Мать и дитя в Кузбассе (Jun 2019)
FORMATION OF THE RISK GROUP OF LOSS AND COMPLICATIONS OF THE CURRENT PREGNANCY BASED ON THE IDENTIFICATION OF COMBINATION OF GENETIC AND IMMUNOLOGICAL FACTORS
Abstract
The aim of the research – develop and pathogenetically substantiate a new diagnostic complex, including combinations of mutations of the genes of the hemostasis system and the folate cycle with autoimmune disorders, which increase the risk of loss and complications of the course of pregnancy. Materials and methods. A two-stage study of women of reproductive age. At the prospective stage, 113 women with retrochorial hematoma participated in the study. Women were divided into 2 groups (with threatened and failed miscarriage). At the retrospective stage, primary documentation of 309 women was studied, which were divided into 3 groups: with habitual and sporadic miscarriage, normal reproduction. The association of mutations in the hemostasis system (PAI-1, FII FV), folate cycle (MTHFR) and elevated levels of embryotropic antibodies with the loss and complications of pregnancy was studied. Results. Associations of the presence of PAI-1, FV, FII, MTHFR gene mutations and increased levels of antibodies to immunoglobulin Fc-fragment, thyroglobulin with spontaneous miscarriage in women with retrochorial hematoma, common miscarriage, cervical insufficiency, premature rupture of fetal membranes (p < 0.05). Conclusion. Thus, the identification of combinations of genetic (mutations of the PAI-1, FV, FII, MTHFR genes) and immunological (increased levels of antibodies to the immunoglobulin Fc-fragment, thyroglobulin) allows changes at the pregravid stage and early pregnancy to form groups of increased risk of developing loss and pregnancy complications, start personalized therapy. Timely pathogenetic therapy will reduce the risk of pregnancy complications.
