Termination threat therapy.
Pathogenetic therapy for miscarriage of endocrine genesis includes taking progesterone preparations for at least 12 weeks.
If hypothyroidism (insufficient functioning of the thyroid gland) was identified among the causes of miscarriage, then treatment is carried out in conjunction with an endocrinologist. In this case, it is necessary to take thyroid hormones throughout the pregnancy, such as L-Thyroxine, Euthyrox.
If the cause of miscarriage was an infection, then antibiotic therapy is carried out, taking into account the isolated flora.
In case of problems in the hemostasis system, anticoagulants are prescribed that inhibit the activity of the blood coagulation system (Fraxiparin, Kleksan) from the moment of conception to childbirth. Antiplatelet agents that prevent thrombosis ("Kurantil"), B vitamins, metafolin (the active form of folic acid).
With an immunological factor, some medical institutions use lymphocytotherapy (LIT) - the introduction of a partner's lymphocytes to a woman.
In a hospital, antispasmodics (No-shpa, drotaverine, papaverine), calcium channel blockers, magnesium solution intravenously are used to treat the threat of miscarriage.
With ICI, when the cervix is shortened by less than 25 mm and / or the cervical canal is opened by 10 mm, a suture is applied to the cervix up to 23 weeks, or an obstetric pessary is used for a period of more than 23 weeks. In parallel, bacteriological vaginal discharge is monitored, progesterone support is required.
If it is no longer possible to maintain a pregnancy in a medical institution, a therapeutic and diagnostic curettage of the uterine cavity and removal of the remnants of the fetal egg or placenta are performed.
In the future, the prophylactic use of antibiotics is mandatory. All Rh-negative women who do not have anti-Rh antibodies are given anti-D immunoglobulin.
To prevent miscarriage in case of a threat, it is necessary to take vitamins and trace elements. They improve the quality of oocytes (sex cells) involved in fertilization, contribute to the proper laying of organs in the embryo, in particular the formation of the neural tube, contribute to the harmonious development of the fetus and placenta, and are components for the synthesis of hormones that maintain pregnancy.
• Folate 3 months before pregnancy + the first 12 weeks - 400-800 mcg / day.
• Iodine preparations - 250 mcg / day 3 months before pregnancy + during the entire gestation period.
Desirable:
• Vitamin D: 3 months before pregnancy 600-800 IU/day and 800-1200 IU/day during pregnancy.
• PUFA - 200-300 mg / day (Omega-3 preparations).
An integrated approach in the management of severe patients is very important, since most of them require the participation of related specialists.