Hepatoprotective therapy with low molecular weight sugar drug for pregnant women with liver dysfunction amid early toxicosis and hepatotoxicity
Authors:   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint Petersburg, Russian Federation, Mozgovaya E.V. ,   Saint Petersburg State University, Saint Petersburg, Russian Federation, Kryshnya M.A. ,   “SM-Clinic” LLC, Saint Petersburg, Russian Federation, Shelaeva E.V. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint Petersburg, Russian Federation, Nagorneva S.V. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint Petersburg, Russian Federation, Oparina T.I. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint Petersburg, Russian Federation, Tumasova Zh.N. ,   D.O.Ott Research Institute of Obstetrics, Gynecology and Reproductology, Saint Petersburg, Russian Federation, Khalenko V.V. ,   Saint Petersburg State University, Saint Petersburg, Russian Federation
Published: July 2021

Objective. To assess the efficacy and safety of low molecular weight sugar solution as a hepatoprotector in the first trimester of pregnancy in patients with liver functional disorders against the background of early toxicosis and / or hepatotoxicity. Patients and methods. The study included 70 patients: the main group (n = 30) – pregnant women with functional hepatopathies who received therapy with drug Heptrong; the control group (n = 30) – pregnant women who received standard treatment, of which 15 patients had hepatotoxicity (essential phospholipid therapy) and 15 patients with early toxicosis (intravenous saline fluid therapy, Cerucal), as well as 10 pregnant women with early toxicosis who were treated without drugs (the placebo group). Results. Pregnant women with early toxicosis noted a decrease in its clinical manifestations against the use of the drug Heptrong after 2.3 ± 0.8 days from the onset of therapy; by the end of therapy, all patients had no vomiting, and nausea stopped in 80%, which was not observed in comparison groups. The normalization of alanine aminotransferase (≤40 U/L) occurred in 80% of pregnant women in the main group (p < 0.01) and in 66% (p < 0.01) when treating with essential phospholipids. The normalization of alanine aminotransferase (≤40 U/L) occurred in 90% (p < 0.01) and 33.3% (p = 0.03), respectively. A significant decrease in the level of bile acids (from 8.49 ± 2.1 μmol/L to 2.74 ± 1.1 μmol/L; p < 0.05) and improvement in the indicators of the antioxidant system – an increase in total antiradical activity (from 804.0.0 ± 10.5 μmol/L to 839.0 ± 11.0 μmol/L; p < 0.05) and a decrease in the level of conjugated dienes (from 3.77 ± 0.2 μmol/L to 3.26 ± ± 0.1 μmol/L; p < 0.05) – were observed only in the main group. A number of other indicators of the “liver panel” tended to improve only in the main group. Conclusion. Heptrong is an effective hepatoprotective drug, which considerably improves the state of pregnant women during early toxicosis and helps to reduce liver transaminases and bile acids in pregnant women with hepatotoxicity. Due to the antiinflammatory and pronounced antioxidant effect, which is not observed in standard pharmacological treatment, Heptrong can be used to prevent late obstetric complications. Key words: Heptrong, drug-induced hepatopathies, “liver panel” indicators, early toxicosis