Obstetrics and Gynecology
doi: 10.25005/2074-0581-2019-21-4-565-569
PREVENTION OF PLACENTAL INSUFFICIENCY IN PREGNANT WOMEN WITH DIFFUSE GOITER AND HYPOTHYROXINEMIA

Sh.D. Saydakhmadova1,2, M.Ya. Kamilova1, M.A. Khaknazarova3, N.G. Rakhimov4

1Tajik Scientific Research Institute of Obstetrics, Gynecology and Perinatology, Dushanbe, Republic of Tajikistan
2Republican Medical College, Dushanbe, Republic of Tajikistan
3Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
4Department of Anesthesiology and Resuscitation, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To assess the clinical acceptability of prevention of placental insufficiency (PI) by nitric oxide donators (NOD) in pregnant women with diffuse goiter.

Methods: Data from 70 pregnant women with diffuse goiter and hypothyroxinemia were analyzed; including 45 (64.3%) patients (I group) received iodine-containing drugs (ICD) and 25 (35.7%) patients (II group) received ICD and NOD Tivortin in combination with Tocopherol in the second trimester of pregnancy. Control of the effectiveness of therapy conducted according to data of dopplerometry in the third trimester of pregnancy.

Results: Of the 45 patients in the group I, 15 (33.3%) were in the cases of dopplerometrically diagnosed disorders of uterine-fetus-placental blood flow: in 8 (53%) cases compensated, in 7 (47%) cases subcompensated. In all women with a subcompensated form of PI, the pregnancy has been complicated by pre-eclampsia. Of the 25 patients in the second group, only 2 (8%) were in the observations revealed the compensated form of the PI.

Conclusion: In diffuse goiter and gestational hypothyroxinemia, the prevention of iodine deficiency, which involves taking iodine-containing drugs reduces the frequency of PI. However, the implementation of comprehensive prevention of PI, which provides the filling of the deficiency of nitric oxide, gives the best results. Apparently, in the studied iodine-deficiency status, despite the replenishment of iodine deficiency, develops pathological dysfunction of the endothelium. The use of NOD at the beginning of the second trimester of pregnancy, during the period of active angiogenesis, contributes to the normal formation and functioning of chorion vessels, as well as explains the difference in the frequency and severity of hemodynamic disorders depending on the prevention of PI.

Keywords: Diffuse goiter, hypothyroxinemia, placental insufficiency, nitric oxide donator , dopplerometry.

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Authors' information:

Saydakhmadova Shakhlo Dzhumakhonovna
Applicant, Tajik Scientific Research Institute of Obstetrics, Gynecology and Perinatology; Head of the Department of Obstetrics and Gynecology, Republican Medical College
ORCID ID: 0000-0001-8266-9469

Kamilova Markhabo Yadgarovna
Doctor of Medical Sciences, Associate Professor, Head of the Department of Obstetrics, Tajik Scientific Research Institute of Obstetrics, Gynecology and Perinatology
ORCID ID: 0000-0002-2525-8273

Khaknazarova Matlyuba Abdulmadzhidovna, Doctor of Medical Sciences, Head of the Department of Obstetrics and Gynecology № 1, Avicenna Tajik State Medical University
ORCID ID: 0000-0003-1903-6882

Rakhimov Nurmakhmad Gulmakhmadovich
Assistant, Department of Anesthesiology and Resuscitation, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-2989-3872

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Saydakhmadova Shakhlo Dzhumakhonovna
Applicant, Tajik Scientific Research Institute of Obstetrics, Gynecology and Perinatology; Head of the Department of Obstetrics and Gynecology, Republican Medical College

734002, Republic of Tajikistan, Dushanbe, Tursun-zade Str., 31

Tel.: +992 (917) 620010

E-mail: saydakhmadova@inbox.ru

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