Objectives: to evaluate the clinical effectiveness of the Metida for the prevention of perinatal pathology in pregnant women with gestational endotheliopathy and with the risk of preeclampsia.Materials and methods. 68 pregnant women with verified gestational endotheliopathy and with risk of preeclampsia > 1:150 participated in a prospective clinical comparative study. The patients were divided into subgroups: the first subgroup included 30 women who from 11–13 weeks of pregnancy received acetylsalicylic acid 100 mg/day and vitamin D 2000 IU/day; the II subgroup included 38 pregnant women who from 11–13 weeks of gestation received acetylsalicylic acid 100 mg/day, vitamin D 2000 IU/day and Metida (300 mg of elemental magnesium, 30 mg of vitamin B6). 28 practically healthy pregnant women of the control group received vitamin D 1000 IU/day. The clinical effectiveness of therapy was evaluated by comparing the number of cases of perinatal pathology; cases of intrauterine suffering of the fetus; the dynamics of indicators of laboratory-instrumental research methods (markers of the risk of perinatal pathology) and the pregnancy outcomes.Results. Metida as an additional preventive therapy made it possible to significantly reduce the number of cases of placental dysfunction (р = 0.01) and intrauterine suffering of the fetus (р = 0.02) compared to standard preventive therapy. There was also a 6-fold reduction in the incidence of preeclampsia and premature birth due to magnesium supplementation, compared to pregnant women who received only acetylsalicylic acid and vitamin D. There was a significant decrease in serum indicators of markers of endothelial dysfunction in women with gestational endotheliopathy as a result of taking magnesium: vascular endothelial growth factor (p < 0.00001), endoglin (p < 0.00001) compared to patients who did not receive magnesium, and there was also normalization of the of 25(OH)D level in blood serum compared to the control group (p = 0.33).Conclusions. Additional Mg supplementation during pregnancy may reduce the likelihood of perinatal pathology in high-risk patients and help normalize serum markers of endothelial dysfunction in women with high risk of preeclampsia.

Objectives: to evaluate the effectiveness of multidose supplementation of vitamin D on the dynamics of serum levels of markers of lipid metabolism in pregnant women with obesity. Materials and methods. The study included 75 pregnant women with the І degree of obesity and low vitamin D status, who were divided into subgroups depending on the vitamin D dose of and the baseline 25(OH)D level in blood serum: I subgroup – 24 women with 25(OH)D less than 22.0 ng/ml who received Decristol 4000 IU/day; II subgroup – 26 pregnant women with 25(OH)D = 22.1–28.0 ng/ml who received Decristol 2000 IU/day; III subgroup – 25 patients with 25(OH)D over 28.1 ng/ml, who received 1000 IU of vitamin D per day. Pregnant women of all these subgroups also took acetylsalicylic acid at a dose of 100 mg/day. The control group included 26 practically healthy women who received 600 IU of vitamin D per day. Serum adipokinins levels were studied at 11–13, 22–24 and 31–33 weeks of gestation.Results. Significant differences were found in the increase of leptin (p < 0.0001) and resistin (p < 0.0001) and the decrease of adiponectin (p = 0.006) in pregnant women with impaired vitamin D metabolism against the background of moderate obesity in the І trimester compared to the control group. A more positive effect was found for Decristol 4000 IU (patients with vitamin D deficiency), against the treatment of Decristol 2000 IU (patients with vitamin D deficiency). At 31–33 weeks of gestation, there was a statistically significant decrease in serum level of resistin (p = 0.006) and a similar increase in adiponectin (p = 0.025) in patients receiving vitamin D 4000 IU, compared with the same indicators in clinical subgroups. Resistin and adiponectin may be markers of perinatal pathology in obese pregnant women in the first trimester of gestation, in terms of specificity (91.5 and 78.7%, respectively), sensitivity (100.0 and 91.3%, respectively); positive probability (11.75 and 4.29%, respectively), negative prognostic value (100.0 and 94.9%, respectively) and test accuracy (94.3 and 82.9%, respectively).Conclusions. The use of markers of lipid metabolism as diagnostic criteria during pregnancy in women with the І degree of obesity and low vitamin D status has predictor and prognostic value for the risk of perinatal pathology and helps to assess the effectiveness of comprehensive prophylactic therapy.

Objectives: to evaluate the clinical effectiveness of the Vitae-Melatonin in the complex treatment of vegetative disorders in postmenopausal women.Materials and methods. The 64 postmenopausal women who complained of vegetative disorders were included in our prospective study. Patients were divided into clinical groups. The first group consisted of 31 women who were prescribed a herbal preparation of Cimicifuga racemosa extract – 30 mg/day for 3 months. The second group included 33 patients who received in addition to the herbal medicine Vitae-Melatonin 3 mg/day every evening 2 hours before bedtime for 1 month. The clinical effectiveness of the therapy was assessed 1, 2 and 3 months after the start of treatment based on the dynamics of psychological disorders, somatic symptoms, vasomotor and sexual disorders, sleep problems and satisfaction with the therapy.Results. The use of herbal medicine containing Cimicifuga rhizome extract alone or in combination with Vitae-Melatonin in postmenopausal women significantly reduced the manifestations of vegetative disorders, including psychological and dyssomnia in a month from the start of therapy. After 3 months from the start of therapy, the advantage of combined therapy involving Vitae-Melatonin compared to the monotherapy of Cimicifuga rhizome was marked by a significant reduction of psychological disorders, somatic symptoms, vasomotor disorders and sleep problems (р = 0.003, р = 0.01, р = 0.02 and p = 0.015, respectively). Patient satisfaction with the combined therapy of vegetative disorders during the menopause compared to monophytotherapy was probably higher (risk ratio 1.63, 95% confidence interval 1.09–2.44, p = 0.018). There was no significant difference between the two research groups regarding side effects during and after the use of the drugs (p > 0.05).Conclusions. The use of Vitae-Melatonin at a dose of 3 mg/day in addition to phytotherapy in postmenopausal women had a clear clinical effect, which was a significant reduction of vegetative disorders, both compared to the initial indicators and in comparison with monophytotherapy. Results of the study showed the safety of melatonin, as well as the willingness of participants to continue using melatonin after 3 months of the treatment.