Correction of placental dysfunction in the first trimester of pregnancy as a method of preventing fetal growth retardation

Abstract

Objective: to study the effectiveness of complex therapy of placental dysfunction (PD) as a method of prevention of fetal growth retardation syndrome in pregnant women with miscarriage in the 1st trimester of pregnancy.Materials and methods. 100 pregnant women with verified PD on the background of miscarriage in the first trimester of pregnancy took part in the study.Verification criteria for PD were: a decrease in the volume of the chorion and its vascularization index by more than 15%, an increase of the resistance index in the uterine and spiral arteries during dopplerometric examination at the end of the first trimester of pregnancy.The patients were divided into groups: group I (main) – 36 pregnant women with PD who received complex treatment, group II (comparative) – 32 pregnant women with PD who were prescribed only hormonal support, III group (control) – 32 patients with the physiological course of the first trimester of pregnancy. Complex therapy in the group I included hormonal agents, venotonic drug Normoven, the drug Magnicum, and the drug Artihol.Clinical data, ultrasound fetometry, dopplerometric study of utero-fetal blood flow were used to assess the effectiveness of treatment.Results. Already in the 22–24th week of gestation there was no significant difference in the resistance index in the spiral and uterine arteries between the main and control groups (p > 0.05). Ultrasound fetometry at 32–34 weeks of gestation showed that in the first group there were 8.3% (3) fetuses small for gestational age, 15.6% (5) in the second group and 3.1% (1) in the control. The average body weight of newborns in the main group and in the comparison group differed significantly and was 2810 ± 267 and 2610 ± 175 g respectively (р < 0.05) and 3295 ± 295 g in the control group.Conclusions. Complex, pathogenetically justified, long-term treatment of PD from the early stages of pregnancy makes it possible to avoid progression of compensated and development of subcompensated stages of placental disorders. Complex therapy of PD, which includes micronized progesterone, Normoven, Artichol and Magnicum, Complex PD therapy, which includes micronized progesterone, Normoven, Artihol and Magnicum, normalizes blood flow in the mother-placenta-fetus system, normal growth and fetus development and is an effective way of preventing fetal growth retardation.