Treatment of preeclampsia of mild and moderate severity.
I. Treatment-protective regime.
II. Dietotherapy (rational protein nutrition, rich in vitamins and microelements, limiting the fluid to 700-800 ml and table salt to 2.5-5 g per day).
1. Sedative preparations (seduksen 0005 g three times a day or a tincture of valerian root for 20 drops three times a day), phytococtails, reflexotherapy.
2. Hypotensive drugs: - dibasol 05% solution 2-4 ml intramuscularly 2 times a day, - papaverine 2% solution 2 ml 3 times a day; - glucose-novocaine mixture intravenously (100ml 20% glucose solution and 100ml 025% novocaine solution) - preparations of rauwolfia (ronatinum 0002 g three times a day or rousedil at 000025 g 2-3 times a day) - with a persistent increase arterial pressure that can not be corrected - ganglioblocators (1ml 5% solution pentamine m or pyrilene 0005 g 3 times a day) - ACE inhibitors (captopril 625 mg three times a day after meals).
3. Desensitizing therapy (dimedrol 1% - 1ml 2 times a day or Tavegil 0001 g twice a day).
4. Strengthen the vascular wall (askorutin 1 tablet three times a day, calcium gluconate 0.5 g three times in
5. At the expressed edemas - infusion therapy of hyperoncotic and hyperosmotic solutions (100ml of 10% albumin solution, 150ml of concentrated plasma or 400ml of reopolyglucin) followed by 40 mg of furosemide.
6. Drugs that improve metabolism in the myocardium (Riboxin 10% solution, 10 ml intravenously once a day, essential 5-10 ml, pre-diluted blood of the patient, intravenously, daily) and funds that purposefully stimulate the production of PNUG cardiomyocytes of the right atrium (orotate Potassium 0.5 g three times a day, 1 hour before meals methionine 0.5 g three times a day, nicotinic acid 0.1 g 3 times a day, folic acid 0003 g three times a day).
7. Irritation of low-pressure volumoreceptors by redistribution of blood in the body, in order to stimulate the release of IPNG by secretory cardiomyocytes for help or an anti-overload suit (compression of the legs and thighs of a pregnant woman with pneumatic pressure 50-60 mmHg for 1 hour daily for 7-12 days ), Or water immersion compression (immersion of patients in a bath filled with water (t-34 ° Q to the level of the sixth cervical vertebra at 1.5-2 hours daily or every other day, 6-12 procedures)
Correction of violations of the central g modynamics (korglikon struyno 1ml 006% solution in 20 ml of saline once a day, for 3-5 days with the subsequent transition to a maintenance dose of digoxin 025 mg 1-2 times a day verapamil 80 mg three times a day day for 10 days)
9. Improvement of the rheological properties of the blood (curantil, trental, under the control of a coagulogram or 300 mg of adjuvant intravenously drip on a solution of rheopolyglucin).
10. Stimulation of prostacyclin synthesis (small doses of aspirin - 60 mg per day or nitroglycerin - 00015 g
11. Donators of nitric oxide (yerenite 10 mg 3-4 times daily before meals).
12. Antioxidant therapy (combined use of 5% solution of unithiol 10 ml intravenously, vitamin E 100 mg per day and ascorbic acid 200 mg per day).
13. Enterosorbents (activated charcoal 2 tablets 3-4 times a day).
14. Improve utero-placental circulation for the prevention of fetal hypoxia: glucose 5-10% solution 500ml with 50mg of cocarboxylase, 10ml of 5% solution of ascorbic acid and insulin, based on one unit per 4g of dry weight of glucose sygetin 2ml of 2% solution intravenously , 5% sodium hydroxycarbonate solution, theonikol 015 g three times a day.
For the purpose of prevention of RDS in a newborn, considering the possibility of an urgent termination of pregnancy from 28 to 36 weeks, it is advisable to use mucosolvan (1 vial - 50 ml, intravenously for 4-5 days) or dexamethasone (4 mg intramuscularly 2 times a day 3 days). The term of treatment of pregnant women with pre-eclampsia of mild severity is up to 3 weeks, the average degree is 5-7 days. When the remission is achieved, the manifestations of the disease disappear and the biochemical parameters are normalized during the two-week stay in the hospital, the patients can be discharged home with the doctor's confidence that in each specific case the pregnant woman will be strictly monitored by the doctor of the women's consultation at least 2-3 times a week. When restoring the slightest clinical manifestations of gestosis - repeated hospitalization. In the absence of positive dynamics in the patient's condition, during the time treatment of pre-eclampsia or if his condition worsens, early delivery is indicated.