CHARACTERISTICS OF BLOOD FLOW IN UTERINE, RADIAL AND SPIRAL ARTERIES IN EARLY SPONTANEOUS ABORTIONS ON THE BACKGROUND OF ENDOTHELIAL DYSFUNCTION
DOI:
https://doi.org/10.11603/24116-4944.2022.2.13342Keywords:
miscarriage, endothelial dysfunction, dopplerometric research, resistance index, pulsation index, uterine arteriesAbstract
Introduction. Early loss of pregnancy is one of the leading problems of modern obstetrics. Loss of desired pregnancy is observed in 30% of cases. Doppler blood flow study of the uterine, radial and spiral vessels is important for determining the course of pregnancy.
Materials and methods. We have examined 34 women with spontaneous abortion (Group I) and 29 women with blighted ovum (Group II). The change in level of the markers of endothelial dysfunction was found in all examined patients. Doppler study of uteroplacental blood flow was carried out using the ALOKA SSD-2000 scanner.
Results obtained. In case of spontaneous abortion, the size of the embryo corresponded to the normative values for this term of gestation. In 100% of cases, hypoechoic structures of various sizes were visualized, which communicated with the uterine cavity and were identified as chorionic detachment. The blood flow in this group of vessels was characterized by a rather high systolic component, the presence of a diastolic component, and in 29.4% of cases, a protodiastolic incision. The dopplerometric study was characterized by a decrease in resistance index and pulsation index in the uterine, radial and spiral arteries by 1.5-2.2 times. In a case of blighted ovum the size of the embryo did not correspond to the normative values of this term of gestation. The heartbeat of the embryo was not determined. At 7-8 weeks of gestation in 18 of 29 women (62.1%) showed a rapid increase in IR and IP of all groups of uterine arteries. In the remaining 11 (37.9%) patients, signs of pregnancy development disappeared after 9-10 weeks of gestation.
Conclusion. In women with miscarriage, against the background of an increase in the level of endothelin-1, as well as a decrease in the concentration of nitric oxide and E-selectin, an increase in IR and IP in the uterine, spiral and radial arteries, starting from the 7-8th week of pregnancy, was established by 1-2 times, which significantly worsens the prognosis for progression of early pregnancy.
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