Is it necessary to treat the mild preeclampsia?
Preeclampsia and eclampsia are the most common causes of gestational complications for both the mother and the fetus. As the results of a confidential audit of maternal deaths from preeclampsia in regions of Russia in 2016 showed, the main causes of maternal deaths from preeclampsia/eclampsia are the lack of prediction of preeclampsia; belated diagnosis of mild preeclampsia and underestimation of its severity; insufficient and untimely examination; belated delivery; cessation of magnesia therapy during and after delivery. The aim of the study was to research the need for the treatment of mild preeclampsia, which, according to the clinical protocols approved by the Ministry of Health of the Republic of Uzbekistan, should not be treated, but it is necessary to observing for arterial pressure and proteinuria.
Under observation were 68 women in the third trimester of pregnancy, admitted to the obstetrics department of the 2nd clinic of the Tashkent Medical Academy with a diagnosis of mild preeclampsia. Women were divided into two groups: 1 (comparison group) – 30 pregnant women with mild preeclampsia, administered according to clinical protocols with monitoring of arterial pressure and proteinuria; 2 (main group) – 38 pregnant women with mild preeclampsia who received L-arginine (Tivortin®) in combination with a complex of antioxidant vitamins.
In the study, 18 women of the comparison group experienced progression of pre-eclampsia to severe, and after a loading dose of magnesium therapy these patients were delivered by induction of labor or a cesarean section. In patients of the main group who were injected with Tivortin® and a complex of antioxidant vitamins, the progression of preeclampsia was not observed and the pregnancy was prolonged until the viable period of the fetus.
Thus, the authors of the study conclude that pregnant women with mild preeclampsia with a high risk of developing severe preeclampsia and eclampsia must be hospitalized for inpatient examination and treatment by introducing an amino acid (Tivortin®) and a complex of antioxidant vitamins.
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Mignini, L.E., Villar, J., Khan, M.S. “Mapping the theories of pre-eclamsia: the need for systematic reviews of mechanisms of the disease.” Am J Obstet Gynecol 194 (2006): 317–21.
Sibai, B., Dikker, G., Kupferminc, M. “Pre-eclampsia.” Lancet 365 (2005): 785–99.
Moris, N., Eaton, B.M. “Natric oxide, the endothelium, pregnancy, pre-eclampcia.” Br J Obstet Gynaecol 103 (1996): 4–15.
Sidorova, I.S., Filippov, O.S., Nikitina, N.A. “The results of the audit of maternal mortality from pre-eclampsia in the regions of Russia in 2016.” Materials of the XI International Congress on Reproductive Medicine, Moscow, Jan 17–20 (2017): 5–7.
GOST Style Citations
1. Mignini, L.E., Villar, J., Khan, M.S. “Mapping the theories of pre-eclamsia: the need for systematic reviews of mechanisms of the disease.” Am J Obstet Gynecol 194 (2006): 317–21.
2. Sibai, B., Dikker, G., Kupferminc, M. “Pre-eclampsia.” Lancet 365 (2005): 785–99.
3. Moris, N., Eaton, B.M. “Natric oxide, the endothelium, pregnancy, pre-eclampcia.” Br J Obstet Gynaecol 103 (1996): 4–15.
4. Сидорова, И.С. Результаты аудита материнской смертности от преэклампсии в регионах России в 2016 г. / И.С. Сидорова, О.С. Филиппов, Н.А. Никитина // Материалы XI международного конгресса по репродуктивной медицине, Москва, 17–20 января 2017 г. – С. 5–7.
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