Optimization of the management tactics for women with fetal loss syndrome and high-risk thrombophilias in history at the preconception stage
DOI:
https://doi.org/10.15574/PP.2025.1(101).2430Keywords:
preconception preparation, fetal loss syndrome, pregnancy loss, early miscarriages, thrombophilia, risk factors, pregnancy, placenta, preeclampsiaAbstract
One of the most significant medico-social problems in modern obstetrics is the reduction of reproductive losses, which underlie pregnancy loss, with a prevalence of up to 55%, reaching 80% in the first trimester.
Aim - to evaluate the effectiveness of an optimized preconception preparation program using folates, a complex of vitamins, vitamin D, and L-arginine aspartate in women with fetal loss syndrome and high-risk thrombophilias in history.
Materials and methods. A prospective controlled clinical study was conducted involving 49 women aged 25 to 42 years with fetal loss syndrome and high-risk thrombophilias in history, divided into two groups. In the control group (n=26), the pre-gravid period was accompanied by standard management, whereas in the main group (n=23), in addition to enoxaparin and acetylsalicylic acid, additional therapy was administered, including folic acid preparations, a complex of vitamins and minerals with the biologically active fourth-generation folate – quatrefolic, vitamin D, and L-arginine aspartate. From the moment of the desired pregnancy diagnosis, the structure and frequency of pregnancy and childbirth complications were studied. Statistical data processing was performed using the SPSS 21 program.
Results. It was established that the administration of folates, a complex of vitamins, vitamin D, and L-arginine aspartate at the stage of comprehensive preconception preparation in women with fetal loss syndrome and high-risk thrombophilias in history is associated with a reduction in the frequency of threatened abortion, vitamin D deficiency, anemia during the first trimester, threatened miscarriage, de novo hypertensive disorders, placental dysfunction with fetal growth restriction in the second and third trimesters of pregnancy.
Conclusions. The proposed pre-gravid preparation and therapy tactics in women with fetal loss syndrome and high-risk thrombophilias in history demonstrated a tendency to increase the number of preserved desired pregnancies from 76.9% to 91.3%.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
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