CHARACTERISTICS AND CAUSES OF PREGNANCY LOSS OF PREGNANCY IN THE FIRST TRIMESTER
About the author:
Ahundova G. I.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The goal is to establish the cause of the threat of miscarriage and loss of pregnancy in the first trimester. Methods. To accomplish this task, we examined 45 pregnant women with the threat of miscarriage and 12 pregnant women with the physiological course of pregnancy. The examined pregnant women were divided into 2 groups – the main and control. The average age of pregnant women of 1 group was 28.8+3.2, the average age of women with physiological pregnancy was 29.1+3.6. Most of the women in the study groups were aged 18-30 years. Results. In the study of the somatic status in women of the main study group revealed a high incidence of thyroid disease (14.1%), gastrointestinal tract (32.5%), cardiovascular system (15.9%), urinary system (27.4%). In the control group, the most common diseases of the gastrointestinal tract (4.3%), urinary system (2.8%). In both study groups, pregnant women were diagnosed with anemia in the main group of 34.2% in the control group 5,3%, respectively. Obesity was diagnosed in 15.9% of pregnant women with threatening miscarriage. In the structure of gynecological pathology in women with menacing miscarriage in the first place, inflammatory diseases of the female genital organs prevailed – 38.9%, dysfunctional ovarian disorders – 21.7%, cervical disease – 12.7%, benign diseases of the uterus and appendages – 16.6%. In the group of women with physiological course of pregnancy among gynecological diseases the most frequent were inflammatory diseases and amounted to 4.6%, other diseases were noted in an unreliably small amount. And 11.8 percent had complications after the abortion – bleeding on the background of residues of the ovum, inflammatory diseases, endocrine diseases, secondary infertility and others At 15.0 per cent the previous pregnancy proceeded against the background of various complications: toxemia, premature labor, preeclampsia. Studies of the degree of purity of the smear in the first trimester showed a significant prevalence of patients with III and IV degree of purity in women with menacing miscarriage, which clinically corresponded to bacterial vaginosis and vaginitis. Among the examined patients of the main group, 17.4% had genital infection. Prevailed uralistica infection of 14.2%, trichomoniasis – 18,4%, fungal vaginitis – 17,6%. Non-specific infection in the vaginal content was isolated in 30.5% of women with threatening miscarriage. Vaginal smear examination of women in the control group showed that the most common non-specific infection, which was 9.7%. Infection of the genital organs was noted: trichomoniasis – 2,4% and fungal vaginitis – 4,5%. In 9.2% of pregnant women with menacing miscarriage in the I trimester, a decrease in the level of progesterone was revealed, which was the basis for the appointment of gestagens. Progesterone preparations were also prescribed to women with a history of reproductive losses. In women of the control group, the level of progesterone was determined within the normal range. Conclusions 1. In the structure of gynecological pathology in women with threatening miscarriage in the I trimester dominated by inflammatory diseases of the female genital organs, dysfunctional ovarian disorders, cervical disease and benign diseases of the uterus and appendages. 2. In women with threatened miscarriage in the first trimester with infectious complications prevail uralistica infection, trichomoniasis and fungal vaginitis. 3. Among this contingent of pregnant women there are complications of childbirth-pathological prelim, abnormalities of labor, untimely discharge of amniotic fluid.
pregnancy, first trimester, miscarriage
- Solovova LD. Ocenka jeffektivnosti konservativnoj terapii ugrozy vykidysha u zhenshhin s retrohorial’noj gematomoj v I trimestre beremennosti. Sb. materialov, posvjashh. 135-letiju MMU GKB №1 im. N.I. Pirogova g. Samara «Modernizacija – nastojashhee i budushhee gorodskoj klinicheskoj bol’nicy №1 im. N.I. Pirogova». Samara, 2010. s. 177-8. [in Russiаn].
- Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG. 2010;117(3):245-57.
- Sidel’nikova VM. Nevynashivannie beremennosti. M.: Medicina; 1986. 237 s. [in Russiаn].
- Gazieva IA, Chistjakova GN. Immunologicheskie aspekty patogeneza fetoplacentar-noj nedostatochnosti. Voprosy ginekologii, akusherstva i perinatologii. 2009;9(1):57-62. [in Russiаn].
- Shljapnikov ME, Solovova LD, Merkulova VI, Garanina O. Profilaktika infekcionnyh oslozhnenij u zhenshhin s nerazvivajushhejsja beremennost’ju v pervom trimestre. Voprosy ginekologii, akusherstva i perinatologii. 2010;9(6):42-6. [in Russiаn].
- Lykke JA, Dideriksen KL, Lidegaard O, Langhoff-Roos J. First-trimester vaginal bleeding and complications later in pregnancy. Obstet. Gynecol. 2010;115(5):935-44.
- Toth B, Jeschke U, Rogenhofer N, Scholz C, Würfel W, Thaler CJ, et al. Recurrent miscarriage: current concepts in diagnosis and treatment. J. Reprod. Immunol. 2010;85(1):25-32.
Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 (144), 2018 year, 135-138 pages, index UDK 618.3-06:618.39-021.3