The importance of pregravid preparation for improving perinatal outcomes in patients with a history of placenta-related pregnancy complications

DOI: https://doi.org/10.29296/25877305-2021-01-07
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1
Year: 
2021

M. Sidelnikova; M. Alekseenkova, Candidate of Medical Sciences; Professor O. Panina, MD M.V.
Lomonosov Moscow State University

Studies of the efficacy of low-molecular-weight heparins (LMWH) used in patients with a history of placenta-related pregnancy complications (PRPC) and the impact of this therapy on perinatal and long-term child development outcomes are presented by small cohort studies that are rather heterogeneous and do not answer the question of whether LMWH therapy is necessary at the pregravid stage. Objective. To evaluate the impact of pregravid preparation using LMWH in women with a history of PRPC on pregnancy course and outcomes and perinatal and long-term child development outcomes. Subjects and methods. The investigation enrolled 89 patients. According to the time of LMWH therapy initiation, the patients were divided into 3 groups: 1) 29 patients who initiated LMWH therapy at the pregravid stage; 2) 30 patients who started this therapy in the first trimester of pregnancy; 3) 30 patients who did this when they developed complications. The effect of the start of therapy on the incidence of PRPC, the course of the early neonatal period, and long-term child development outcomes was evaluated. Results. Combination therapy using LMWH in patients with a history of PRPC leads to a decrease in the frequency of these complications. The efficiency of the therapy depends on the time of drug administration: pregravid preparation is most effective and makes it possible to reduce the frequency and severity of PRPC, perinatal morbidity and mortality rates, and infant morbidity during the first year of life. The therapy that is initiated when the complications manifest is ineffective. Conclusion. Pregravid preparation using LMWH improves perinatal outcomes in patients with a history of PRPC.
Keywords: 
obstetrics and gynecology
placenta
low-molecular-weight heparins
preeclampsia

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