Enterosorption as concomitant therapy for early toxicosis in pregnant women after assisted reproductive technologies against the background of constipation
Authors:   SI «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova NAMS of Ukraine», Kyiv, Davydova Iu.V. , Lymanskaya A.Y. ,   SI «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova NAMS of Ukraine», Kyiv
Published: May 2021

The aim is to evaluate the effectiveness of the drug «Atoxil Plus» use in the group of pregnant women after assisted reproductive technologies (ART) with early mild toxicosis against the background of constipation. Materials and methods. The effectiveness of the drug «Atoxil Plus» (Orisil-Pharma) in 37 pregnant women with early mild toxicosis on the background of constipation was studied. The pregnant women in the study had no other comorbidities (pathology of the gastrointestinal tract, severe heart failure, infectious diseases, etc.). Taking into account that the definition of the quality of life indicator is an integral indicator of the effectiveness of treatment, the quality of life of pregnant women was assessed according to the «Gastrointestinal Simptom Rating Scale» (GSRS), a special questionnaire, before and after complex treatment of early toxicosis using the drug «Atoxil Plus». GSRS includes 15 questions to assess the following domains: the presence of abdominal pain, heartburn, constipation, diarrhea and signs of dyspepsia. The lower the results for the studied domains, the better. All pregnant women used the «Atoxil Plus» (2 g 3 times/day) for 10–14 days. Any general or local laxatives were excluded from the treatment regimen. Results. Treatment of early pregnancy toxicosis is important, given the loss of electrolytes, microelements, water and significant deterioration in the quality of life. High sorption capacity of Atoxil Plus in relation to microorganisms and bacterial toxins, the possibility of moderate therapeutic doses use due to the large active surface area, the increased binding rate of bacteria and their toxins provide quick therapeutic effect. Against the background of the «Atoxil Plus» enterosorbent use, not only does the constipation frequency not increase, which is very important during pregnancy, but the number of bowel movements is normalized due to the presence of lactulose in the medication, especially given the significant amount of gestagens pregnant women receive after ART. Conclusions. The non-invasive nature of the use of Atoxil Plus, its oral administration, high efficacy in pregnant women with early toxicosis, which manifests itself in improving the quality of life and general well-being, a high safety profile make it possible to recommend this drug as a treatment for early mild toxicosis against the background of constipation in pregnant women after ART. The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of women was obtained for the research. The authors declare no conflict of interest. Key words: pregnant women, assisted reproductive technologies, constipation, treatment, sorbents.