Зміни в системі гемостазу у вагітних із різними формами безплідності в анамнезі

Abstract

Most pregnant women with a history of endocrine and combined infertility are overweight, and the presence of obesity during pregnancy is associated with the development of serious hypercoagulation complications. Purpose - to study changes in the hemostasis system in pregnant women with different types of infertility in their history. Materials and methods. Changes in the hemostasis system in 127 pregnant women aged 23 to 40 years were studied, of which 102 women had a different history of infertility. Patients were assigned to 4 groups. The distribution of pregnant women into groups was based on infertility factor: group I - 35 pregnant women who had a history of endocrine infertility, group II - 37 pregnant women who had a history of infertility of tube-peritoneal genesis, group III - 30 pregnant women who had a history of combined infertility: tube-peritoneal genesis with endocrine, control (IV) group - 25 healthy pregnant women who did not have a history of infertility. To evaluate hemostasis, the levels of: activated partial thromboplastin clotting time (APTT), fibrinogen, fibrinogen B. Hemostasis indicators were performed on a semiautomatic 4-channel coagulograph «Huma Clot Qatro», which works according to the photomechanical principle. The validity for relative values was evaluated by the Fisher angular transform method. Results. Estimating the measurement data of the level of APTT in women with different types of infertility by groups in the I and III trimesters, it turned out that in the I group there were slightly increased rates in 1 (2.9%) patient in the I trimester and in 2 (8.6%) in the III trimester; in group III in 1 (3.3%) patients in the I trimester and in 2 (6.7%) in the III trimester; while group II women had a slightly different rate of APTT: no one had an increased rate in the I trimester, and the III trimester had 1 (2.7%) patient, and in group IV no one had an increased APTT, both in the I trimester and III trimester. Analyzing fibrinogen measurement data in women with different types of infertility by groups in the I and III trimesters, it turned out that in the I group, increased rates were in 1 (2.9%) patient in the I trimester and 20 (57.1%) in the III trimester; in group III, 2 (6.7%) patients in the I trimester and 20 (66.7%) in the III trimester; while the fibrinogen score in women of group II was in the I trimester - in 2 (6.7%), and in the III trimester - 20 (66.7%), and in the IV group no one had an increased level of fibrinogen in the I trimester, and in the III trimester there were 5 (20%) patients. Analyzing fibrinogen B measurement data in women with different types of infertility by groups in the I and III trimesters, it turned out that in all groups no one had an increased this indicator in the I trimester, whereas in the III trimester there were single cases: in 3 (8.6%) pregnant women of group I, in group III - in 4 (13.3%) patients, in 2 (5.4%) women of group II and in group IV, increased fibrinogen B was in 1 (4%) patients. Conclusions. High levels of fibrinogen were observed in all pregnant women regardless of the type of infertility (up to 66.7%), in the group of pregnant women who did not have a history of infertility, this indicator was increased only in 20% of women. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author. Key words: APTT, fibrinogen, fibrinogen B, pregnancy after infertility.