Treatment of the threat of termination of pregnancy

The first trimester of pregnancy is the most difficult period of pregnancy and largely determines its course. During this period, the formation of the placenta, embryogenesis and the formation of complex interrelations of the body of the mother and fetus. Treatment during this period should be conducted so as not to disrupt these complex processes, so that the used means do not give teratogenic or embryotoxic effect and do not violate complex hormonal and immune relationships.

Taking into account that in early pregnancy (2-4 weeks) spontaneous abortions of more than 50% are due to chromosomal abnormalities, we do not recommend the use of hormonal and immune methods of therapy in those cases when the cause of the miscarriage is not clear and there was no pre-pregnancy examination and preparation for pregnancy. Medication, including hormonal drugs, should be prescribed according to strict indications and in minimal, but effective doses. In order to limit the duration of the use of medications, it is advisable to use non-drug therapies.

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

1. Physical and sexual rest;
2. Psychotherapy, sedatives: decoction of motherwort, valerian. Psychiatric testing conducted in the clinic for miscarriage using the method of multilateral personality research.

With the onset of pregnancy, the anxiety-depressive neurotic syndrome was characterized by a state of internal tension, uncertainty, anxiety, a decrease in mood, a pessimistic assessment of the outlook, which indicated the appearance of considerable psychological discomfort. The pathogenetic basis of the psychovegetative syndrome is formed by various forms of disintegration of the activity of nonspecific integrative brain systems, which resulted in a violation of adaptive, purposeful behavior. It can be assumed that the psychosomatic unity of the organism helps to maintain a certain level of pathological changes in those organs and systems that ensure the successful development of pregnancy, forming a vicious circle in women with habitual miscarriage. The main task of psycho-vegetative syndrome treatment is to reduce the level of anxiety by changing attitudes towards traumatic stress factors and optimistic evaluation of the outcome of pregnancy, which can be achieved with the help of psychotherapy, acupuncture, and by treating the threat of interruption and eliminating the pain syndrome as augmenting feelings of anxiety. The lack of often corrective therapy of psycho-vegetative disorders in a complex of medical measures explains the insufficient effectiveness of drug treatment of miscarriage in this contingent of women.

An alternative way of therapy can be the use of a magne-Vb preparation. As a result of experimental studies, the effectiveness of magnesium anti-stress action was demonstrated. Clinical studies have shown that anxiety intensity decreased by 60%. Magnesium is a catalyst for the activity of enzymes, it initiates the metabolism of proteins, nucleic acids, lipids and glucose. Anti-stress action has and pyridoxine (vitamin B6) and it also plays the role of an enzyme in relation to the metabolism of proteins. Magnesium prevents the penetration of calcium into the cell and thus relieves muscle spasm, has an antithrombotic effect, by affecting the metabolism of prostacyclin.

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 a night; as well as 1 tablet in the morning, 1 tablet for lunch and 2 tablets for the night. Duration of admission is determined by the patient's well-being from 2 weeks to almost the entire gestation period. Tolerability of the drug is good, no side effects have been observed in almost anyone. Assign magne-VB from 5-6 weeks of pregnancy, especially in patients with a high level of anxiety and severe pain. There were no any violations in the development of the fetus from the use of magnesia therapy.

The experience of using magne-Vb for 2 years in more than 200 patients showed the following results:

• sedation, a decrease in anxiety, normalization of sleep was noted in 85% of pregnant women;
• reduction of pain in the lower abdomen, lower back was observed in 65% of pregnant women;
• normalization of the intestine was noted in all patients suffering from constipation.

Thus, magne-Bb is an effective treatment for the threat of abortion along with etiopathogenetic methods in a very complex patient population. Magne-Vb provides an optimal level of cellular metabolism and acts as a mild tranquilizer, replacing it. Magne-Vb is recommended for wide application in obstetric practice, in inpatient and outpatient settings, as an independent tool, as well as as a drug that potentiates other methods of therapy of the threat of premature termination of pregnancy, especially in such a complex contingent as pregnant women with habitual miscarriage.

• Spasmolytic therapy: no-spawning to 0,04 g 3 times a day, suppository with papaverine hydrochloride 0,02 - 3-4 times a day. In the case of severity of pain, a no-shpa 2.0 ml is used intramuscularly 2-3 times a day, baralgin 2.0 ml intramuscularly.
• Pathogenetically grounded hormone therapy, depending on the causes of the threat of interruption, hormonal parameters, gestational age. Doses of drugs are selected individually under the control of clinical and laboratory data.