Prophylaxis of early losses of pregnancy, analysis of motion of pregnancies and results of births for women from hyperandrogenism

Abstract

DOI: 10.52705/2788-6190-2025-3-03
УДК 618.3/.5-036.1-06:612.616.31:618.39-084

Research purpose. To develop the algorithm of prophylaxis of early losses of pregnancy, obstetric and perinatal pathology for women from hyperandrogenism.
Material and methods. We are inspect 380 patients with violation of generative function (infertility is primary, second, early losses of pregnancy) on a background the clinical and biochemical displays of hyperandrogenism. In research appeared plugging criteria: violation of generative function (infertility, early losses of pregnancy) and clinical displays of hyperandrogenism. Initially all 380 investigated patients parted on two groups depending on concomitant obesity, as viscelar adipose tissue plays not only an important role in the biosynthesis of sexual steroids but also to development of peripheral insulinoresistance and, as a result, hyperinsulinemia. Group I: 163 patients from hyperandrogenism and by normal mass of body (body mass index < 25) in age from 23 to 35 years, middle age made 27,5±2,5. Group II: 217 patients from hyperandrogenism and by viscelar obesity in age from 24 to 36 years, middle age made 28,1±2,1. A control group was made 30 practically healthy women of reproductive age (middle age 27,9±1,9), from them 15 – with normal mass of body (body mass index <25, middle age 27,2±1,8) and 15 – from exogenic-constitutional obesity (body mass index >25, middle age 26,7±2,1). At an inspection studied complaints and anamnesis of disease, and then conducted the extraclinical and special methods of research.
Results. Pregnancies made off urgent births in 98,1% (n=312). At the analysis of methods of delivery for women from hyperandrogenism the high percent of operations is marked caesar section - 33,6% (n=107). Certificates served as: persistent weakness of childbirth which is not added to medicinal therapy (18,7%), anatomic narrowing of pelvis, wrong position of fetus (4,7%), heavy gestosis (7,3%). Last 68% (n=73) operative delivery is conducted pregnant on the sum of relative certificates, taking into account duration of infertility in anamnesis. 2 pregnant pre-schedule delivery was needed: 1 - concerning decompensation of placenta dysfunction in a term 34-35 weeks pregnancies, and 1 – concerning a heavy gestosis which does not respond to treatment in a term 36-37 weeks pregnancies. The state of new-born was estimated on the set parameters. In the inspected groups of cases of mortinatality discovered it was not. Children gave birth with an estimation after a scale Apgar 8-10 points, by middle mass 3240±280 grammes. Defects of development of fetuses discovered it was not.
Conclusion. Pregnancy which came for patients from hyperandrogenism after treatment of infertility and especially after induction of ovulation, behaves to the group of high risk on miscarriage and development of complications of motion of pregnancy. Therefore tactician of conduct I to the trimester of pregnancy of this group of patients must be directed on a prophylaxis, early exposure and treatment of threat of terminating pregnancy, placenta dysfunction and gestosis. At uncomplicated of pregnancy is conducted correction in ambulatory terms, on the testimonies of patient hospitalized in permanent establishment. The complex going near the conduct of pregnant of high group of risk allows to reduce frequency of miscarriage. At that rate it is possible to consider not only achievement of pregnancy success of treatment but also happy to its motion with subsequent birth of healthy child. That, birth of viable children was 98,1%.