Clinical and hemostasiological aspects of the habitual fetal loss syndrome and possible preventive measures

Abstract

Aim of the work: to determine the changes in hemostasis system and the features of polymorphism of genes, responsible for the state of coagulation system and endothelium in women with habitual fetal loss syndrome for substantiation and elaboration of the treatment-prophylactic complex for them.Methods of research. The main group included 58 pregnant with habitual fetal loss syndrome (HFLS). The control group included 34 somatically healthy women with physiological course of pregnancy and non-complicated obstetrical anamnesis. Polymorphisms in genes of factor V Leiden 1691 G → A, prothrombin 20210 G → A, fibrinogen β 455 G → A, methylenetetrahydrofolatereductase (MTHFR) 677 C → T were defined by the method of allele-specific polymerase chain reaction. The main parameters of hemostasis system were defined on automatic coagulometer, the level of D-dimer by immune-enzyme method.Reults. The pregnant with pathologic genotypes and alleles: 1691 G→A FVL, 20210 G→A FII and 677 C→T MTHFR must be related to the risk group of miscarriage development. For these pregnant the hypercoagulation is typical already at the early terms of pregnancy. The assessment of effectiveness of treating arrangements demonstrated, that in the main group in 56 (96,6 %) women pregnancy was finished with delivery (рК>0,05). The term of delivery did not reliably differ in the main group comparing with the control one (рК>0,05) and was 38,0 [36,0–39,0] weeks (C=39,0 [38,0–40,0] weeks).Conclusions. The study of hemostasis system and the thrombophilia markers allows reveal pregnant with hypercoagulation syndrome that form the group of risk of miscarriage and the use of treating-prophylactic complex significantly improves the results of pregnancy