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PHARMACOLOGICAL CORRECTION OF FETOPLACENTAL INSUFFICIENCY WITH FETAL GROWTH RETARDATION SYNDROME

Introduction: fetoplacental insufficiency (FPI) is an important problem of obstetrics. This pathological condition leads to the development of fetal growth retardation syndrome (FGRS). Any standard treatment regimens cannot exist due to a combination of individual etiological factors and pathogenetic mechanisms of the development of this complication. Angioprotective drugs take the lead in the treatment, improving blood flow, coagulation and rheological properties of blood, tissue perfusion, and their supply with oxygen and nutrients. Objectives: the aim of the study was to compare the pharmacological effectiveness of commonly used angioprotective agents «Pentoxifylline»®, «Phlebodia 600»,® and "Curantil 25»® based on the results of laboratory and instrumental methods of research conducted after treatment. Methods: the retrospective and prospective survey of 120 pregnant women with 28-36 weeks of gestation were carried out on a clinical site of the Department of Obstetrics and gynecology of KSMU, and on the site of the Regional Perinatal Center of the City of Kursk. Results: as a result of the study, there was developed and scientifically substantiated a variant of monotherapy of placental insufficiency with fetal growth retardation syndrome, using the drug «Phlebodia 600»®, aimed at improving the microcirculation in the system «mother-placenta-fetus» for the purpose of having children with a higher weight and growth parameters. It is recommended to take a course of 1 tablet (600 mg) per day in the morning, on an empty stomach, during 1 month. Conclusions: the analysis of the results of the instrumental research methods after pharmacological correction revealed an equivalent improvement in hemodynamic parameters in both the uterine vessels and in the artery of the umbilical cord, which is due to the action of the preparation «Flebodia 600»®, whereas «Pentoxifylline»® has a partial positive effect on the uterine and placental blood flow, and «Kurantil 25»® predominantly affects the uterine blood flow. 

Иллюстрации

Fig. 1. Age characteristics of pregnant women.

Table 1. Structure and frequency of sonographic markers of fetoplacental insufficiency.

Note: # - the significance of differences of indicators of comparison groups (differences were significant when comparing these two groups р1-2<0.05);
& - the significance of the performance differences between the comparison groups (differences were significant when comparing these two groups р2-3<0.05);
μ - the significance of differences of indicators of comparison groups (differences were significant when comparing these two groups р1-3<0.05).

Table 2. Structure and frequency of sonographic markers of FPI patients groups researches after of pharmacological correction.

Note: # - the significance of differences of indicators of comparison groups (differences were significant when comparing these two groups р1-2<0.05);
& - the significance of the performance differences between the comparison groups (differences were significant when comparing these two groups р2-3<0.05);
μ - the significance of differences of indicators of comparison groups (differences were significant when comparing these two groups р1-3<0.05).

Table 3. Comparative analysis the frequency of occurrence degrees of severity of FGRS in pregnant women after treatment between the study groups.

Table 4. Structure and frequency of hemodynamic disturbances before drug therapy.

Table 5. Comparative analysis of the frequency of hemodynamic disturbances after drug therapy between the study groups.

Table 6. Comparative analysis of the dopplerometria data of patients of surveyed groups before treatment and after its completion.

Table 7. The systolic-diastolic relationship dopplerometriavascular of mother and fetus before and after pharmacological correction.

Table 8. Comparative analysis of cardiotocography and non-stress test fetuses of patients groups being compared before and after treatment.

Fig. 2. Birth weight, grams

Note: p<0.05 - confidence score difference results between groups I and II, III

Fig. 3. Growth at birth, cm

Note: p<0.05 - confidence score difference results between groups I and II, III

Table 9. The comparative analysis of the data of the physical development of the child at birth in the studied groups.

Table 10. Pathological examination afterbirth.

Table 11. Comparative analysis of the incidence of side effects after a drug therapy for patients in investigations groups.

DOI: 10.18413/2313-8971-2017-3-2-64-78
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