New therapeutic opportunities in improving the antenatal management of obese women

Abstract

Research objectives: to assess the effectiveness of the developed treatment complex on the course of pregnancy and childbirth in obese women.Materials and methods. 135 pregnant women were examined depending on the degree of obesity and received treatment. The women were examined and treated in the Department of Pathology of Pregnancy and Childbirth, SI “O.M. Lukyanova Institute of Pediatrics, Obstetrics and Gynecology of the NAMS of Ukraine” during 2019–2021.The developed medical complex included: Miofolic 2 sachets/day 3 months before pregnancy and throughout the gestation period; in case of insufficiency or deficiency of vitamin D, this vitamin was prescribed in a dose of 4000 IU/day; magnesium citrate 250–300 mg/day during pregnancy; micronized progesterone vaginally 200–400 mg/day in the II phase of the menstrual cycle before conception and up to 34 weeks of gestation (if necessary); individual programs of prenatal psychological rehabilitation using psychophysical exercises were used depending on the psychosomatic disorders.Results. it was found that the number of pregnant women of older reproductive age is increasing. There was a decrease in pre-pregnancy weight (which was positively reflected in the subsequent course of pregnancy) at the 3 months before the onset of pregnancy in women with lifestyle modification (diet therapy, dosed physical activities) and who intake a developed treatment complex at the pre-gravid stage.A peculiarity of the somatic morbidity of pregnant women was the combination of various types of extragenital diseases. Significant differences were found between chronic diseases of the cardiovascular system and diseases of the gastrointestinal tract and liver compared to the control group. The course of pregnancy largely depended on the reproductive system status before fertilization – an increase in the frequency of infertility was noted with an increase in the woman’s body mass index.Pregnant women who received the developed treatment complex had fewer pregnancy complications, the frequency of which was not significantly different from the control group. At the same time, against the background of the treatment, their lipid profile and vitamin and mineral supply improved. All this had a positive effect on the pregnancy outcomes.Conclusions. Developed medical complex including myo-inositol, starting from the pre-gravid period and throughout pregnancy, helps to reduce insulin resistance in obese women, improve the lipid profile and normalize the leptin level, which has a positive effect on the course of pregnancy and childbirth and improves perinatal outcomes.