NA. V.I.KULAKOV»
FSBI «National Medical Research Center for Obstetrics, Gynecology
and Perinatology named after Academician V.I.Kulakov»
Ministry of Health of the Russian Federation
FSBI «National Medical
Research Center for Obstetrics, Gynecology
and Perinatology named after Academician V.I.Kulakov»
Ministry of Health of the Russian Federation
The 2nd Obstetric Department of Pregnancy Pathology
The 2nd Obstetric Department of Pregnancy Pathology
Head of Department: Nana Tetruashvili, M.D.
E-mail: n_tetruashvili@oparina4.ru
The Department provides a whole spectrum of expert medical care for women with complications in pregnancy, focusing on those, who have a threat of miscarriage, preterm labor, multiple pregnancy, rhesus-sensitization, placental insufficiency and the past history of repeated pregnancy loss.
Health care is provided by highly qualified personnel both in outpatient and the specialized inpatient facility. Management of the patients with habitual fetal losses is based on holistic approach and continuity of care from preconception to labor.
Every year more than 1 200 pregnant women undergo inpatient treatment and get ready for labor. More than 12 000 patients receive counselling annually.
TREATMENT OF HABITUAL MISCARRIAGE
The patients with previous failures of pregnancy undergo a special examination in accordance with algorithm elaborated in the Department. It includes detection and treatment of causative factors of habitual miscarriage: infectious-inflammatory, anatomical, hormonal, immunological, immunogenetic, thrombophilic disorders.
The attending physician after identifying all disorders and risk factors conducts their preconceptional correction and gives all necessary recommendations for management of hormonal causes (hyperandrogenia, hyperprolactinemia and the resulting irregularities of the menstrual cycle, infertility, miscarriages); infectious and inflammatory factors (inflammatory processes of the uterus and adnexa, sexually transmitted infections caused by chlamydia, mycoplasma, ureaplasma, genital herpes, cytomegalovirus ); anatomical causes (uterine malformations, uterine myoma, endometrial polyps, synechia, isthmic-cervical insufficiency); genetic malformations (consultations are held together with geneticist); immunological and immunogenetic problems (antiphospholipid syndrome, anti-HCG antibodies, compatibility of married couples according to HLA system); thrombophilia (congenital and acquired).
Unprecedented work experience since 1962, high qualification, continuity of care and team spirit in the activities aimed to achieve and preserve pregnancy in all possible cases allowed to introduce the best domestic and foreign standards in obstetric-gynecological and prenatal care for women with complicated pregnancy.
THE SCOPE OF MANAGEMENT
- multiple pregnancy
- monochorionic multiple pregnancy (feto-fetal transfusion syndrome, reverse arterial perfusion syndrome), fetal surgery;
- hemolytic disease of the fetus, Rh-sensitization (intrauterine blood transfusion to the fetus);
- antiphospholipid syndrome, congenital thrombophilia leading to pregnancy problems (placental insufficiency, fetal growth restriction);
- autoimmune disorders (HLA-compatibility, immunocytotherapy before and during pregnancy (ICT, LIT);
- habitual miscarriage (two or more pregnancy losses at early stages);
- invasive diagnostic procedures: choriocentesis, amniocentesis;
- preparation of patients with obstetric problems for IVF program;
- management of pregnancy after IVF at all terms of pregnancy;
- gestational arterial hypertension (selection of therapy, follow-up);
- preeclampsia;
- placental insufficiency, fetal growth restriction;
- placenta previa, placenta accreta;
- preterm labor
The diagnosis and treatment are carried out at the up-to-date level of healthcare services in accordance with the developments of the Department and international recommendations for the management of women with complicated pregnancy.