FEATURES OF THE COURSE OF PREGNANCY AND CHILDBIRTH IN WOMEN WITH THROMBOPHILIA IN COMBINATION WITH DISTURBANCE OF FOLATE METABOLISM
Keywords:
pregnancy, childbirth, folate metabolism, thrombophiliaAbstract
The article presents the results of a prospective comparative analysis of the course of pregnancy and childbirth with folate metabolism disorders and thrombophilia and in the absence of the latter. In the two compared groups, a Doppler study of blood flow, general clinical and specific laboratory studies were performed, as well as dynamic monitoring of the course of pregnancy and childbirth outcomes, which makes it possible to judge the characteristics of the course of gestation and its outcomes in women with thrombophilia and folate deficiency.
An assessment of the course of pregnancy showed that every third patient with thrombophilia and impaired folate metabolism has a threat of abortion and every tenth pregnancy is complicated by intrauterine fetal retention syndrome, and hypertensive disorders occur on average in every 20 cases. Also, in women of the main group, pathology of the amniotic medium prevails in the form of premature maturation of the placenta, low/polyhydramnios and impaired blood flow in the “mother-placenta-fetus” system during Doppler examination, which account for 23.3% and 42% of cases, respectively.These rates are significantly higher than these complications of gestation in the study group in comparison with patients who did not have thrombophilic and folate-dependent abnormalities. According to the analysis of childbirth, there were no differences in the duration of labor and the nature of the complications of the birth process between the compared groups. An analysis of the frequency of caesarean section revealed that in women of the main group, abdominal delivery was 3 times more common than in women in the control group, which is mainly due to the unfavorable state of the intrauterine fetus, anomalies of placentation (previa), hypertensive disorders in pregnant women requiring emergency delivery.An assessment of the condition of newborns in both compared groups established lower height and weight indicators in newborns from women with thrombophilia and impaired folate metabolism.
References
Белоцерковцева Л. Д., Исаев Т. И., Коваленко Л. В. Наследственные тромбофилии при осложненном течении и неблагоприятных исходах беременности.// Вестник СурГУ. Медицина. 2019. № 4 (42). C.67-70.
Демина Т.Н., Железная А.А. и соавторы. Анализ частоты наследственных форм тромбофилий и полиморфизма генов фолатного цикла в развитии акушерской патологии. // Медико-социалные проблемы семьи. 2021.Т. 26, №1. С. 11-15.
Фролова Н.И., Белокриницкая Е.Т. Эпигенетические факторы и молекулярные маркеры риска ранних потерь беременности.
Гинекология 2019. T. 21, №3. C.9-16
Шаталов А.Е., Петров Ю.А.// Тромбофилия как фактор невынашивания беременности// Журнал научных статьей «Здоровье и образование» 2019. T. 21, № 4. C. 63-67.
Beloserkovseva L.D., Isaev T.I., Kovalenko L.V. Nasledstvenii trombofilii pri oslojnennom techenii i neblagopriyatnikh iskhodakh beremennosti.[ Hereditary thrombophilia in complicated and unfavorable pregnancy outcomes]. Vestnik SurGU. Medicina, 2019, No 4 (42), pp 67-70.
Demina T.N. Zheleznaya A.A. i soavtori. Analiz chastoti nasledstvennikh form trombofiliy i polimorfizma genov folatnogo cikla v razvitii akuwerskoy patologii.[Analysis of hereditary forms of thrombophilia and polymorphism of folate cycle genes in the development of obstetric pathology]. Mediko-sotsialnie problemi semi, 2021, Vol 26, No 1, pp11- 15.
Frolova N.I., Belokrinickaya E.T. Epigenetichiskiye factori I molecularniye marker riska rannikh poter beremennosti. [ Etiogenetic factors and molecular risks of early pregnancy losses]. Gynecology, 2019, Vol.21, No 3, pp.9-16
Shatalov A.E.,Petrov U.A. Trombofiliya kak factor nevinashivaniya beremennosti.[ Thrombophilia as a factor of miscarriage of pregnancy]. Journal nauchnikh statey “zdorove i obrazovanie”, 2019, Vol 21, No4, pp-63-67.
Ahangari, N.; Doosti, M.; Mousavifar, N.; Attaran, M.; Shahrokhzadeh, S.; Memarpour, S.; Ghayoor Karimiani, E. Hereditary thrombophilia genetic variants in recurrent pregnancy loss. Archives of. Gynecology and Obstetrics. 2019, Vol.300, pp.777–782.
Chidinma Magnus Nwogu, Kehinde Sharafadeen Okunade et al. Association between maternal serum homocysteine concentrations in early pregnancy and adverse pregnancy outcomes. Annals of African Medicine, 2020, Vol. 19, Iss.2, pp.113-118.
Chuce Dai , Yiming Fei , Jianming Li, et. al. A Novel Review of Homocysteine and Pregnancy Complications. BioMed Research International. Published online 2021 May 6. DOI: https://doi.org/10.1155/2021/6652231
Croles F. Nanne et al. Pregnancy, Thrombophilia, and the Risk of a First Venous Thrombosis: Systematic Review and Bayesian Meta- Analysis. The BMJ 359. (2017): j4452. PMC. Web. 26 Apr. 2018.
Liu X, Chen Y, Ye C, et al. Hereditary thrombophilia and recurrent pregnancy loss: a systematic review and meta-analysis. Human Reproduction 2021;36:1213–29.
Maha Othman, et.al Thrombosis and hemostasis health in pregnancy: Registries from the International Society on Thrombosis and Haemostasis. Research and Practice in Thrombosis and Haemostasis 2019, Vol.4, Iss. 3, pp. 607-614 doi:10.1002/rht2.12243
Patel P, Patel P, Bhatt M, et al. Systematic review and meta-analysis of outcomes in patients with suspected deep vein thrombosis. Blood Adv 2020, Vol.12, Iss.4, pp.2779–2788
