Оптимізований комплекс заходів профілактики прееклампсії, спрямований на корекцію ендотеліальної дисфункції

Т. В. Коломійченко; Ю. О. Яроцька

doi:10.18370/2309-4117.2015.25.88-92

Authors

Т. В. Коломійченко National Medical Academy of Postgraduate Education named after P.L. Shupyk, Ukraine
Ю. О. Яроцька Kyiv Perinatal Center, Somalia

DOI:

https://doi.org/10.18370/2309-4117.2015.25.88-92

Keywords:

pre-eclampsia, endothelial dysfunction, L-arginine, tivortin

Abstract

In a study of 60 pregnant women it was prove safety and high efficiency of complex treatment and preventive measures with the use of the drug L-arginine (tivortin) for women with high risk of pre-eclampsia. Reduce the appearance of endothelial dysfunction (increased levels of L-arginine in reducing homocysteine levels), decreased by 1.5 times the frequency of pre-eclampsia and frequency of occurrence of its severe forms (8.3% vs. 20.0%), the incidence of other pregnancy complications (threat of premature birth, placental insufficiency, distress and fetal growth retardation), the frequency of caesarean sections and frequency of the preterm birth, there were no cases of perinatal mortality, improved condition of the fetus (fetal biophysical profile increased) and newborn (26.7% of children were born in a satisfactory condition, and decreased frequency of prematurity wasting disadaptation syndrome). The order of the Ministry of Health of Ukraine № 676 from 31.12.2004 provides for prevention in pregnant women with high risk of preeclampsia the use of aspirin 60–100 mg/day, starting from the 20th week of pregnancy, calcium 2 g/day from the 16th week. However, these measures only recommended in chronic hypertension and clear criteria for high risk of preeclampsia are absent. Recent studies indicate the need of preventive treatment of pregnant women with high risk of pre-eclampsia should affect on other components of endotheliopathy which is the main mechanism of preeclampsia. The study to prove the effectiveness of treatment and prevention measures of the preeclampsia progression to address endothelial dysfunction in women at high risk of it. The study involved 60 pregnant women at high risk of preeclampsia. The women were divided into main research group (30

women) and comparison group (30 women). 20 pregnant women without a high risk of preeclampsia consist a control group.

Pregnant women in both groups received basic treatment as recommended by the above-mentioned order of the Ministry of Health of Ukraine. Main group additionally taking the drug L-arginine (tyvortyn) within 4 weeks at 12–16 weeks gestation for the preeclampsia prevention.

The results showed safety and high efficiency of complex treatment and preventive measures with the use of the tivortin for women with high risk of pre-eclampsia. Reduce the appearance of endothelial dysfunction (increased levels of L-arginine in reducing homocysteine levels), decreased by 1.5 times the frequency of pre-eclampsia and frequency of occurrence of its severe forms (8.3% vs. 20.0%), the incidence of other pregnancy complications (threat of premature birth, placental insufficiency, distress and fetal growth retardation), the frequency of the use of caesarean sections and frequency of the preterm birth, there were no cases of perinatal mortality, improved condition of the fetus (fetal biophysical profile increased) and newborn (26.7% of children were born in a satisfactory condition, and decreased frequency of prematurity wasting disadaptation syndrome).

Author Biographies

Т. В. Коломійченко, National Medical Academy of Postgraduate Education named after P.L. Shupyk

Senior researcher

Ю. О. Яроцька, Kyiv Perinatal Center

Obstetrician-gynecologist

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