Principles of pathogenetic therapy in complicated pregnancy with an impaired state of the fetus
With the aim to provide a pathogenetic substantiation of the expediency and clinical effectiveness of using Actovegin in impaired states of fetuses against the background of various complications of pregnancy, a complex dynamic Dopplerometric sonography and clinical examination of 378 women (basic group) was carried out. Of them, 108 women with recurrent pregnancy loss, 153 women from a high risk group for intrauterine infection of the fetus, 117 women in whom pregnancy was complicated by gestosis. A comprehensive clinical and laboratory examination of pregnant women, dynamic ultrasonic and Dopplerometric testing, and special techniques such as invasive methods of prenatal diagnostics, assessment of the cytokine status of amniotic fluid, acid-base blood balance test of newborns were applied. A complex system of examining pregnant women with a high risk for development of placental insufficiency beginning from the first trimester of gestation has been worked out. A scientific substantiation of applying new techniques to studying the state of the placental system and to correct the impaired function of the placental system with drugs that improve microcirculation and metabolic processes (Actovegin) is given. Based on specific features of pathogenesis of impaired placental functioning and a comprehensive analysis of specific features of the course of placental insufficiency in pregnant women with a high risk for perinatal complications the optimal obstetric tactics has been proposed, potential of Actovegin therapy and indications for operative delivery have been determined.