Features of the course of pregnancy in women with menstrual cycle disorders and their correction with didrogesterone at the stage of pregravid preparation

• Alina V. Solovieva
• Larisa A. Chegus
• Kristina S. Ermolenko
• Olga A. Kuznetsova
• Ekaterina Yu. Aleynikova

Abstract

Aim – to identify the features of the course of pregnancy in women with menstrual cycle disorders (MCD) in anamnesis with and without dydrogesterone administration during pregravid preparation.

Material and methods. A retrospective analysis of outpatient antenatal clinic cards and birth histories in the District Clinical Hospital of Khanty-Mansiysk for women aged 19–39 years was carried out. Data from 85 patients were included in the analysis. Of these, 54 patients had menstrual disorders before pregnancy, of which 23 women complained of menstrual irregularities and were prescribed dydrogesterone in accordance with the instructions for the medical use of the drug (20 mg per day from the 11^th to the 25^th day of the menstrual cycle for at least 3 months). 31 patients with menstrual disorders were not prescribed therapy. The comparison group included 31 healthy women.

Results. Based on menstrual disorders’ correction with dydrogesterone, positive dynamics was observed in the study group, which was manifested by normalization of frequency in 69.6%, duration of menstruation in 87% and blood loss volume in 73.9% of women. 2.2 times more often, threatening miscarriage complicated the course of the I trimester in pregnant women with MCD who did not receive dydrogesterone in comparison with patients who received the drug starting from the stage of pregravid preparation. Women who did not receive MCD therapy at the stage of pregravid preparation were significantly more likely to have mild iron-deficiency anemia (IDA) in the I trimester and during prenatal period (2.97 times more often than in women who received dydrogesterone). Moderate IDA was observed in the I trimester only in women with MCD without dydrogesterone administration (12.9%). In patients with previous MCD who received dydrogesterone at the stage of pregnancy planning, spontaneous delivery was less common compared with no therapy. Significantly more often, programmed and operative births were recorded in treated and preconception-treated patients. The average term of delivery in women with preconception preparation with dydrogesterone did not differ from the indicators of women from the comparison group and amounted to 38–40 weeks.

Conclusion. The course of pregnancy and childbirth in women with MCD is characterized by an increase in the frequency of such complications as: threatened miscarriage in the I trimester; IDA diagnosed at various stages of pregnancy; earlier delivery time. Therefore, such patients need pregravid preparation. Dydrogesterone administration in women with MCD at the stage of pregravid preparation led to menstrual cycle normalization, a decrease in the frequency of threatened miscarriage in early pregnancy and iron deficiency anemia at various gestational ages.

Keywords:menstrual cycle disorders; dydrogesterone; pregnancy; pregravid preparation

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