Treatment of threatened abortion

The first trimester of pregnancy is the most difficult period of pregnancy and largely determines its course. During this period, the placenta is formed, embryogenesis and the formation of complex relationships between the mother and fetus. Treatment during this period should be carried out in such a way as not to disrupt these complex processes, so that the drugs used do not have a teratogenic or embryotoxic effect and do not disrupt complex hormonal and immune relationships.

Considering that in early pregnancy (2-4 weeks) spontaneous miscarriages are caused by chromosomal abnormalities in more than 50% of cases, we do not recommend using hormonal and immune therapy methods in cases where the cause of the miscarriage is unclear and there was no examination before pregnancy and preparation for pregnancy. Medications, including hormonal ones, should be prescribed according to strict indications and in minimal but effective doses. In order to limit the duration of use of medications, it is advisable to use non-drug therapies.

If there is a threat of termination of pregnancy in the first trimester, it is necessary to urgently do an ultrasound to determine the viability of the embryo, since often signs of a threat appear after the death of the embryo. After establishing the fact that there is a heartbeat of the embryo, the treatment should be comprehensive:

1. Physical and sexual peace;
2. Psychotherapy, sedatives: motherwort decoction, valerian. Psychodiagnostic testing conducted in the miscarriage clinic using the method of multifaceted personality research.

With the onset of pregnancy, the anxiety-depressive neurotic syndrome was characterized by a state of internal tension, uncertainty, anxiety, decreased mood, pessimistic assessment of the outlook, which indicated the occurrence of significant psychological discomfort. The pathogenetic basis of the psychovegetative syndrome is made up of various forms of disintegration of the activity of non-specific integrative systems of the brain, which resulted in a violation of adaptive goal-oriented behavior. It can be assumed that the psychosomatic unity of the body contributes to the maintenance of a certain level of pathological changes in women with habitual miscarriage in those organs and systems that ensure the successful development of pregnancy, forming a vicious circle. The main goal of treating the psychovegetative syndrome is to reduce the level of anxiety by changing the attitude to psychotraumatic factors and an optimistic assessment of the outcome of pregnancy, which can be achieved with the help of psychotherapy, acupuncture, as well as by treating the threat of interruption and eliminating pain syndrome as factors that increase the feeling of anxiety. The absence of corrective therapy for psychovegetative disorders in a complex of treatment measures often explains the insufficient effectiveness of drug treatment for miscarriage in this group of women.

An alternative therapy may be the use of the drug Magne-Vb. Experimental studies have shown the effectiveness of the anti-stress effect of magnesium. Clinical studies have shown that the intensity of anxiety was reduced by 60%. Magnesium is a catalyst for enzyme activity, initiates the metabolism of proteins, nucleins, lipids and glucose. Pyridoxine (vitamin B6) also has an anti-stress effect and it also plays the role of an enzyme in relation to protein metabolism. Magnesium prevents calcium from penetrating into the cell and thus relieves muscle spasm, has an antithrombotic effect by influencing the metabolism of prostacyclins.

The drug Magne-Vb is prescribed in a dose of 4 tablets per day. The regimen can be 2 tablets in the morning and 2 tablets at night; as well as 1 tablet in the morning, 1 tablet at lunch and 2 tablets at night. The duration of administration is determined by the patient's well-being from 2 weeks to almost the entire pregnancy period. The drug is well tolerated, side effects were almost not observed in anyone. Magne-Vb is prescribed from 5-6 weeks of pregnancy, especially in patients with a high level of anxiety and severe pain syndrome. No violations in fetal development from the use of magnesium therapy have been noted.

Experience of using Magne-Vb for 2 years in more than 200 patients showed the following results:

• sedative effect, reduction of anxiety, normalization of sleep was noted in 85% of pregnant women;
• a reduction in pain in the lower abdomen and lower back was observed in 65% of pregnant women;
• Normalization of bowel function was noted in all patients suffering from constipation.

Thus, Magne-Vb is an effective treatment for threatened miscarriage along with etiopathogenetic methods in a very complex contingent of patients. Magne-Vb provides an optimal level of cellular metabolism and acts as a soft tranquilizer, replacing it. Magne-Vb is recommended for wide use in obstetric practice, in inpatient and outpatient settings, as an independent remedy, as well as a drug potentiating other methods of treating the threat of premature miscarriage, especially in such a complex contingent as pregnant women with habitual miscarriage.

• Antispasmodic therapy: no-shpa 0.04 g 3 times a day, suppositories with papaverine hydrochloride 0.02 - 3-4 times a day. In case of severe pain, no-shpa 2.0 ml intramuscularly 2-3 times a day, baralgin 2.0 ml intramuscularly are used.
• Pathogenetically justified hormonal therapy depending on the causes of the threat of interruption, hormonal indicators, and the term of pregnancy. Doses of drugs are selected individually under the control of clinical and laboratory data.