akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLCakusherstvo-72Research ArticleОRIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИANTITHROMBOTIC PROPHYLAXIS REPEATED PREECLAMPSIA IN PATIENTS WITH THROMBOPHILIAПРОТИВОТРОМБОТИЧЕСКАЯ ПРОФИЛАКТИКА ПОВТОРНЫХ ПРЕЭКЛАМПСИЙ У ЖЕНЩИН С ТРОМБОФИЛИЕЙЖуравлеваЕ. В.ZhuravlevaE. V.evyashenina@list.ruГБОУ ВПО «Первый МГМУ имени И.М. Сеченова» Минздрава РФ, МоскваРоссияFirst Moscow State Medical Sechenov University of the Ministry of Health Russian FederationRussian Federation201407062016821116Copyright © Zhuravleva E.V., 20162016Журавлева Е.В.Zhuravleva E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/72

Objective. To evaluate the efficiency of antithrombotic therapy to prevent repeated preeclampsia in patients with thrombophilia. Subject and methods. A prospective clinical study was conducted 66 patients with thrombophilia (genetic, acquired or concomitant) and with history of preeclampsia: 35 patients addressed and were followed since fertile cycle (subgroup Ia) and 31 patients addressed during pregnancy and were followed since 6-13 weeks of gestation – IIa subgroup. Control group – 50 patients without both obstetrics and gynecology and thrombotic complications in history. Therapy included LMWG (klexan), B vitamins, antioxidants and micronized progesterone. Results. The all period of pregnancy, obstetric and perinatal outcomes were better in patients receiving therapy since fertile cycle compared with group of patients whose therapy was initiated during pregnancy.Conclusion. To prevent re-PE at a subsequent pregnancy, the therapy should be start since fertile cycle, continuing during pregnancy, childbirth and the postpartum period. Therapy should include LMWH, B vitamins, antioxidants and micronized progesterone.

Цель исследования - оценка эффективности противотромботической профилактики повторных ПЭ у женщин с тромбофилией. Материал и методы. Проведено проспективное клиническое исследование с участием 66 пациенток с тромбофилией (генетической, приобретенной или сочетанной) и ПЭ в анамнезе: 35 - обратившиеся и, соответственно, находящиеся под нашим наблюдением с фертильного цикла (подгруппа Ia), и 31 - обратившиеся к нам уже будучи беременными (с 6 по 13 нед. гестации) - IIa подгруппа. Контрольную группу составили 50 женщин с неотягощенным акушерскогинекологическим и тромботическим анамнезом. Терапия проводилась: НМГ (эноксапарин), витамины группы В, антиоксиданты и микронизированный прогестерон. Результаты исследования: у пациенток, получавших терапию с фертильного цикла, течение беременности, акушерские и перинатальные исходы были лучше, чем в группе пациенток, терапия которым была начата во время беременности. Заключение: для предотвращения повторной ПЭ при последующей беременности необходимо начинать терапию с фертильного цикла, продолжая во время беременности, родов и в послеродовом периоде. Терапия должна включать НМГ, витамины группы В, антиоксиданты и микронизированный прогестерон.

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The authors declare that there are no conflicts of interest present.