Креативная хирургия и онкология (Oct 2018)
Peculiarities of the Haemostatic System in Pregnant Patients with Burdened Obstetric Anamnesis
Abstract
Introduction. A number of researchers point at a direct connection between mutations of genes affecting the haemostasis system and risks of venous thromboembolism and / or infertility. Quite often, a thrombophilia diagnosis is a result of overdiagnosis, which may lead to ungrounded and even dangerous medical prescriptions. In this context, the key goal of this work was to analyse the homeostasis system in women with recurrent pregnancy loss and establishes the causes of this phenomenon.Materials and methods. Over the course of this work, we analysed 79 women in various stages of pregnancy who were receiving treatment in the Pregnancy Pathology Department of the BSMU Clinic. We analysed their medical histories, Body Mass Indexes (BMI), polymorphisms of haemostasis system genes and thrombosis risk factors.Results and discussion. BMI analysis found normal body mass in 39 patients (49.4 %) and excessive body mass in 40 patients (50.6 %). F2 and F5 gene polymorphisms were almost entirely absent. ITGA2 and ITGB3 gene mutations were found in the patients analysed in 48.1 % and 17.7 % of the cases, respectively. PAI-1 gene mutations were found in 84.8 % of cases. MTR and MTRR gene polymorphisms were detected in 35.4 % and 81.0 % of the patients, respectively. MTHFR mutations were found in more than 40 % of the patients.Conclusion. Obesity and hereditary thrombophilia are primary factors in venous thromboembolism. Body weight loss and antithrombotic therapy reduce risk obstetric complications, improving prognosis and pregnancy outcomes.
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