Method of prevention of preeclampsia in high-risk development

 

(57) Abstract:

The invention relates to medicine, obstetrics. Determine the state of the autonomic nervous system, the type of blood circulation, adaptive response. Assign the reception of adaptation funds. Impact vibration massage of biologically active corporeal point. At point VB 20, H 43, F 2, C 7, MC 6, E 36 affect thermovibrational. Sessions are conducted daily or every other day with 8-12 weeks of pregnancy. The course of 10-12 treatments. Teach two courses. The method reduces the number of complications. 3 table.

The invention relates to medicine, namely to obstetrics, and for prevention of preeclampsia in high risk of its development.

Currently known method for drug prevention of preeclampsia [4], according to which women with high risk of development of this obstetric complications 7-8 weeks. pregnancy along with adherence to rational regime of work and rest, protein diet and treatment of extragenital diseases are assigned multivitamin preparations. With 15-16 weeks. pregnancy in complex prophylaxis added herbs, improves kidney function, vascular tone and condition of the Central nervous system, as well as spasmodic the chronic pyelonephritis at this stage of gestation appoint disaggregants (trental), membrane stabilizers (Essentiale-Forte) and antioxidants (tocopherol acetate, ascorbic and glutamic acid). The medications provided during the month, the amount spent during the period of gestation courses of prevention equals 2-3, a break between courses is 2-3 weeks.

Despite a significant reduction in the incidence of clinically this horizon manifest itself preeclampsia and perinatal mortality, as well as the complete elimination of severe forms of preeclampsia, this method has significant disadvantages:

1) the need for long-term continuous use of a large number of pharmacological preparations;

2) late onset (15-16 weeks). correction of the disturbed when preeclampsia mechanisms of adaptation to pregnancy;

3) the possible effect development of prooxidative and worsening fetal suffering of the fetus.

A method of treating primary forms of preeclampsia on the basis of laser irradiation of biologically active points of the body pregnant [3]. In the complex therapy except svetarundra includes a balanced diet, oxygen-herbal cocktails and substances sedative, antispasmodic and hypotensive actions in minimum quantities. This sposobnosti this way:

1) possible adverse effects of laser radiation on organogenesis preclude the use of this method in the early stages of pregnancy as early prevention of preeclampsia;

2) requires special facilities and special training for working with laser radiation.

Closest to the present invention is a method of prevention of preeclampsia using complex predominantly non-pharmacological interventions: psychotherapy, acupuncture, rational diet, physical therapy and herbal medicine [1] . The method provides for 3-4 two-week courses for the entire period of gestation. The effectiveness of this method in the prevention of clinical forms of preeclampsia is high enough, but he is not devoid of drawbacks that limit its use:

1) requires participation in the treatment of a psychologist, neurologist, physician-reflex, and doctor in physical therapy that can be carried out only in large medical institutions;

2) in the monitoring process are poorly controlled by the basic mechanisms of homeostasis in gestosis: concentration and select tion of the kidneys, gemology is lugenia for the pregnant woman and the fetus does not allow to consider this method of prevention of preeclampsia in full pathogenetically justified.

3) acupuncture is accompanied by pain, which is undesirable in high vegetative lability of the body during pregnancy;

4) using invasive method reflex therapy, this method requires careful observance of measures of asepsis and antisepsis, which complicates its use.

A new technical result is an increase in efficiency of the method by reducing complications - reaching a new way to prevent preeclampsia, including the allocation of risk groups the possible development of the disease on the basis of accounting anamnestic data and assigning a multivitamin, with the subsequent impact of physical factors on biologically active points of the body in patients with high risk of preeclampsia, and further define the autonomic nervous system, adaptive response and the type of blood circulation and appoint adaptogens (extracts of Siberian ginseng, Rhaponticum carthamoides, zamanihi, Chinese Magnolia vine) in therapeutic doses, simultaneously stimulating vibration massage of biologically active points of the skin Gi 11 (qu Chi), R 3 (tai-si) and Vg 14 (Yes-Jui), vibrating every point mode toning within 1-1,5 min with a frequency of 100 Hz and the amplitude of 0.3 mm is -if) mode dispersion, vibrating specified points within 2-3 min showerhead, heated to 40-42oC, with a frequency of 30-50 Hz and amplitude of 1-1,5 mm rate of 10-12 procedures carried out daily or every other day with 8-12 weeks. pregnancy, increasing the number of points from 3 to 8, the course repeat 2 times, in the absence of somatic pathology in pregnant affect point 14 Vg (Yes-Jui), Gi 11 (qu Chi), MC 6 (nei-Guan) and E-36 (zu-San-Li), in the presence of a pregnant woman chronic pyelonephritis, hypertension, disorders of contractility in the complex therapy include another point R 3 (tai-si), VB 20 (Feng Chi), H 43 (Xue-Dian), F 2 (Blu-Jian), C 7 (Shen-men).

The method is as follows:

1. On its own prognostic scale (table. 1) on the basis of the extracted diagnostic ratios that measure the presence of preeclampsia in a previous pregnancy, and extragenital pathology in the time of the survey (chronic pyelonephritis, anemia, diseases of the endocrine glands, neurocirculatory dystonia), types of vegetative regulation (sympathicotonia, normotone, vagotonic), circulatory (hypokinetic, akineticheskie, hyperkinetic), reaction of adaptation (training, activation, acute and chronic is SS="ptx2">

2. Women with a high risk of developing preeclampsia appoint adaptogens (extracts of Siberian ginseng, Rhaponticum carthamoides, zamanihi, Chinese Magnolia vine) in therapeutic doses and complex multivitamin preparations, simultaneously stimulating vibration massage of biologically active points of the skin Gi 11 (qu Chi), R 3 (tai-si) and Vg 14 (Yes-Jui), vibrating every point mode toning within 1-1,5 min with a frequency of 100 Hz and the amplitude of 0.3 mm, and optionally at point VB 20 (Feng Chi), H 43 (Xue-Dian), F 2 (Blu-Jian), C 7 (Shen-men), MC 6 (nei-Guan) and E-36 (zu-San-Li) in mode dispersion, vibrating specified points within 2-3 min showerhead, heated to 40-42oC, with a frequency of 30-50 Hz and amplitude of 1-1,5 mm Each procedure involves exposure to no more than 8 points. The course consists of 10-12 procedures carried out daily or every other day. If necessary, repeat the course 2 times.

3. In the absence of somatic pathology in pregnant affect point 14 Vg (Yes-Jui), Gi 11 (qu Chi), MC 6 (nei-Guan) and E-36 (zu-San-Li). If the expected development of combined preeclampsia on the background of chronic pyelonephritis, hypertension in violation of contractility in the complex therapy include another point R 3 (tai>4. When signs of preclinical stage of preeclampsia (PreExecute) drug treatment is conducted according to generally accepted for this state method (antiplatelet agents, membrane stabilizers, antihypoxants, antispasmodics etc), but the principle of vibration exposure remains unchanged.

Example 1. Parvovirinae Meters, 24 years old, classified as at high risk for development of preeclampsia, as had a number of adverse factors: neurocirculatory dystonia of mixed type, chronic pyelonephritis, obesity 1 tbsp. and moderate lymphopenia (sum of scores for prognostic scale was equal to 18). With 10 weeks. pregnancy she started a course of vibratory massage of biologically active points in combination with taking adaptogens (extract of Eleutherococcus 30 drops 2 times a day - morning and mid-day), herbal infusions, sedative and diuretic actions (motherwort herb, knotweed, bilberry leaf, rosehips, and so on) in 20 ml a day multivitamins. The reflex course of treatment consisted of 12 sessions, the point of impact R 3 (tai-si), VB 20 (Feng Chi), H 43 (Xue-Dian), F 2 (Blu-Jian), C 7 (Shen-men), MC 6 (nei-Guan) and E-36 (zu-San-Li). Procedures were performed every other day with the following parameters of vibration: frequency of 30 Hz, the am is yum. Herbal medicine continued throughout the entire period of gestation. In 16 weeks. pregnancy the patient was determined to increased activity of the coagulation potential of blood fibrinogen concentration of 4.2 g/l, were weakly positive tests paracoagulation, platelets decreased to 160109/L. In the daytime the woman were conducted 5 intravenous infusions trental with next enteral administration of the drug within 24 days. Hypercoagulation syndrome was eliminated and further progression of pregnancy was not renewed. The course of reflex therapy and taking adaptogens were repeated at 18 and 28 weeks. of gestation. During pregnancy blood pressure did not rise above 130/80 mm RT. Art., glomerular filtration remained within 96,4-106,9 ml/min, specific gravity of urine - 1017-1029. The total weight gain during pregnancy was 8.8 kg of Rodorazresheniye in time a living fetus weighing 3550 g rated on a scale of Apgar at 1 minute of life score of 8 on the 5th minute of the 9 points.

Example 2. Patient W., 29 years old had a history of previous 2 pregnancies, one of which is artificially interrupted in the early stages the desire of women. Second pregnancy ended in a cesarean FIC). After birth within 6 months was in the dispensary at the nephrologist, extragenital pathology is not diagnosed. For the first time for medical care for this pregnancy the woman turned at the 21st week. On initial examination revealed symptoms of pretexts: lability of arterial pressure during functional tests, Express sample McClure - Aldrich, reduce the daily amount of urine, angiopathy of the retina, sympathicotonia; the score was equal to 14. Prevention of preeclampsia assigned mini-dose (60 mg/day acetylsalicylic acid, kidney tea 200 ml/day, vitamin E 0.4 g/day. Simultaneously, the course started vibrating massage of biologically active points Gi 11 (qu Chi), R 3 (tai-si) and Vg 14 (Yes-Jui) mode toning within 1-1,5 min with a frequency of 100 Hz and amplitude fluctuations of 0.3 mm were 10 treatments over-the-counter daily. With 24 weeks of pregnancy in women committed excessive weight gain - up to 700 g per week. At 26 weeks of gestation in patients receiving acetylsalicylic acid and kidney tea was repeated course of vibratory massage of biologically active points of the body. Under the influence of therapy increased total urine output, increased glomerular filtration, improved krovat the Lena in table 2). Normal body weight was restored to 30 weeks. of gestation. An ultrasound performed at 36 weeks. pregnancy, defined the size of the fetus in excess gestational norm. Clinical manifestations of preeclampsia (edema, hypertension, proteinuria), as well as the suffering of the fetus until the end of pregnancy were not diagnosed. At 38 weeks. the woman was made cesarean section, the indication for which was the combination of large fetus and the uterine scar. Retrieved live fetus weighing g 4050 in satisfactory condition. The postoperative period and the condition of the newborn remained normal.

A mode of action selected on the basis of clinical observations. Treated 80 patients.

For vibration selected biologically active points of the body through the stimulation of which may change in blood pressure, improving kidney function, eliminate fatigue, increase adaptation. Point VB 20 (Feng Chi), F 2 (Blu-Jian), C 7 (Shen-men), MC 6 (nei-Guan) and E-36 (zu-San-Li) are the points of General jurisdiction, sanogenetic affect the entire body; the point Gi 11 (qu Chi), H 43 (Xue-Dian), F 2 (Blu-Jian), VB 20 (Feng Chi), 14 Vg (Yes-Jui) and E-36 (zu-San-Li) are the points of control of vascular tone. T is 20 (Feng Chi), Vg 14 (Yes-Jui) and H 43 (Xue-Dian) directly affect the trophic and bioelectrical activity of the brain functional state of the anterior lobe of the pituitary and thyroid glands.

Vibration frequency of 100 Hz, stimulates physiological processes, increases local functional lability, which is useful to provide toning of biologically active points. Frequency is 30 Hz, which is close to the minimum resonance frequency is 25 Hz, at which the body begins to respond to the effects of vibration and is therefore optimal for the effect of dispersion. Vibration with a frequency of less than 25-30 Hz no therapeutic effect on vibration with a frequency greater than 100 Hz, the organism responds to local and segmental angiospasm, which can impair blood flow to the brain and cause stress effect.

For toning biologically active points of the displacement of the vibrator, 0.3 mm. selected empirically. When arousing reflex effects healing factor should cause a mild local tenderness that vibration with a frequency of 100 Hz in the majority of observations is achieved by displacement of the vibrating nozzle 0.3 mm Large amplitude causes patients expressed pain, etc is less than 1 mm in patients does not cause the so-called unforeseen sensations, testifying to activate this point. Vibration with a frequency of 30 Hz and an amplitude of more than 1.5 mm causes a feeling of sharp pain and unwanted pain.

The temperature of the nozzle equal to 40-42oC, while providing a braking effect on biologically active point causes the feeling of light heat, which increases the effect of dispersion. The higher temperature of vibrator can cause burning zone of impact and pain, the temperature of the nozzle is less than 40oC is close to the temperature of the body and may reduce the expected therapeutic effect.

Use no more than 3 points in the beginning of therapy, due to the necessity of gradual training in conditions of increased autonomic lability pregnant. The impact of end-of-course no more than 8 points eliminates a possible overload of the organism and the subsequent development of the stress response.

The number of procedures, equal to 10-12, associated with the need to achieve sustainable adaptation reactions of the organism, which develops after 8-10 treatments. Over the next 10-15 sessions all the parameters of the body remain unchanged, and to 25-28 procedure begins with the natural reaction of fatigue and exhaustion. Shadowrose (8-12 weeks. pregnancy) selected with the aim of timely correction of violations of the mechanisms of adaptation to the gestational process. The later beginning of the prevention of preeclampsia reduces the efficiency of the method. Reflex treatment during implantation of the ovum and early organogenesis may cause abortion.

Because therapeutic effect of any visioneering impact remains less than 2 months, and most intensively preeclampsia is manifested in the second half of pregnancy, courses vibroreplacement and adaptive prevention of preeclampsia repeated twice in 18 and 28 weeks.

Thus, the application of this method allows to correct broken when preeclampsia processes of adaptation to pregnancy, to stabilize vascular tone, strengthen concentration and renal excretory function, increase the contractile activity of the myocardium. As a result of this possible reduction in mean arterial pressure, elimination of hidden swelling, improve blood circulation to the kidneys and fetoplacental system. Although our results (table. 3) prevention and treatment of preeclampsia are more modest than in the method prototype, and slightly greater than those of laterobasal much lower than analogues. Unlike the prototype of the proposed method is easily tolerated by patients, does not require special facilities, simple in execution, can be used in the outpatient setting and in obstetric hospitals, if necessary, may educate patients to self-massage. Low cost devices for the hardware vibration makes them available for any medical institution, and for home use.

Indications for use: the definition of a pregnant high risk of developing preeclampsia.

Contraindications:

1) the patient extragenital pathology in the stage of subcompensation or decompensation;

2) febrile condition;

3) high risk of miscarriage this pregnancy.

References

1. Jerkin N. A. Clinical and pathogenetic basis of psycho-vegetative regulation in the prediction, prevention and treatment of OPT-gestosis: author. dis. Prof. the honey. Sciences. - M., 1991. - 49 S.

2. Jerkin N. A. // WHOLESALE-gestosis: the Plenary session of the Interdepartmental scientific Council on obstetrics and gynecology RAMS. - Cheboksary, 1996 - S. 133.

3. Malevich, K. I., Gerasimovich, I., Rusakevich P.F. Methods lasertherapie in obstetrics and inassociation of obstetricians and gynecologists. - 1995. - #4. - S. 83-88.

Method of prevention of preeclampsia in high risk of its development, is based on identifying groups at risk of possible development of the disease on the basis of accounting anamnestic data and assign multivitamin with subsequent exposure to physical factors on biologically active points of the body in patients with high risk of preeclampsia, characterized in that it further determine the state of the autonomic nervous system, adaptive response and the type of blood circulation and appoint adaptogens (extracts of Siberian ginseng, Rhaponticum carthamoides, zamanihi, Chinese Magnolia vine) in therapeutic doses, simultaneously stimulating vibration massage of biologically active points of the skin Gi 11 (qu Chi), R 3 (tai-si) and Vg 14 (Yes-Jui), vibrating every point mode toning within 1 - 1.5 min with a frequency of 100 Hz and the amplitude of 0.3 mm, and optionally at point VB 20 (Feng Chi), N 43 (Xue-Dian), F 2 (Blu-Jian), 7 (Shen-men), 6 MS (nei-Guan) and S 36 (zu-San-Li) in mode dispersion, vibrating specified points within 2 - 3 min showerhead, heated to 40 - 42oC, with a frequency of 30 to 50 Hz and amplitude of 1 - 1.5 mm rate of 10 - 12 procedures carried out daily or every other day with 8 - 12 weeks of pregnancy, increasing the number of Takeda-Jui), Gi 11 (qu Chi), 6 MS (nei-Guan) and S 36 (zu-San-Li), in the presence of a pregnant woman chronic pyelonephritis, hypertension, disorders of contractility in the complex therapy include another point R 3 (tai-si), VB 20 (Feng Chi), N 43 (Xue-Dian), F 2 (Blu-Jian), 7 (Shen-men).

 

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