COMPLEX APPROACH TO TREATMENT OF SUBCHORIONIC HEMATOMA IN EARLY THREATENED ABORTION
| Autor: | V. Yu. Dobryanska, N. V. Petrenko, S. N. Heryak, N. I. Bagniy, O. Y. Stelmakh, I. Ya. Kuziv, I. V. Korda, L. V. Bagniy |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pregnancy Fetus 030219 obstetrics & reproductive medicine business.industry Obstetrics lcsh:R lcsh:Medicine Estriol 030204 cardiovascular system & hematology Abortion medicine.disease Miscarriage 03 medical and health sciences 0302 clinical medicine Hematoma Pregnancy Maintenance threatened miscarriage Medicine business subchorial hematoma Tranexamic acid micronized progesterone tranexamic acid medicine.drug |
| Zdroj: | International Journal of Medicine and Medical Research, Vol 2, Iss 1 (2016) |
| ISSN: | 2414-9985 2413-6077 |
| Popis: | Background. Currently, miscarriage is considered to be a multietiological disorder with trombofilic violationsand hormone deficiency as the leading factors. Despite the achievements in treatment of miscarriage, thefrequency of preterm termination of the wanted pregnancies is still high and the number of perinatal losses issignificant. Therefore, pathogenetically based therapy, safe for the foetus, is very important in management ofpregnancy interruption in the first trimester. A proper drugs administration provides optimal concentration ofactive ingredients and fast action. The aim is to improve effectiveness of the early threatened abortion treatmentin cases of subchorionic hematoma (SCH) by combination of sublingual natural micronized progesterone andtranexamic acidObjective. We examined 50 pregnant women with early threatened abortion with SCH. We studied systemof haemostasis, basic hormonal markers and ultrasound criteria of threatened abortion. We compared efficacyof treatment between traditional (supportive) therapy (sedation, spasmolytic, haemostatic drug) and combinationof supportive therapy in combination with tranexamic acid and natural micronized progesterone.Results. The result of lab tests showed minimal signs of hypercoagulation, hyperfibrinogenemia and platelethyperactivity, a significant β-hCG level decrease and approximate decrease in progesterone and free estriolproduction.Sonographic examination showed presents of local myometrial hypertonus, deformation of fertilized egg,hypoplasia of chorion, low location of fertilized ovum, retarded growth of CRL.The research proved that combined administration of sublingual micronized progesterone and tranexamicacid for the treatment of threatened abortion with SCH has more significant positive effect for pregnancymaintenance due to clinical, biochemical, hormonal and ultrasound results if compared with the group whichunderwent supportive therapy.Conclusions. Complex application of natural micronized progesterone 100 mg three times a day sublinguallyand 500 mg of Tranexamic acid dissolved in 200 ml normal saline solution improves the dynamics of themain hormonal, haemostatic and ultrasound markers of abortion and significantly reduces reproductive losses.Tranexamic acid treatment proved a rapid and effective action on hematoma and absence of embryotoxical andсoagulopathyc influence. Tranexamic acid does not cause any significant disorders of hemostatic system. This isvery important at the early gestation because of intravascular coagulation, physiological hypercoagulable conditionduring pregnancy that can cause microthrombosis and disrupt placentation. On the other hand, it isdangerous for the mother’s health because of the increased risk of thrombosis.KEY WORDS: threatened miscarriage, subhorial hematoma, micronized progesterone, tranexamicacid. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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