PREGRAVIDAL PREPARATION OF WOMEN WITH ANTIPHOSPHOLIPID SYNDROME AND ITS RESULTS
Systemic enzyme therapy and plasmapheresis is positioned as methods of pathogenetic treatment of antiphospholipid syndrome. One manifestation of this syndrome is the habitual miscarriage. Therefore, these approaches can be used in the preparation for pregnancy.
The purpose of research - assessment of the impact of systemic enzyme therapy on the functional state of hemostasis in women with antiphospholipid syndrome in pregravidal preparation.
Materials and Methods: The study included 70 women of reproductive age with APS, verified by clinical and laboratory methods studies. The age of women was between 23-35 years old (mean age 27,6 ± 1,3). The drug of systemic enzyme therapy (SET) Wobenzym in the dose of 5 tablets 3 times a day for 1 month and 5-course intermittent plasmapheresis exfusions of 0.5-1.0 liters of plasma in 1 day with the substitution of albumin have been appointed for 33 women of the main group. Repeated courses SET and plasmapheresis are appointed by each month before the onset of pregnancy. The dynamics of hemostasis and contents of interleukins in the peripheral blood were studied, as well as the outcomes of pregnancy and childbirth.
Results: On the background in the use of complex methods of preparation by SET and plasmapheresis was revealed a trend toward normalization of hemostasis, mainly due to vascular platelet link. In addition, the use of the complex methods of treatment led to improve of parameters of the immune status in pregnant women with APS, which indicates a significant decrease in the degree of proinflammatory preparedness and immunocomplex pathology.
Among of 37 women of the comparison group, pregnancy was ended in birth by alive newborn only in 9 cases - (24,3 ± 7,1)%. But, among of the 33 women from basic group there were 17 births by live newborns - (51,5 ± 8,2)% (p <0,05).
In general, the use of this complex methods showed high efficiency on pathogenic mechanisms and big clinical significance.
G. A. Tanysheva, M. S. Zhelpakova, N. B. Mausymbaeva,
D. A. Kurmangalieva, O. G. Sidorova
Semey State Medical University, Semey, Kazakhstan
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12. Kably Ambe A., López Ortiz C. S., Serviere Zaragoza C., Velázquez Cornejo G., Pérez Peña E., Santos Haliscack R., Luna Rojas M., Valerio E., et al. Mexican National Consensus on Assisted Reproduction Treatment // Ginecol Obstet Mex. 2012 Sep;80(9):581-624.
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14. Newnham J. P., Dickinson J. E., Hart R. J., Pennell C. E., Arrese C. A., Keelan J. A. Strategies to prevent preterm birth // Front Immunol. 2014 Nov 19;5:584.
15. Ohmura K., Oku K., Atsumi T. The pathogenesis, diagnosis and treatment of antiphospholipid syndrome // Nihon Rinsho. 2014 Jul;72(7):1309-1313.
16. Rac M.W., Sheffield J.S. Prevention and management of viral hepatitis in pregnancy // Obstet Gynecol Clin North Am. 2014 Dec;41(4):573-92.
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Tanysheva G. A., Zhelpakova M. S., Mausymbaeva N. B., Kurmangalieva D. A., Sidorova O. G. Pregravidal preparation of women with antiphospholipid syndrome and its results. Nauka i Zdravoohranenie [Science & Healthcare]. 2015, 6, pp. 124-132.Related publications:
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