Резюме

Лахно І.В., Неєлова О.В., Пак С.А. , Даниленко О.К. Пошук шляхів профілактики ускладненого перебігу вагітності.

Проведено вивчення ефективності використання препарату йодомарин у вагітних для профілактики ускладнень процесу гестації і родового акту. Йодна профілактика дозволила запобігти розвитку оксидативного стресу , нівелювала мітохондріальну дисфункцію і енергодефіцит, усувала передумови для генералізованих вазоконстрікторних реакцій, забезпечувала необхідну готовність для спонтанного початку пологів при доношеній вагітності та сприятливий перебіг родового акту.

Ключові слова: вагітність, йододефіцит, йодомарин, ускладнення вагітності та пологів , профілактика .

Резюме

Лахно И.В., Неелова О.В., Пак С.А., Даниленко О.К. Поиск путей профилактики осложненного течения беременности.

Проведено изучение эффективности использования препарата йодомарин у беременных для профилактики осложнений процесса гестации и родового акта. Йодная профилактика позволила предотвратить развитие оксидативного стресса, нивелировала митохондриальную дисфункцию и энергодефицит, устраняла предпосылки для генерализованных вазоконстрикторных реакций, обеспечивала необходимую готовность для спонтанного начала родов при доношенной беременности и благоприятное течение родового акта.

Ключевые слова: беременность, йоддефицит, йодомарин, осложнения беременности и родов, профилактика.

Summary

Lakhno I. V., Neelova O. V., Pak S. A., Danilenko O.K. The search of the ways to prevent pregnancy complications.

It was performed the investigation of iodomarin application efficacy in pregnant women to prevent gestational and delievery complications. Iodine prophylaxis has allowed to prevent the development of oxidative stress, mitochondrial dysfunction and energy deficit, eliminated the prerequisites for generalized vasoconstrictor responses, provides the necessary ability for spontaneous onset of the term delievery and beneficial current of labor.

Key words: pregnancy, iodine deficiency, iodomarin, complications of pregnancy and delievery, prophylaxis.

UDC 618.3+618.5+618.7]-06-036-084:616.018.2

THE SEARCH OF THE WAYS TO PREVENT PREGNANCY COMPLICATIONS

Lakhno I. V., Neelova O. V.¹, Pak S. A., Danilenko O.K².

Kharkiv Medical Academy of Postgraduate Education

Dnipropetrovsk City Clinical Hospital № 9

¹- oksana.neelova78@gmail.com

²-danilenko_o.66@mail.ru

The goal of the research was studying of gestation course and act of delivery for habitants of Kharkiv in the conditions of iodic prophylaxis.

We examined 450 pregnants that were divided into 3 clinical groups. The Ist (control) group consisted of 50 patients that got iodomarin 200 of 1 pill 1 one time per 24 hours on the stage of  preconceptional preparation  2-3 months prior to the  planned pregnancy and during the whole gestation period. The IInd (comparison) group consisted of 200 pregnants that were under care and who did not get  an iodic prophylaxis  . The IIId (basic) group consisted of 200 patients that were getting from the II trimester during  the whole pregnancy iodomarin 200 of 1 pill 1 one time per 24 hours . The middle age of groups was: (24,8±3,6); (24,2±4,1) and (26,1±4,6) years in the Ist, IId, and IIId groups accordingly.

It was studied the plasma concentration of zyme α-hydroxybutyrate dehydrogenase  (α-HBDG) for the estimation of pregnants energetical status. Oxidation status of pregnants was estimated by determination of concentration of  lipid peroxidation (LPO) indexes and antioxidant protection system (AOPS) : malondialdehyde (MDA) according to the method of Gavrilov - Gavrilova - Mishul, catalase of blood plasma by the  Bakh’s  method and peroxydase by the Popov’s method.

It was  studied heart rate variability (HRV) of mother  by noninvasive registration of ECG on 5 minutes records by means of the computer-diagnostic system "Cardiolab plus fetal" technical research centre "KAI-Medica" (Kharkiv, Ukraine) for estimation of vegetative status of all  the examined pragnants. Frequency characteristics were got by fast Fourier transformation. It was estimated the value of total capacity of spectrum of the autonomic nervous regulation (TP) and power of three spectral components: very low-frequency (VLF) metaboly-vasoactive, low-frequency (LF) sympathoadrenal and high-frequency (HF) vagal-insular. Also it was studied the value of sympathovagal balance (LF/HF).

All laboratory and instrumental researches were conducted in the same terms: on 24, 32 and 38 weeks of pregnancy. It was estimated the level of complications of pregnancy and act of delivery by groups.

During the conducted work it was set distinctions of energetical status of the examined patients. The values α-HBDG were on 24, 32 and 38 weeks of pregnancy : (162,0±21,5) UN, (162,4±19,6) UN, (162,6±20,2) UN; (171,4±32,6) UN, (172,5±29,8), (176,4±26,4) UN; (162,4±18,2) UN, (162,8±20,8) UN, (163,1±32,6) UN in the Ist, IInd and IIId groups accordingly. Thus distinctions of this index for the patients of the comparison group  were statistically reliable in comparison with control (p<0,05), and in the basic group they practically did not differ. It points to progression for pregnants of the IInd  group of mitochondrial disfunction. It is notable that iodine donation allowed to level energy exchange abnormalities in the basic group.

Undertaken by us studies allowed to reveal considerable distinctions of indexes of the functional state of LPO and AOPS for the inspected cohort in the IIId trimester of pregnancy. The level of the end product LPO - MDA in the blood serum   was for certain increased for pregnants of the IId  group in comparison with control values (р<0,05). Analogical changes were registered at the study of MDA concentration  in the erythrocytes of patients from the comparison group . The concentration of peroxydase and catalase was for certain decreased for all patients of the IInd  group in comparison to control (р<0,05). The indexes of oxidative status of pregnants of the control and basic groups were practically identical.

The concentration of bioelements for examined pregnants had practically identical values in all clinical groups for  alcium, zinc, iron and copper. It was set the reliable decrease of magnesium level for pregnants of the comparison group that did not get potassium iodide. Thus serumal magnesium content for the patients of the basic group was  almost identical to control values.

The state of autonomic nervous regulation  in the group of pregnants that did not get an iodic prophylaxis demonstrated decrease of level of control mechanisms functioning of  mother's circulatory dynamics systems. Thus in the group of comparison on a background of decrease of  general power of HRV spectrum  changed correlations of sympatic (LF) and parasympathetic (HF) regulation links, that found a reflection in growth of sympathovagal balance (LF/HF). The value of sympathovagal balance for pregnants of the control group  was practically unchanging  (0,5±0,1) during the IIId  trimester of pregnancy. In the basic group the increase of this index was registered in the dynamics of supervision: (0,5±0,1); (0,6±0,1) and (0,8±0,2) on 24, 32 and 38 weeks of pregnancy accordingly. Realization of iodic prophylaxis allowed pregnants of large industrial center of the East Ukraine to decrease the level of gestational complications and optimize the act of delivery.

Thus prescription of iodomarin allowed to improve the indexes of energetic status of pregnants organism, repressed the  peroxidation processes, restored the level of magniamia, formed steady vagal insular pattern of the autonomic nervous regulation and allowed to decreases the level of gestational complications and optimize the act of delivery.