GynecologyGynecologyГинекология2079-56962079-5831Consilium Medicum7610010.26442/20795696.2021.3.200960REVIEWОБЗОРReview ArticleRisk factors and prevention of placenta-associated diseasesФакторы риска и профилактика плацента-ассоциированных заболеванийhttps://orcid.org/0000-0001-8555-6670MinaevaEkaterina A.МинаеваЕкатерина Алексеевна
Russian Federation

Graduate Student

аспирант 1-го отд-ния патологии беременных

minaevakatya93@yandex.ruhttps://orcid.org/0000-0002-2206-1002ShmakovRoman G.ШмаковРоман Георгиевич
Russian Federation

D. Sci. (Med.), Prof. RAS, National Medical Research Center for Obstetrics, Gynecology and Perinatology

профессор РАН, доктор медицинских наук, директор Института, главный внештатный специалист по акушерству Минздрава России

r_shmakov@oparina4.ruKulakov National Medical Research Center for Obstetrics, Gynecology and PerinatologyФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России130820212332362401607202116072021Copyright ©; 2021, Consilium MedicumCopyright ©; 2021, ООО "Консилиум Медикум"2021Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://gynecology.orscience.ru/2079-5831/article/view/76100

The review presents modern data on the preventive effect of antiplatelet and anticoagulant therapy of placenta-associated diseases. The review includes data from foreign and Russian articles published over the past 15 years on the Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, Pubmed databases. In recent years, there have been reports of the effectiveness of low molecular weight heparins in the prevention of placenta-associated complications. M. Rodger et al. In their study (2016), report on the effect of low molecular weight heparins on the development of placenta-associated complications. Patients whose previous pregnancy was complicated by preeclampsia or fetal growth restriction were randomized into 2 groups. The first group of pregnant women began to receive injections of low molecular weight heparins at an early stage of pregnancy (before 12 weeks), the second group did not receive low molecular weight heparins. Thus, only 19% of women receiving low molecular weight heparin therapy and 43% of women not receiving it developed placenta-associated complications, which may indicate the effectiveness of low molecular weight heparins. This data shows the urgency of the problem of placenta-associated complications, and the development of effective methods of early prevention of these diseases can improve the outcomes of the pregnancy.

В обзоре представлены современные данные о профилактическом действии антиагрегантной и антикоагулянтной терапии плацента-ассоциированных заболеваний. Включена информация из зарубежных и отечественных статей, опубликованных за последние 15 лет в базах данных Scopus, Web of Science, MedLine, The Cochrane Library, EMBASE, Global Health, CyberLeninka, Pubmed. В последние годы появились сообщения об эффективности низкомолекулярных гепаринов (НМГ) в профилактике плацента-ассоциированных осложнений (ПАО). M. Rodger и соавт. в своем исследовании (2016 г.) рассматривают влияние НМГ на развитие ПАО. Пациентки, предыдущая беременность которых осложнилась преэклампсией или задержкой роста плода, были рандомизированы на 2 группы. 1-я группа беременных начала получать инъекции НМГ на раннем сроке беременности (до 12 нед), 2-я группа – не принимала. Таким образом, только у 19% женщин, получающих терапию НМГ, и у 43% женщин, не принимающих препарат, развились ПАО, что может свидетельствовать об эффективности НМГ. Представленные данные подтверждают актуальность проблемы ПАО, а разработка эффективных методов своевременно начатой профилактики этих заболеваний позволяет улучшить исходы беременности.

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