Recurrent miscarriage is one of the main problems of obstetrics, gynecology and reproductive medicine. The incidence of recurrent misscarriage is fairly high, with most cases of abortion occurring at I trimester, and the true cause is difficult to establish. The aim of the work is to find out the predictors of early reproductive losses in women with a history of habitual miscarriage. The study included 88 women with a habitual miscarriage (the main group) and 50 women with a physiological course of I trimester of gestation (control group). The study was carried out on the basis of the Vinnitsa maternity hospital No. 2. The following research methods were used: clinical, instrumental, mathematical-statistical. Methods of research: clinical, laboratory, biochemical, instrumental, fluorescence spectroscopy, mathematical and statistical methods. According to the results of the retrospective analysis of women with the usual miscarriage during the period from 2009 to 2016 it was found that their number is approximately the same every year. Although in 2015, the proportion of non-pregnancy cases was the smallest (10.68%) compared with 2013 (18.29%) (p=0.008), the share of women with this pathology continued to increase. During the ultrasound assessment of the blood flow in the uterine vessels, it was found that the index of resistance and pulsation index in women of the main group was lower than that of control group women. It was also found that there was a strong direct correlation between certain blood flow parameters in uterine arteries and spiral arteries. So, conducting an ultrasound study for all women with a history of unexplained pregnancy and detecting changes in the blood flow in the uterine vessels will enable us to predict the pathology of placenta in the early stages, and to timely correct the findings.
Missing pregnancy is a consequence of the simultaneous or sequential action of several factors. The main causes of miscarriage and spontaneous interruption of pregnancy include: genetic factors, endocrine disorders, immune and infectious factors, congenital and acquired diseases of female genital organs. In almost 50% of women, it is not impossible to determine the reason of miscarriage, so the question of early diagnosis and prevention of this condition is quite acute.Materials and methods. In this study, we performed a pathohistological study of the deciduum in order to determine the etiological factor of the pathology of implantation of the embryo and placentation. The study included 88 women with a diagnosis of "recurrent miscarriage" that met the criteria for inclusion and exclusion.Results of research. In the study group, the age of women was from 19 to 35 years old (mean age was 27.6±4.1 years old). The abortion was observed at differentst ages of pregnancy, more often during the period of 4-9 weeks of gestation (67 cases – 76.14%). According to the results of the histopathological study of decidouum lymphohistiocytic infiltration was revealed in the stroma of villi in 62 cases (70.45%), other changes were less common.Conclusions and perspectives of further research. The obtained data indicate that the determination of the etiologic factor of miscarriage of the pregnancy, especially in women with a diagnosis "Reccurent miscarriage of obscure etiology", will allow to predict the development of the pathology of implantation and placentation in subsequent pregnancies.Prospects for further research are to develop adequate preparation before pregnancy and prevention of the pathology of implantation and placentation.
Звичне невиношування вагітності – це поліетіологічний симптомокомплекс, який є гострою соціальною та медичною проблемою.Мета дослідження – знизити частоту ранніх репродуктивних втрат шляхом розробки алгоритму прегравідарної діагностики та прогнозування ризику розвитку невиношування вагітності.Матеріали і методи. У даному дослідженні проводили аналіз ранніх репродуктивних втрат за період 2009–2016 рр. та визначали поліморфізм генів рецепторів прогестерону та ендотеліального фактора росту як можливу причину патології імплантації ембріона. У дослідження було включено 88 жінок із діагнозом звичного невиношування вагітності, які відповідали критеріям включення та виключення.Результати досліджень та їх обговорення. За звітний період було зареєстровано 533 випадки самовільного переривання вагітності, 1130 – завмерлої вагітності. За допомогою молекулярно-генетичного дослідження у 26 жінок (29,46 %) було виявлено поліморфізм гена рецепторів прогестерону, а у 70 (79,54 %) – поліморфізм ендотеліального фактора росту судин.Висновки. Отримані дані свідчать про значну роль поліморфізму генів рецепторів прогестерону та ендотеліального фактора росту в порушенні процесів імплантації та плацентації у жінок із звичним невиношуванням вагітності.
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