Objective. To present an algorithm for providing medical care to women with fetal pathological conditions requiring artificial termination of pregnancy in order to minimize the negative impact of the pregnancy artificial termination on the woman’s physical and mental health.
Materials and methods. 129 patients were examined: 104 patients undergoing hospital treatment due to the pregnancy artificial termination for medical reasons caused by the fetus state at 13 — 22 weeks (group I). The main group (IA) consisted of 33 women who received medical care according to the algorithm we had developed and the comparison group (IB) consisted of 71 women with the pregnancy terminated artificially who received medical care the developed algorithm not applied. The control group (group II) consisted of 25 pregnant women at 13-22 weeks that further gave birth to healthy full-term pregnancy children. All women had been determined the plasma levels of amino acids and their derivatives by high-performance liquid chromatography. The patients’ mental state was assessed by clinical interviews using the Hospital Anxiety and Depression Scale (HADS), Hamilton’s 21-point depression scale (HAM-D — 21).
Results. While analysing the mental state and metabolic changes among the women of group I before the pregnancy artificial termination a statistically significant increase in the total content of amino acids by 15% (p<0.001), essential amino acids by 12.3% (p=0.003) and non-essential amino acids by 13.6% (p<0.001) was revealed as compared with those of the women in the control group II as well as the frequency of the clinically expressed anxiety by 14.1% (p=0.041), of the subclinically expressed depression by 32.8% (p=0.009), and of the mild depressive episodes by 45% (p<0.001) as compared with the control group. The algorithm developed for providing medical care to pregnant women with the fetus pathological conditions requiring the pregnancy termination at later stages including an effective medical method of the pregnancy termination and psychic correction allowed minimize the risk of the uterus and cervix rupture, the pathological blood loss, the number of infectious complications, improve the mental state and achieve the metabolic balance by optimizing the plasma amino acid composition.
Conclusion. The developed algorithm use for providing medical care to women with pregnancy terminated artificially for medical reasons caused by the fetus state allows minimize the negative consequences on the woman’s mental and physical health.Ключевые слова:
Автор(ы): L. N. Keda, L. V. Gutikova