Possibilities of optimization of pregnancy preparation in the presence of conditions accompanied by endothelial dysfunction
The implementation of the reproductive function is one of the main components of women’s quality of life. Despite significant progress in the treatment of infertility and prevention of reproductive losses, these problems are still relevant. It is also important to timely diagnose various pathological processes in order to determine the tactics of preparing women for pregnancy and its further management, taking into account the pathogenetic characteristics of diseases. Various attempts have been made to optimize both diagnostic and therapeutic approaches. Special attention is paid to identifying risk groups and ensuring the most effective preparation for pregnancy, taking into account possible risk factors for adverse outcomes. Adequate diagnostics of background pathology and the use of proven effective methods of pregravid preparation can significantly improve pregnancy outcomes. Peculiarities of the vascular system functioning may affect both the life of the woman in general and the outcome of pregnancy. Endothelial dysfunction is a component of pathogenesis of many nosologies (diabetes mellitus, chronic venous disease, hypertension, autoimmune pathology, etc.). Restoration of vascular endothelial dysfunction and, as a consequence, prevention of probable vascular complications is one of the new goals in the preventive approach to pregnancy. The promising center of this approach is considered to be the drug sulodexide. The three main effects of this drug - antithrombotic, anti-inflammatory and defensive in relation to endothelium - provide a significant increase in pregnancy preparation possibilities in many nosologies. This review presents its main features and areas of use.