Prevention of reproductive losses and placental insufficiency in pregnant women with early toxicosis
For evaluation of the efficacy of using dydrogesterone (Dufaston) in a complex therapy of pregnant women with early toxicoses to prevent reproductive losses and placental insufficiency in this pathology the authors carried out a prospective examination of 138 women. The basic group comprised 76 women with early toxicosis (moderate and severe vomiting of pregnancy). They underwent prophylaxis of reproductive losses and placental insufficiency from the 1st trimester immediately after coping with vomiting till 20 wk of gestation with dydrogesterone (in the dose 10 mg 2 times daily and 10 mg 3 times daily in moderate and severe (excessive) vomiting, respectively). The reference group included 32 patients with early toxicosis (moderate and severe vomiting of pregnancy) who did not receive dydrogesterone for preventive or therapeutic purposes. It was found that pregnant women with early toxicosis comprised a group of risk for miscarriage and preterm labor, placental insufficiency, gestosis- administration of dydrogesterone to pregnant women with moderate and severe vomiting of pregnancy reduced the frequency of miscarriage by more than 2.5 times, of placental insufficiency by 3.1 times, of gestosis by 1.6 time- the positive effect of using dydrogesterone was obtained due to normalization of conditions for the formation of the mother-placenta-fetus system in the 1st–2nd trimesters of gestation, metabolic indices in a pregnant woman (leptin level), parameters of uteroplacental blood flow, production of the placenta growth factors and the vascular-endothelial growth factor.