its use in the later stages allows to observe the principle of therapy continuity of the natural hormone of pregnancy. Intravaginal route of administration creates conditions for the full implanting and normalization of immune status of patient’s by producing PIBF. The advantages of using of vaginal progesterone are: the targeted delivery to target organs, provision a stable hormonal level in blood serum, the lack of hepatotoxicity, the possibility of use in women with extragenital pathology. By intravaginal route Utrogestan reaches maximum concentration in all layers of the uterus after 4 hours.

It is important to note that today Utrogestan is the only progestin drug, which officially registered in Ukraine for the prevention of preterm birth in women at risk. It’s provide to physicians the necessary legal security and, if necessary, allows to assign the drug from pregravid step and up to 36 weeks of pregnancy.


Keywords


placenta; progesterone; placental dysfunction; Utrogestan

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DOI: http://dx.doi.org/10.18370/2309-4117.2017.33.77-82

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ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)