THE AIM OF THE STUDY
Was to justify the advisability of gestagens’ application in pregnant women with acute pyelonephritis (OP) and to evaluate their effectiveness in prevention of obstetric complications.
MATERIAL AND METHODS
The study included 145 pregnant women with OP. In group 1 (n=70) gestagens (micronized progesterone 100 mg or dydrogesterone 10 mg every 12 hours, orally) were used daily in a complex of therapeutic measures. In group 2 (n=75), a standard therapy was carried out: infusion, antibacterial, antispasmodic, herbal medicine, kidney stenting according to indications. 3rd group (n=50) represented by women with a physiological pregnancy development. The complex of examination included ultrasound examination with Doppler’s measurement, examination of serum steroid hormones’ concentration (progesterone, cortisol, dehydroepiandrosterone sulfate) and gravid proteins (trophoblastic beta-1-glycoprotein, placenta-specific alpha-1-microglobulin) by enzyme immunoassay.
RESULTS
Incidence of acute pyelonephritis during pregnancy leads to desynchronization of steroid hormones’ synthesis and gravid proteins, disorders of the utero-placental blood flow, which increase the number of placenta premature maturation (38.7%), pathology of amniotic fluid (32.0%), fetal growth retardation (24, 0%), gestational arterial hypertension (34.7%), preeclampsia (32.0%), and premature childbirth (28.0%). It has been proven that usage of gestagens allows timely and safely to correct the hormonal and hemodynamic disorders, preventing further progression of placental dysfunction and its negative impact on pregnancy development and its outcome.
CONCLUSION
The additional usage of gestagens in a complex of therapeutic applications in pregnant women with OP increases the effectiveness of therapy by reducing the incidence of complications and early termination of pregnancy. In pregnant women with OP who received progestogens, it is advisable to carry out further careful dynamic control of urine bacterial tests.
