The viral hepatitis abnormalities in the female reproductive system are due to hepatic and extrahepatic damage. On the background of HBV- and HCV-infections, menstrual disorders prevail in the structure of reproductive system pathology; disorders of reproductive function in the form of pregnancy loss and infertility are detected in each second case. Depression of T-cell immunity in the immune status is observed in the patients with intact reproductive function. When miscarriage was in past medical history then divergent changes subpopulations of lymphocytes are found. When patients have infertility, signify depression of T-cell immunity is observed with a decrease in total T-cells, T-helper cells and active lymphocytes.
Peculiar characteristics of cytotoxic endometrial cells' response depending on the clinical aspects (frequency, gestational age, form of miscarriage, hysteroscopic pattern) have been studied. Patients with pregnancy loss in their past medical history demonstrate a decreased level of CD8 þ lymphocytes, and the decrease is exacerbated as the incidence of miscarriages increases and in the presence of endometrial hypoplasia. The content of CD16 þ lymphocytes increases in comparison with the control group, however, there is a reducing trend of this phenotype of killers as the incidence of miscarriages increases and in the presence of endometrial hypoplasia. Reduction of CD56 þ lymphocytes progresses with repeated pregnancy loss and endometrial hyperplasia. ARTICLE HISTORY
A study of the endometrium of women with herpetic infection has shown that early miscarriages (under 12 weeks) occurs as activation of cytotoxic natural killer (NK) cells with CD16 + phenotype and a pronounced suppression level of CD56 + cells endometrial type, and late miscarriages (13-22 weeks of gestation) occurs as cell deficit, followed by reduction of all CD8 + cytotoxic lymphocytes, and of CD56 + and CD16 + NK cells.
With the view of comprehensive assessment of immunity in 75 female patients having recurrent pregnancy loss in the past medical history, profiles of lymphocyte subpopulations from peripheral blood and endometrium were investigated. Depending on CD16+ levels in peripheral blood, female patients were divided into two groups: 43 females with low (first group) and 32 with high CD16+ levels (second group). It was found that the patients with high level of CD16+ lymphocytes had significantly higher levels of expression of the activation markers HLA-DR+ and CD95+ than those in the control group, and CD25+ expression levels were also higher compared to the first group. As a criterion for choosing the type of immunotherapy, CD95+/CD16+ index is used. If its value is less than 0.8 in the context of decrease of CD3+, CD4+, interferon inductors are prescribed, in case the index value is within the range of 0.9-1.29, interferon preparations are expedient. If the index value exceeds 1.3, interleukin-2 preparations are to be administered. KeywordsComprehensive assessment of immunity, recurrent miscarriage History
According to the article, pregnancy in adolescence is associated with a high risk of developing adverse outcomes both during pregnancy and childbirth in the later period. The purpose of our study was to identify the features of pregnancy and childbirth, the postpartum period in young mothers. Materials and methods. A retrospective analysis of the birth history of 299 maternity hospitals was performed. The research material was archived data from the Regional perinatal center No. 3 in Turkestan (Kazakhstan). The main (1) group was formed by 199 maternity women under 19 years of age (2019). The control (2) group was formed by 100 maternity women aged 20 to 30 years, whose sexual life began after the age of 18. Results. The age of the surveyed women in group 1 ranges from 15 to 19 years, averaging ~16.9 years. 17-year-old girls predominated (66.7%). The average age of women in group 2 was ~25.8 years. Adolescent pregnancy is a risk factor for adverse child outcomes, such as premature birth, low birth weight, fetal growth retardation, neonatal and infant mortality. In the adolescent pregnancy and delivery group, preterm birth occurred in 35 cases, which accounted for 6.8% of the total preterm birth population for 2019, but in the adolescent birth group it was 17.5%. Of the 199 births in 2 were multiple births (1%), 197 live births, the percentage of live births among adolescents was 98%, respectively, the stillbirth rate was 2% (4 cases). Conclusion: the frequency of teenage pregnancy in the dynamics of years does not tend to decrease, among young mothers only every 6 received pre-pregnancy training, and every 5 was re-pregnant and among repregnant women under 19 years.
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