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Health

Habitual miscarriage - Treatment

Treatment of the threat of abortion in patients with habitual miscarriage (symptomatic therapy)

In the early stages of pregnancy, with the emergence of dragging, aching pain in the lower abdomen and lower back, women with a habitual miscarriage of pregnancy, along with pathogenetic therapy, should undergo treatment aimed at normalizing the tone of the uterus. Up to 12 weeks gestation therapy includes:

  • semi-postal regime;
  • physical and sexual rest;
  • antispasmodics:
    • drotaverina hydrochloride in a dose of 40 mg 2-3 times a day in / m or 40 mg 3 times a day inside;
    • papaverine hydrochloride in a dose of 20-40 mg twice a day rectally or 40 mg 2-3 times a day orally;
    • Magnesium preparation - 1 tablet contains magnesium lactate 500 mg (including magnesium 48 mg) in combination with pyridoxine 125 mg; the average daily dose of 4 tablets - 1 tablet in the morning and in the afternoon and 2 tablets in the evening. Duration of treatment is set individually, depending on the symptoms of the threat of termination of pregnancy.

In the presence of a partial detachment of the chorion or placenta (up to 20 weeks gestation), along with spasmolytic, haemostatic therapy is performed with calcium preparations at a dose of 1000 mg / day, sodium etamzilate 250 mg 3 times a day or, with severe bleeding, 250 mg 3 times per day in / m.

With abundant bloody discharge with a haemostatic purpose, tranexamic acid is administered iv droplet 5-10 ml / day for 200 ml of a 0.9% solution of sodium chloride, followed by a transition to tablets at a dose of 250 mg 3 times a day until the bleeding is stopped.

In the formation of retrochoric and retroplacentary hematomas, a complex preparation containing bromelain 45 mg, papain 60 mg, pancreatin 100 mg, chymotrypsin 1 mg, trypsin 24 mg, alpha-amylase 10 mg, lipase 10 mg, ascorbic acid + rutoside 50 mg 3 tablets 3 times a day for 30 minutes before meals, the course is 14 days.

If there are pronounced tonic contractions of the uterus within 16-20 weeks of gestation, if indigestion of spasmolytic drugs is ineffective, indomethacin is used rectally or orally at a dose of not more than 200 mg / day, for a course not more than 1000 mg: 1st day - 200 mg (50 mg 4 once a day in tablets or 1 suppository 2 times a day), a 2-3 day of 50 mg 3 times a day, a 4-6 day with 50 mg twice a day, a 7-8 day - 50 mg at night.

Forecast

In the detection of the cause, correction of violations outside pregnancy, monitoring during pregnancy, the birth of viable children in couples with habitual miscarriage reaches 95-97%. According to the world literature, positive results are about 70%.

Preventing habitual miscarriage of pregnancy

Women with a history of 2 or more miscarriages or premature births should be advised before the next pregnancy to determine the cause, correct the violations and prevent subsequent complications. Methods of prevention depend on the causes underlying the habitual miscarriage of pregnancy.

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