FEATURES OF CYTOKINES BALANCE IN WOMEN WITH REPRODUCTIVE LOSSES IN ANAMNESIS IN DYNAMICS OF COMPLICATED AND UNCOMPLICATED PREGNANCY
DOI:
https://doi.org/10.11603/24116-4944.2018.1.8803Keywords:
habitual miscarriage of pregnancy, microbiota, vaginal dysbiosis, cytokines.Abstract
The aim of the study – the verification of risk factors for habitual miscarriage and the analysis of immunological features in pregnant women with a habitual miscarriage in the history, subject to the provision or absence of preliminary training.
Materials and Methods. 170 women with a habitual miscarriage of pregnancy in the anamnesis were examined.
Results and Discussion. 92.7 % of pregnant women have habitual innocence. Those who received complex pregravid preparation received normocenosis, whereas in the absence of such pre-pregnancy normocoenosis was detected only in 11.1 % of women. In women with a history of habitual miscarriage, there were more frequent indications of inflammatory diseases of the lower genitalia (68.3 % and 16.0 %, RR 5.69, 95 % CI 1.96–16.5, p = 0.047, NNT 1.777), salpingooophoritis, chronic endometritis (74.5 % and 20.0 %, RR 3.72, 95 % CI 1.69–8.2, p = 0.0077, NNT 1.835). Among 145 women with a habitual miscarriage in 40.7 % of cases, the first pregnancy was in the earlier (18.5±0.8 g) or vice versa at a later age (36.7±0.6 rock) in comparison with the control (p<0.0001), and it was less often completed with term deliveries (28.8 % and 88.0 %, RR 1.64, 95 % CI1.26-2.14, p<0.001). Risk of miscarriage in pregnant women with habitual miscarriage and vaginal dysbiosis occurs against the backdrop of an imbalance of pro- and anti-inflammatory cytokines – increased levels of TNF-alpha and IL-6 and decreased production of IL-10, which is an unfavorable factor for the progress of the pregnancy.
Conclusions. Imbalance in the cytokine system in women with habitual miscarriage and vaginal dysbiosis is one of the pathogenetic links in the development of the threat of abortion. The determination of levels of TNF-α, IL-6 and IL-10 in the first trimester in the blood of pregnant women has prognostic value regarding the course of pregnancy and the development of personalized measures aimed at maintaining pregnancy. Conducting complex pregravid preparation aimed at eliminating the dysbiotic processes and hormonal imbalance with the continuation of gestagenotherapy in the first trimester of pregnancy contributes to the preservation of dynamic equilibrium in the cytokine system in women with habitual miscarriage and vaginal dysbiosis and contributes to the uncomplicated course of pregnancy in 96.4 % of cases.
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