Материнська тромбофілія як предиктор виникнення акушерських ускладнень та перинатальних втрат у жінок з невиношуванням вагітності залежно від маси тіла

Abstract

The article gives a scientific and practical justification for the timely detection of maternal thrombophilia at the stage of pregnancy planning taking into account the phenotype of a woman. The objective: analysis of the structure of the revealed gene polymorphisms and their effect on the course of the gestational process and the hemostasis system in pregnant women, depending on the phenotype. Patients and methods. A total of 175 women with a threat of miscarriage at the age of 20 to 41 years were selected, who were recruited and further divided into groups: I clinical group (primary) – 120 (68.6%) women with a threat of miscarriage, body weight, II clinical group (comparisons) – 55 (31.4%) of women with normal body weight (BMI 20-24.9 kg/m2) and with symptoms threatening to bear pregnancy, in which an in-depth study of the state of health was conducted. Results. The carriage of thrombophilia genes in women with miscarriage was revealed in 100% of cases regardless of body weight. However, it was found that the polymorphism of the F2 gene: 20210 G> A and 3-5 times more often in the F5-Leiden gene: 1691 G> A with hetero- and homozygous polymorphism, respectively, was found to be 6 times more frequent in women with excess body weight, respectively. testified to the relationship between the presence of excess body weight in women and the mutation of the clotting factor F5-Leiden. These women belong to the group of extremely high risk of thrombohemorrhagic complications during pregnancy. Conclusion. A study on maternal thrombophilia should be conducted at the pre-vaginal stage in order to conduct timely pathogenetically based treatment, with emphasis on treatment in the fertile cycle, which will improve the perinatal outcomes in these women. Key words: phenotype, pregnancy, loss of pregnancy, obesity, thrombophilia, gestational complications, hemostasis system.