Changes in the hemocoagulation system in pregnant women, after pre-gravid preparation before the DRT program, with a history of sexually transmitted infections

Abstract

The objective: to analyze the dynamics of laboratory parameters of the functioning of the thermocoagulation system in pregnant women with a history of sexually transmitted infections(STIs) after pre-gravid preparation before cycles of assisted reproductive technologies (ART). Materials and methods. An analysis of the functioning of the thermocoagulation system was carried out in women with infertility who had a history of STIs after the DRT program: GroupI – 56 pregnant women received our proposed treatment and prevention measures in the pregravidperiod; II group – 55 pregnant women received generally accepted medical and preventive measures. The assessment of the state of the hemostasis system was determined by the following indicators: fibrinogen concentration (Fg), activated recalcification time (ACR), activated partial thromboplastin time (ATP), integrative indicator «Thrombodynamic Potential Index» (TIP), the concentration of fibrin and fibrinogen degradation products (FRP). and the level of more stable, but less biologically active metabolites of prostacyclin and thromboxane – 6-keto-PGF1α and T×B2. Statistical processing of research results was carried out using standard programs «MicrosoftExcel 5.0» and «Statistica 8.0». Results. In the period of the final formation of the placental barrier, in pregnant women of the Igroup, the APTC slowly lengthened (31.3±1.6 s in the II trimester, 34.3±2.9 s in the III trimester)with an increase in gestational age and probably differed from the indicators in the II group(27.6±3.0 s and 30.2±1.7 s respectively; p<0.05); there was a slow reduction of AChR during the II and III trimesters of pregnancy in pregnant women of the I group (63.1±2.8 s, 59.3±2.8 s); gradual decrease in the level of PDFF (5.8±0.27×10-2 g/l, 5.1±0.22×10-2 g/l) in contrast to the level of PDFF in the II group, where a gradual increase of this indicator was observed (9.4 ±0.17×10-2 g/l, 11.6±0.27×10-2 g/l) (р<0.01). The level of a stable metabolite of thromboxane (T×B2) in the trimesters decreased by 2 times and was found to be lower (p<0.05) than in the II study group; the level of a stable metabolite of prostacyclin (6-keto-PGF1α) also increased in the III trimester(p<0.05). This led to an increase in the PgI2/T×A2 balance in group I from 0.34±0.02 to 1.16±0.03, which corresponded to the physiological needs of systemic and organ hemodynamics during pregnancy. Conclusions. The development and implementation of effective pre-gravid preparation before cycles in women with a history of STIs and medication correction during pregnancy contribute to increasing the adaptive compensatory and adaptive potential of the mother’shemocoagulation homeostasis and perinatal protection of the fetus.