UA96161U - Method for preventing gestational complications in pregnant women with vitamin d deficiency - Google Patents

Abstract

A method for preventing gestational complications in pregnant women with vitamin D deficiency include the use of oral formulations of vitamin D(cholecalciferol). From the 12th week of gestation Akvadetrim is administered which dosage depends on the level of the active metabolite of vitamin D-25(OH)Din the blood of pregnant women, in so doing, the check of vitamin D level in the blood is performed every three weeks.

Description

A useful model belongs to medicine, in particular obstetrics and gynecology, and can be used for the prevention of gestational complications in pregnant women with vitamin 0 deficiency and deficiency.

Pregnancy is a period of important physiological changes, when the normal development of the fetus requires not only a regular and balanced diet, but also an adequate supply of all necessary vitamins and trace elements. It was established that even a balanced diet is deficient in basic vitamins by 20-30 90, and already at the end of pregnancy, 50-9295 women have a deficiency of 2 or more micronutrients in blood serum. The low provision of vitamins and microelements in women creates a high risk of pregnancy and childbirth complications (I.S. Sydorova, The role of the vitamin-mineral complex in pregravidary preparation, pregnancy and lactation / I.S. Sydorova, A.L. Unanyan // Gynecology. - 2011 -

Vol. 13, Mo. 5. - pp. 83-85). Until recently, the role of vitamin O during pregnancy was associated only with the prevention of rickets. However, it has been proven that vitamin ХO is important for reproductive health, as it affects steroidogenesis and folliculogenesis; regulates the functioning of the endometrium, and also affects the processes of fertilization, development of the embryo and its implantation in the wall of the uterus.

Deficiency of vitamin O during pregnancy can not only worsen the condition of the skeleton in the mother and the fetus, but also contribute to the development of atherosclerosis, increase the risk of preeclampsia, premature birth, cause the development of insulin resistance and gestational diabetes, metabolic syndrome, neonatal hypocalcemia (Noite5 MA, Vatev5 M5. Miatip 0 deiiisiepsu apa ipziyiisiepsu ip rgedpapi motep: a Iopoyshaipai! vishau. Vg U Mii" 2009; 102 (6): 876-811.

Among the well-known ways of correcting vitamin O deficiency is the use of various preparations containing pure cholecalciferol or multivitamin preparations with various combinations of vitamins and trace elements.

A well-known method of correcting vitamin OO deficiency in pregnant women is the use of the multivitamin-mineral complex Elevit Pronatal, which contains 500 IU of cholecalciferol (vitamin Oz) I|Fofanova I.Yu. Prevention of vitamin deficiency during pregnancy: the role of vitamin and mineral complexes / I.Yu. Fofanova //Gynecology Mo 2 (appendix to the magazine SopviShit theaisit). - 2010. - Vol. 12. - P. 2-5). The drug is prescribed orally in a dose of 1 tablet/day, starting from the 12th week of pregnancy. This is a complex drug

Zo contains vitamins and microelements in different dosages, but does not contain the necessary dose of vitamin 0 for pregnant women, which is determined by different levels of saturation of the body with vitamin 0.

Today, from the large list of multivitamin preparations available on the Ukrainian market and recommended for use during pregnancy, none contain optimal doses of the vitamin

Oh, which are recommended according to world norms. The currently recommended dosage parameters of vitamin O during pregnancy in Ukraine are outdated and do not provide adequate correction of its deficiency, which prompts the search for new drugs and the introduction of alternative treatment regimens.

The basis of a useful model is the task of creating a method of preventing gestational complications in pregnant women with deficiency and lack of vitamin O, which will allow to ensure sufficient intake of vitamin O in the pregnant woman's body, correct its deficiency and prevent complications of the gestational process.

The task is solved by the fact that in the method of preventing gestational complications in pregnant women with a deficiency of vitamin O, which includes the oral use of vitamin Oz preparations (cholecalciferol), according to a useful model, the drug Aquadetrim is prescribed from 12 weeks of pregnancy, the dosage of which depends on the level of the active metabolite of the vitamin 0-25(OH)Oz in the blood of pregnant women, while the control of the level of vitamin O in the blood is carried out every 3 weeks.

The task is also solved by the fact that at a level of 25(OH)Oz in the range of 20-32 ng/ml (lack of vitamin 0), the drug Aquadetrim is prescribed in a dose of 1000 IU (2 drops/day), at a level of 25(OH)Oz less than 20 ng/ml (vitamin 0 deficiency) - in a dose of 2000 IU (4 drops/day), with the normalization of the level of vitamin Y (25(OH)Oz in the range of 32-60 ng/ml), the dose of the drug up to 36 weeks of pregnancy is 500 IU ( 1 drop/day).

In the proposed method of prevention of gestational complications in pregnant women with deficiency and deficiency of vitamin Y, the drug Aquadetrim is used from 12 weeks of pregnancy, and the dosage of the drug is adjusted depending on the severity of vitamin Y deficiency by determining its active metabolite 25(OH)Oz in the blood.

At a level of 25(0OH)Oz in the blood in the range of 20-32ng/ml (vitamin Y deficiency), the recommended dose is 1000 IU (2 drops/day) of the drug Aquadetrim, and at a level of 25X0OH)Oz less than 20 ng/ml (vitamin Y deficiency ) a dose of 2000 IU (4 drops/day) is required. Duration of use of the drug

Aquadetrim is monitored by determining the level of 25X(OH)Oz in the blood every 3 weeks.

The drug Aquadetrim |"Medapa" is proposed for the prevention of gestational complications

Rpapta Tegro! dgoyr" Joint Stock Company, Poland| this is a synthetic preparation of cholecalciferol, identical to endogenous, which is formed in the human body under the influence of solar radiation. It is produced in the form of an aqueous solution for oral use at 15,000 IU/ml, 10 ml in 1 vial. The composition of the preparation includes cholecalciferol (vitamin Yuz) as an active anti-rickets factor that plays a significant role in the absorption of calcium and phosphates from the intestines, in the transport of mineral salts and in the process of bone calcification, regulates the excretion of calcium and phosphates by the kidneys. The concentration of calcium ions affects a number of important biochemical processes that determine maintenance of muscle tone of the skeletal muscles, participate in nerve stimulation and affect blood clotting. Vitamin Oz also participates in regulating the activity of the immune system

The significance and role of microelements in human physiology and pathology: (textbook for students of medical universities / M.V. Fedosenko, R.R. Shiryaev, O.A. Gromova (and others) - GOU VPO Ivanovskaya state Medical Academy, Ivanovo, 2005. - 123 p.|

The method is carried out as follows. The duration of treatment is determined by the level of vitamin O deficiency in the blood of pregnant women by determining its active metabolite 25(OH) Oz by chemiluminescent magnetic immunoassay (CMIA). In case of vitamin O deficiency (level of 25(OH)Oz in the blood within 20-32 ng/ml) prescribe 1000 IU (2 drops/day) of the drug

Aquadetrim, and with vitamin O deficiency (level of 25X0OH)Oz less than 20 ng/ml) the dose is 2000 IU (4 drops/day) under the control of the level of vitamin ХО in the blood every 3 weeks. When the level of vitamin O is normalized (the level of 25(OH) Oz in the range of 32-60 ng/ml), pregnant women are prescribed the drug

Aquadetrim up to 36 weeks of pregnancy in a dose of 5200 IU/day.

To determine the clinical effectiveness of the proposed method of preventing gestational complications in pregnant women with vitamin O deficiency and deficiency, 80 pregnant women were monitored in the Department of Extragenital Pathology of Pregnant Women of the Lviv Regional Clinical Hospital and the Department of Pregnancy Pathology of the Lviv Regional Perinatal Center. Patients of the main group (40 women) with predicted risks of gestational complications (obesity, gestational diabetes, premature birth), who used the proposed method, were divided into two subgroups: 1-28 pregnant women with vitamin O deficiency (level of 25(OH)Oz in the blood in group 25,654.2

Z ng/ml, I - 12 pregnant women with vitamin O deficiency (level of 25(OH)Oz in blood 18.3:20.8 ng/ml). In the control group (40 women), the method chosen as the closest analogue was used, and the women were also divided into two subgroups, respectively, I subgroup - 3 women with vitamin 0 deficiency, HER subgroup - 10 women with vitamin 0 deficiency.

Therapy in the main group included: for vitamin deficiency 0-1000 IU (2 drops/day) of the drug Aquadetrim, and for vitamin deficiency 0-2000 IU (4 drops/day) of the drug

Aquadetrim under the control of the level of vitamin O in the blood every 3 weeks. When the vitamin level is normalized

OB (25(OH) Oz) in the range of 32-60 ng/ml pregnant women were prescribed the drug Aquadetrim up to 36 weeks of pregnancy in a dose of 500 IU (1 drop/day).

In the control group, the multivitamin and mineral complex Elevit Pronatal, which contains 500 IU of cholecalciferol, was used in a dose of 1 tablet/day in the same periods of pregnancy.

The effectiveness of the treatment was evaluated by the dynamics of the course of the gestational process, the proportionality of the growth of the fetus according to the data of ultrasound fetometry, the development of gestational diabetes and preeclampsia.

The results of clinical observations are presented in the table.

Effectiveness table 25)" 25(ONUz z/p: 26,853.2 19,120.6 treatment 25.6:4.2 (ng/ml) 18.30.8 (ng/ml) (ng/ml (ng/ml )

Number

Z. medicinal 1 1 1 1 drugs

Continuation of Table

According to According to 4. | ultrasound of gestational gestational SZRPUu5 SZRPU With fetometry and and term term 110/60-120/80 110/60-120/80 Gestational Gestational 5. | Blood pressure during the period during the period | hypertension hypertension observation in 5 in Z

A two-hour test with Y Y Y in GD glucose did not reveal GD-A1 GD-Z GD-1. 26-37-40 week. 11-37-39 week.

Clinical observation of patients in the main group proved that the use of the drug Aquadetrim in differentiated doses (depending on the severity of vitamin deficiency

Or) effectively prevents the development of such severe gestational complications as preeclampsia, gestational diabetes, premature birth. This gives reason to use the drug Aquadetrim (cholecalciferol) in the indicated doses for the prevention of gestational complications in women with vitamin D deficiency and deficiency.

Claims (2)

USEFUL MODEL FORMULA 1. The method of prevention of gestational complications in pregnant women with vitamin Y deficiency, which includes the oral use of preparations of vitamin YOz (cholecalciferol), which differs in that from 12 weeks of pregnancy, the drug Aquadetrim is prescribed, the dosage of which depends on the level of the active metabolite of vitamin O-25 (OH )Oz in the blood of pregnant women, while monitoring the level of vitamin O in the blood is carried out every 3 weeks. 2. The method according to claim 1, which differs in that at a level of 2XOH)Oz in the range of 20-32 ng/ml (lack of vitamin Y), the drug Aquadetrim is prescribed in a dose of 1000 IU (2 drops/day), at a level of 25(OH) Oz less than 20 ng/ml (vitamin 0 deficiency) - in a dose of 2000 IU (4 drops/day), with the normalization of the level of vitamin O (level of 25(OH)Oz within 32-60 ng/ml) drug dose up to 36 weeks of pregnancy is 500 IU (1 drop/day).