New options for preeclampsia prevention
The analysis of literature data on the role of placenta disorders in the development of preeclampsia (PE) was performed according to Pubmed and eLibrary updates. Although a complete understanding of the pathogenesis of PE remains unclear, the placenta theory was found as one of the principal ones. The appropriateness of prescribing progestogens for the prevention of PE is the subject of an actual debate. Based on the results of our own research, there was demonstrated the efficacy in the preventative prescription of dydrogesterone (at a dose of 30 mg/day) from early periods to 20 weeks of gestation in pregnant women with high-risk factors. The prescription of dydrogesterone contributed to a statistically significant reduction in this pregnancy complication (13.1 and 71/4%, p < 0,001).It was found that women taking dydrogesterone significantly less developed such disorders as arterial hypertension (3.2 and 71.2%, p < 0.001), proteinuria (0 and 66.18%, p < 0.001), fetal growth restriction (2.2 and 21.58%, p < 0.001), uteroplacental vascular insufficiency (3.2 and 21.58%, p < 0.001), and preterm birth (8.6 and 53.95%, p < 0.001).
Conclusion. The importance of the placental factor in the pathogenesis of PE, the prescription of progestogens corresponds to the main principle of pathogenetic prevention of this complication. Administration of dydrogesterone in the first and second trimesters (6 to 20 weeks of pregnancy) significantly reduces the incidence of PE in high-risk pregnant women.
Key words: preeclampsia, prevention, high-risk groups, progestogens, dydrogesterone
For citation: Tskhay V.B., Schindler A.E. New options for preeclampsia prevention. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2021; 20(4): 123–130. (In Russian). DOI: 10.20953/1726-1678-2021-4-123-130