Abstract
The aim. Study of hemostasis, antiphospholipid antibody levels and immunological parameters in pregnant women with antiphospholipid syndrome (APS), in particular with retrochorial hematoma (RCH).
 Materials and methods. 90 women were selected and divided into two groups: the control group – 30 pregnant women with a normal pregnancy (without APS) and the main group – 60 pregnant women with APS. Women in the main group were diagnosed with APS before pregnancy. In turn, the main group was divided into two subgroups: 1 subgroup – 41 pregnant women without RCH and 2 subgroup – 19 pregnant women with RCH.
 The main indicators of hemostasis were determined in all pregnant women, namely: the degree and rate of platelet aggregation, Willebrand factor, D-dimers. In addition, the level of antiphospholipid antibodies (APLA), antibodies to β2-glycoprotein, to annexin V, to prothrombin was examined, and the level of annexin V was also determined. The absolute and relative content of Treg, CD3+, T-lymphocytes, CD4+ (T-helpers), CD8+ (cytotoxic T-lymphocytes), CD19+ (B-lymphocytes), CD16+CD56+ (NK cells), CD16+CD56+CD107a+ (activated NK cells).
 Results. The obtained results showed that in pregnant women with APS compared to pregnant women without APS there are statistically significantly higher values of the degree and rate of platelet aggregation (90.6±6.3% and 106.3±6.7% vs. 65.3±5.3 % and 73.4±5.6%, respectively). There were also higher values of Willebrand factor and D-dimers (2.5±0.3 IU/ml and 378.1±34.3 ng/ml against 1.7±0.2 IU/ml and 268.1±27, 3 ng/ml, respectively).
 APLAs were significantly higher in pregnant women with APS compared with pregnant women in the control group, namely: 16.1±1.5 vs. 3.8±0.4 U/ml. With regard to antibodies to β2-glycoprotein, to annexin V, to prothrombin and to the level of annexin V, their values were also statistically significantly higher in the group of pregnant women with APS.
 In addition, the results of the study showed that pregnant women with APS showed changes in subpopulations of immunocompetent cells.
 However, examining the difference in hemostasis, antibody content, and level of lymphocyte subpopulations between pregnant women with APS with and without RCH, it was found that their shifts in pregnant women with RCH were more pronounced than in women without RCH.
 Conclusions. Pregnant women with APS are characterized by significantly more significant changes in hemostasis, manifested by activation of intravascular thrombosis. In addition, such pregnant women had a significantly higher concentration of autoantibodies. There are also changes in the immune system, in particular, a decrease in Treg-cells, which have the ability to reduce the specific proliferation and effector functions of lymphocytes, thereby participating in the pathogenesis of APS.
Highlights
Despite significant advances in medicine, the problem of miscarriage still remains one of the most difficult
The results of the study showed that pregnant women with antiphospholipid syndrome (APS), in particular in the first trimester of pregnancy, had significantly more significant changes in hemostasis
In the group of pregnant women with APS there was a significantly higher concentration of autoantibodies to antiphospholipid antibodies (APLA), to β2-glycoprotein, to annexin V, to prothrombin, as well as the level of annexin V compared to pregnant women in the control group
Summary
Despite significant advances in medicine, the problem of miscarriage still remains one of the most difficult. As a result of such processes, blood clots appear in the (2021), «EUREKA: Health Sciences» Number 4 vessels, which is accompanied by further complications during pregnancy The most common such complications include retrochorial hematoma, which is a blood clot formed as a result of violation of the integrity of the walls of blood vessels and blood flow between the chorion and the uterine wall. Such hematomas are often accompanied by the development of placental dysfunction and fetal growth retardation [1, 2]
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