MODERN DIRECTIONS OF OPTIMIZATION OF THE SYSTEM OF TREATMENT AND PROPHYLACTIC MEASURES OF PRETERM BIRTH IN PREGNANT WOMEN WITH POLYHYDRAMNIOS
Keywords:
vitamin D, pregnancy, polyhydramnios, complications of pregnancy, vitamin D deficiencyAbstract
Frequency of miscarriage during pregnancy ranges from 10 to 25–35% according to the data of different authors and has no tendency to decrease. Reducing perinatal mortality and preserving reproductive health is one of the main areas of modern midwifery. The purpose of the study is to establish the etiology, pathogenesis, treatment and prevention of the threat of preterm childbirth in pregnant women with polyhydramnios. Material and methods of research are based on the City Clinical Maternity Hospital № 2 and the City Clinical Hospital “Mother and Child Center” in Vinnytsia, together with the Department of Obstetrics and Gynecology № 2, VNMU named after M. I. Pyrogov there was conducted a number of scientific studies in pregnant women with a diagnosis: the threat of preterm childbirth in pregnant women. The study included: clinical and statistical analysis of outpatient surveillance cards, the history of births and developmental maps of newborns, the study of catamnesis examination of pregnant women, general-clinical studies, psycho-emotional state studies, study of changes in the autonomic nervous system, immune status, endocrine homeostasis. Results of the research and their discussion. According to our research, the use of traditional tocolic therapy allows an absolute majority to prolong the pregnancy for 48 hours to prevent respiratory disturbances in the fetus. In the analysis of the data of this study, it was found that in the group of pregnant women receiving vitamin D at a dose of 4,000 units a day the risk was significantly reduced: caesarean section by 43%, other complications of pregnancy (gestational diabetes, hypertension, preeclampsia) by 30%. Conclusions According to the results of the study, there are several mechanisms of preterm birth (50.7% is an infectious and inflammatory process, 24.75% — polyhydramnios). Pregnant women with preterm labor are advised to carry out a more detailed examination aimed at finding a source of chronic or acute inflammation, clinical or subclinical manifestations of thrombosis, vitamin D deficiency, the presence of a psycho-emotional component to determine the pathogenetic mechanism of birth activity. Adding to the scheme of treatment for pregnant women with a threat of premature births adequate to the etiological factor of drugs and the use of psychotherapeutic techniques can significantly increase the effectiveness of treatment and prolong the pregnancy to the term of delivery.
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