Optimization of Prevention of Intrahepatic Cholestasis of Pregnant Women

Abstract

Discrete plasmapheresis was performed as follows: blood transfusion was performed by puncturing the ulnar vein in plastic bottles "Hemakon 500/300". After thorough mixing, the blood was placed in a Bechman refrigerated centrifuge and centrifuged at 3000 rpm for 6 minutes at 22°C. The plasma separated from the cell mass was removed using a plasma extractor. The remaining cells were diluted with 150 ml of saline and re-infused into the patient. During one session, 1-2 blood samples were taken, depending on the patient's condition, the patient's weight and the tolerance of the procedure. Plasma exfusion was carried out from 25-30% of the circulating plasma volume. Plasma replacement was performed with hydroxyethyl starch (HES 6%) preparations, crystalloid solutions in a ratio of 2:1 to the removed plasma. Administration of hyperoncotic albumin solution was performed when the albumin content in the blood was below 30 g/l. All patients were prescribed a high-protein diet. Stabilization of the blood was carried out with 100 ml of glucagon solution in each double bag. All patients were heparinized at 50 U/kg of patient weight. The treatment course consists of an average of 3-4 PA sessions with an interval of 2-4 days, depending on the clinical and laboratory parameters describing the patient's condition, laboratory parameters, etc. The average number of courses per pregnant woman was 3.6±0.7 per pregnancy. Hematological, hemostatological and biochemical indicators were determined in all patients to evaluate the effectiveness of therapy.