PREGRAVID PREPARATION IN WOMEN WHO UNDERWENT ECTOPIC PREGNANCY

Abstract

The aim of the study – to carry out rehabilitation measures, which included the appointment of therapeutic agents to improve the status of fallopian tubes and stimulate ovulation in ovarian dysfunction after conservative and surgical treatment of ectopic pregnancy.

Materials and Methods. For medical treatment, women with an ectopic pregnancy were taken on the type of tubal abortion (15 women), in whom, according to the definition of β-subunits of HCG and data of ultrasound scan, there were indications for prescribing conservative methotrexate therapy by the scheme. As well as 15 women who had an ectopic pregnancy and treatment was carried out by the laparoscopic method. Treatment of progressive ectopic pregnancy was carried out by methotrexate 75-100 ml intramuscularly with indicators β CGL more than 1500ME / l, according to ultrasound – the diameter of the fetal egg is not more than 3.5 cm in the area of the uterus appendages. In addition, geneotoprotectors and folate were prescribed for elimination of side effects and effects on the liver. Control over the dynamics of treatment was carried out by redefining β-HGL. If it decreases by more than 15 %, then methotrexate is not re-administered again, in the case of a lower reduction, repeated administration of methotrexate was carried out. An extract of the patient from the hospital was carried out for 8-10 days under the control of ultrasound and indicators of β-HGL. Patients from the 2nd group carried out laparoscopic removal of the fetal egg: tubotomy with neosalpingodomy.

Results and Discussion. Restoration of reproductive function was carried out according to data defined in serum, FSH, progesterone and prolactin. For the purpose of pre-glare preparation phytopreparations of the fruit extract of the willow shrubbery (Cyclodinone, Mastodinon) and folate were used. In the postoperative period, the appointment of monophasic contracents during the 3 menstrual cycles followed by the determination of the patency of the fallopian tubes. During conservative treatment of ectopic pregnancy and a set of measures to restore reproductive function during three menstrual cycles, uterine pregnancy occurred in 6 women within 6 months of pre-admission training. In 6 women, pregnancy occurred within one year with the inclusion of a second course of hormonal correction after a six-month break, and 3 women failed to achieve a positive result. In the 2nd group of women who had surgical treatment of ectopic pregnancy in the complex of pre-bladder training, they included the appointment of monophasic contraceptives for 3 months and control of MSG for the passage of fallopian tubes. Pregravid training included a series of activities that contributed to the restoration of patency of the fallopian tubes and single-phase hormonal contraceptives. As a result of rehabilitation and pre-glare preparation, pregnancy occurred in 33 % of surveyed women in the first 12 months.

Conclusions. Conducting conservative treatment of EP with preservation of the uterine tube allowed to achieve pregnancy in earlier terms of carrying out rehabilitation measures for performing reproductive function in women under our supervision. The purpose of the phytocomplex (cyclodinone) and folic acid for correction of hormonal dysfunction allows to get pregnancy and its bearing in 33 % of the examined women.