IMPACT OF COMBINATION PATHOGENETIC THERAPY FOR PREECLAMPSIA ON THE OUTCOMES AND PROLONGATION DURATION OF PREGNANCY

Objective. To evaluate the efficiency of anticoagulant therapy and plasmapheresis (PA) as the components of combination therapy for preeclampsia, which contribute to better treatment results and prolonged pregnancy. Material and methods. Thirty-f ive cases of pregnancy prolongation in gestosis at 31.5±0.42 weeks’ gestation were prospectively analyzed. The course of therapeutic PA consisted of 4—6 sessions with 654 to 876 ml of autoplasma per session. Central hemodynamic changes and the time course of changes in the hemocoagulation system, blood biochemical parameters, and C-reactive protein were estimated before and after PA. Results. The use of therapeutic PA in varying gestosis, regardless of the baseline type of blood circulation, could prolong pregnancy by an average of 16.5±1.6 days and prevent gestosis progression and health worsening in 74% of cases. The combined use of a course of therapeutic PA and anticoagulant therapy in pregnant women with gestosis resulted in elimination of chronometric hypercoagulation, its statistically significant reduction as compared to the baseline level of the soluble fibrin monomer complex, platelet aggregation, and fibrin degradation products and in a considerable decrease in the level of C-reactive protein by an average of 18.4±1.7 to 2.2±1.1 mg. Conclusion. Hemodynamic correction based on the individual choice of antihypertensive drugs, PA, and continuous anticoagulant therapy in pregnant women with preeclampsia could ensure stable hemodynamics, maintain electrolyte balance, the hemic component of blood oxygen-transporting function, prolong pregnancy, make prophylaxis of neonatal respiratory distress, and, in all cases, have live babies.

pregnancy, preeclampsia, heparins, plasmapheresis, hemostasis