Abstract
Objective: to determine prognostic significance of low molecular weight metabolites in women with missed abortion. Material and methods: the research included 100 women of reproductive age, 79 of them with missed abortion diagnosed by ultrasound and 21 with progressive pregnancy who were admitted for an artificial abortion. All women underwent immunohistochemical studies of the endometrium and organic acids in blood serum and endometrium were determined by HPLC. Reliably significant organic acids in blood serum and endometrium, associated with metabolic disorders of fatty acids, amino acids, as well as intermediate metabolites in the Krebs cycle. Statistical analysis of the obtained data was performed using the STATISTICA® for Windows, Release 6.0 module package from StatSoft® Inc., USA (2003), serial number AXAR802D898511FA. Results: statistically significant changes were revealed in the profile of organic acids in the studied women at the levels of lactic, pyruvic and 4-hydroxyphenylpyruvic acids. In women with missed abortion, the change in the lactate / pyruvate. In all women with missed abortion, 4-hydroxyphenylacetic were determined, in contrast to women with a progressing pregnancy, combined with morpho-immuno-histochemical features (pronounced focal necrosis, venous fullness, lymphohistiocytic infiltration, increased levels of HLA-DR, CD 16, CD20 expression, reduced VEGF and LIF expression). Conclusion: missed abortion is associated with the accumulation of intermediate metabolites of tyrosine catabolism (4-hydroxyphenyacetic, 4-hydroxyphenylpyruvic and homogentizic acids), which, despite normal levels of TSH and T4, may reflect organ dysfunction. Timely correction of iodine deficiency in the pre-conception period after missed abortion can be a criterion for a successful subsequent pregnancy. Overcoming iodine deficiency potentiates the possibility of a conceptual restoration of fertility after a previous NB.
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