Literary data show that with a complicated premorbid background accompanied by endocrine dysfunction, the proportion of placental insufficiency and disorder of the prenatal development are increased; the number of perinatal complications, operative delivery and negative postnatal effects constantly grows. The purpose of the study is to develop a program of preconception preparation of patients with a disorder of menstrual function regularization and to assess its effectiveness in improving the hemodynamic potential of the uterus and ovaries at the preconception stage.
Materials and methods of the research: To evaluate the effectiveness of the proposed modified program of preconception preparation, all patients were divided at random into two groups – the main (40 patients), where the complex metabolic therapy with the use of L-arginine aspartate with vitamin B8 (inositol) was employed, as well as the comparison group (40 patients) with a standard approach to preconception preparation.
Results of the study and their discussion: The results of monitoring the level of growth factors in the cervical mucus of the patients in the main group showed the approximation of these criteria to the reference limits in 67.5% of observations, along with improvement of hemodynamics of the uterus in more than half of the examined women. Implementation and use of the modified protocol of preconception preparation in patients of the main group contributed to significantly higher indices of clinical pregnancy, its prolongation, and the birth of living children against the data of the comparison group. It should be noted that the proportion of early toxicosis was reduced by 2.2 times, retrochoric hematoma – 1.8 times; involuntary miscarriages and non-developing pregnancies, as well as the number of coagulation disorders, were also lower.
Conclusions: Assessment of the dynamics of the level of growth factors in cervical mucus even at the preconception stage gives an opportunity to predict deep injuries of the vascular endometrium and can be used to control the effectiveness of preventive measures in women at risk. The development and implementation of a comprehensive diagnostic system for the endometrial factor, an assessment of the mechanisms of the synthesis of growth factors, an optimized program of preconception preparation and pathogenetically arranged hormonal support have contributed to a reduction of early reproductive loss and prolongation of pregnancy in this category of patients.