PRINCIPLES OF THERAPY FOR SYMPHYSIOPATHY IN THE THIRD TRIMESTER OF PREGNANCY
Objective. To evaluate the efficiency of multimodality treatment including calcium preparations and local ultraviolet radiation (UVR) for symphysiopathy in the second and third trimesters of pregnancy. Subjects and methods. Fifty pregnant women with symphysiopathy were examined. According to treatment options, the investigators identified 2 patient groups: 1) 30 pregnant women who received Calcemin and UVR and 2) 20 who took Calcemin only. The efficiency of the therapy performed was evaluated from the time course of changes in bone metabolic parameters: the bone formation marker osteocalcin, the bone resorption marker β-isomer of C-terminal telopeptide of type 1 collagen, and plasma vitamin D levels. Results. The vast majority (more than 80%) of pregnant women with symphysiopathy accompanied by evolving pelvic bone pain syndrome, convulsions and parasthesias in the limbs, and pubic symphysis diastasis were found to have urinary tract infections that were both chronic and first detected during pregnancy. The clinical symptoms of symphysiopathy were associated with changes in bone remodeling: lower vitamin D3 levels, inhibited osteosynthesis, and, in severe cases, suppressed bone resorption. Conclusion. Multimodality therapy with currently available calcium preparations and local UVR causes not only a reduction in the clinical symptoms of symphysiopathy, but also improves bone metabolic processes.