pregravid preparation

The article presents modern data on the etiology, pathogenesis, diagnosis, prevention and treatment of iron deficiency anemia (IDA) and anemia of chronic disease, as well as their combination on the eve of and during pregnancy. The emphasis is made on the role of iron deficiency of any etiology in the development of obstetric and perinatal complications, especially its impact on the central nervous system formation and further psychophysical child development. Need for prevention of iron deficiency states in risk groups which includes all women of reproductive age who have menstruation is shown based on evidence-based medicine data. Effectiveness and safety of modern drugs containing iron in oral and parenteral forms has analyzed. The paper presents data on the safety and effectiveness of an innovative form of ferric iron in the form of liposomal iron, which differs in the mechanism of action, digestibility and the absence of side effects typical for this group of drugs.

According to various authors the frequency of IDA in pregnant women ranges up to 80%, in puerperas up to 40%. It is unimpossible to stop IDA without iron supplementation only with an iron-rich diet. Two main groups of iron preparations are used to correct iron deficiency differing in the valence of iron atoms – bivalent iron salts and trivalent complexes. These drugs differ in the tolerability and bioavailability of atomic iron. Liposomal iron is a new drug for treatment of iron deficiency and IDA today; it has an innovative way of iron delivery to the body. Liposomal iron has advantages for the prevention of anemia in patients with anemia of chronic disease or its combination with IDA (inflammatory bowel diseases, obesity, after resection of the stomach and intestines, etc.). An innovative form of liposomal iron in Ukraine is represented by a dietary supplement Ferroview containing 30 mg of elemental iron, that is corresponds to the average prophylactic dose recommended in WHO documents

Purpose of the study: to determine the effectiveness of micronized progesterone with antibacterial therapy in the complex of pregravid training and during pregnancy in women with recurrent pregnancy loss on the background of chronic endometritis.

Materials and methods. It was assessed the course of pregnancy and childbirth on clinical and instrumental grounds with a prospective analysis of reproductive losses in women with recurrent miscarriage and chronic endometritis. 45 pregnant women with recurrent miscarriage on the background of chronic endometritis formed the main group and were prospectively examined. Main group were divided into subgroups: I subgroup – 24 patients who were included in the study at the stage of perconception training; subgroup II – 21 patients who were included in the study with a diagnosed pregnancy for up to 12 weeks. The control group consisted of 32 pregnant women with a normal course of previous pregnancies without a history of reproductive loss.

Results. Patients with recurrent miscarriage and chronic endometritis who received a complex of preconception training with support of the luteal phase with micronized progesterone showed a statistically significantly lower percentage of clinical symptoms of threatened abortion, with no significant difference in control group. Thus, only 2 (8.3%) patients lost pregnancy in the I subgroup who received the proposed preconception therapy, and 6 (28,5%) women lost pregnancy in the II subgroup who started taking micronized progesterone only from the moment of pregnancy diagnosed.

Conclusions. Obtained results prove the effectiveness of the micronized progesterone (Utrogestan®) at the stage of pre-pregnancy training in women with recurrent pregnancy loss and chronic endometritis, as evidenced by the percentage of reproductive losses. The universality of routes of administration for micronized progesterone and possibility of its use throughout pregnancy contributes to individualize of treatment regimens

Polycystic ovary syndrome (PCOS) is a significant component in the structure of diseases that cause female infertility, and the most common cause of ovarian dysfunction in women of reproductive age. This disease significantly increases the risk of miscarriage, the development of preterm labor, and increases the incidence of perinatal complications such as gestational diabetes, fetal macrosomia, and gestational hypertension.

A comparative prospective study was conducted with 60 patients of reproductive age suffering from PCOS (phenotype A) and having an increased body mass index. At the beginning of the study, all patients received recommendations about an individually selected reduction diet, a set of physical exercises, and adherence to an eight-hour night's sleep regimen. By random sampling, the patients were divided into 2 groups of 30 people each. For 6 months, the patients of the main group received twice a day 1 sachet Miofolik. 1 sachet contains: myo-inositol 2000 mg, vitamin B12 5 μg, folic acid ((68)-5-methyltetrahydrofolate) 200 μg. Patients in the control group did not receive drug support, observing dietary recommendations and performing a set of physical exercises only.

An analysis of the results of the study of the drug Myofolik in women with PCOS indicates its positive complex effect on metabolic disorders (improved lipid and carbohydrate metabolism), decreased hyperandrogenia, restoration of the ovulatory cycle (decreased levels of LH and LH / FSH, increased levels of estradiol, progesterone), which accordingly significantly increases the chances of pregnancy. The results of the study allow us to recommend the drug Miofolik for pregravid preparation in patients with polycystic ovary syndrome.