Affiliation:
1. Kharkiv Medical Academy of Postgraduate Education, Ukraine
Abstract
The most common cause of hyperthyroidism in pregnant women is recognized by Graves' disease. Because it leads to serious complications in the mother and fetus, timely correction of disorders of homeostasis provides a successful outcome of pregnancy. In order to study the effectiveness of the drug with the active substance sulodexide in pregnant women with Graves' disease, 28 women were examined for the possibility of reducing obstetric and perinatal complications. They performed general clinical examinations, performed an extensive hemostasis, determined the fetal fetal condition. It has been found that the development of chronic syndrome of disseminated intravascular coagulation is characteristic for pregnant women and as a result this aggravates the gestational period for the mother and fetus. Supplementation of the standard protocol of treatment with anticoagulant sulodexide has led to an improvement in the parameters of the coagulation unit of hemostasis, and was also characterized by anti−adhesive and antithrombotic action. Clinically, the effectiveness of this therapy was manifested by the elimination of symptoms of placental insufficiency, the threat of pregnancy termination, preeclampsia, delayed fetal fetal development, thrombotic complications. The results obtained in this study indicate that the use of sulodexide anticoagulant has contributed to a reliable normalization of the hemostatic index, improved blood supply to the placental and fetal complex, which reduced an obstetric pathology occurrence and perinatal mortality. Thus, we can recommend to include natural anticoagulant sulodexide into standard protocol of treatment for patients with Graves' disease, because it has no side effects, unlike other anticoagulant drugs and can be safe for pregnant women.
Key words: hemostasis, pregnancy, Graves' disease, sulodexide.
Reference13 articles.
1. Treatment of Graves Disease with Antithyroid Drugs in the First Trimester of Pregnancy and the Prevalence of Congenital Malformation / Ai Yoshihara, Jaeduk Yoshimura, Noh Takuhiro [et al.] // The J. of Clin. Endocrinology & Metabolism.− 2012.− Vol. 97, Iss. 7.− P. 2396−2403. https://doi.org/10.1210/jc.2011−2860
2. The 2015 European Thyroid Association Guidelines on Diagnosis and Treatment of Endogenous Subclinical Hyperthyroidism // D. S. Cooper, L. Bartalena, L. Hegedus [et al.] // Eur. Thyroid J., Guidelines.− 2015.− Vol. 4.− R. 149−163. https://doi.org/10.1159/000438750
3. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis / D. S. Ross, H. B. Burch, D. S. Cooper [et al.] // Thyroid.− 2016.− Vol. 26 (10).− R. 1343−1421. https://doi.org/10.1089/thy.2016.0229
4. Lechenie diffuznogo toksicheskogo zoba vo vremya beremennosti / Yu. S. Lovkova, V. V. Potin, N. N. Tkachenko, E. V. Shelaeva // Zhurn. akusherstva i zhenskih boleznej.− 2017.− № 66 (3).− S. 89−96.
5. Bolezn Grejvsa i beremennost / M. V. Altashina, E. A. Troshina, N. Yu. Sviridenko, N. V. Latkina // Klinicheskaya medicina.− 2012.− № 10.− S. 71−74.