Interleukin-18 gene polymorphism in pregnancy With premature rupture of membranes: A case-control study

Background. Imbalanced pro- and anti-inflammatory systems can unfavourably condition carrying of pregnancy and provoke gestation complications, such as premature rupture of membranes.Objectives. Assessing the contribution of SNP variants -137G>C (rs187238), -607G>T (rs1946518) and -656A>C (rs5744228) of the IL-18 gene promoter to the incidence of extremely preterm premature rupture of membranes.Methods. A case-control study enrolled 120 pregnant women managed at the Perinatal Centre. The women were divided in two cohorts. The study cohort comprised 80 women with premature rupture of membranes at 22–27 weeks 6 days’ gestation hospitalised in a high-risk pregnancy unit, a control cohort consisted of 40 women with physiological pregnancy at 22–27 weeks 6 days’ gestation following outpatient counselling. The cohorts had comparable obstetric and gynaecological histories. The study exclusion criteria were: multiple gestation, foetal chromosomal anomalies, congenital foetal malformations, pregnancy due to assisted reproduction. Genotyping was performed at positions -137G>C, -607G>T and -656A>C of the IL-18 gene promoter with determining a peripheral blood IL-18 level in cohorts.Results. The premature rupture of membranes cohort had a statistically higher serum interleukin-18 concentration compared to control (p = 0.001). Genotyping of the IL-18 gene promoter revealed a statistically higher rate of homozygous -137G>C mutation (CC genotype) in the premature rupture of membranes cohort at 22–27 weeks 6 days’ term (p <0.001), 67 vs. 27% in control.Conclusion. A homozygous IL-18 -137G>C polymorphic variant associated with elevated blood IL-18 levels is statistically more common in pregnant women having premature rupture of membranes at 22–27 weeks 6 days’ gestation

Early pregnancy miscarriages in Rostov Region. Technology for record of early reproductive loss

To assess the dynamics of early reproductive loss in Rostov region was used Form 13 for the period 2009-2014. After code O.02 which stands for attempted abortion was added to Form 13 in 2011, there was an increase in number of miscarriages in Rostov region before reaching 12 week mark which indicates previous miscount of early reproductive loss. It doesnt seem possible to get realistic results for the number of reproductive losses due to non developing pregnancy because Form 13 which is the only statistical document used to collect the numbers for early reproductive loss does not include a line for non developing pregnancy

ANALYSIS OF UTEROPLACENTAL DOPPLER IN THE II TRIMESTER OF PREGNANCY IN WOMEN WITH RETROCHORIAL HEMATOMA DIAGNOSED IN THE EARLY STAGES OF PREGNANCY

The article presents an analysis of indicators of uteroplacental hemodynamics and outcomes of pregnancy of women with a threatened abortion in the early stages of pregnancy with the formation of a retrochorial hematoma. The increasing of the intensity of blood flow in the right uterine artery was found in pregnant women with retrochorial hematoma according to Doppler at 19-21 weeks of pregnancy. The blood flow appeared to be reduced in the left uterine artery at 19-21 weeks in pregnant women that occurred in 1 trimester retrochorial hematoma volume > 1 cm3. The analysis showed that pregnant women, who received dydrogesterone, and ones, who received micronized progesterone, had significantly elevated uteroplacental blood flow in the basin of the right uterine artery. There is significantly higher incidence of caesarean section in pregnant women who had the retrochorial hematoma volume >1 cm3 occurred in 1 trimester

PREVALENCE OF THROMBOPHILIC POLYMORPHISMS IN WOMEN WITH RECCURENT MISCARRIAGE

Objective: to study the prevalence of polymorphisms of the coagulation system genes and folate cycle in women with recurrent miscarriage (having two or more reproductive losses. Materials and methods. Carried out of molecular genetic study of 57 women with recurrent miscarriage and 35 patients without reproductive loss and having a history of at least one normally progressing pregnancy, culminating in the birth of a healthy term baby. Results. we have revealed a high incidence of MTHFR C677T, MTRR A66G, FGB G455A, ITGB3 T1565С gene polymorphisms. Conclusion. To prevent repeated reproductive losses in patients with an anamnesis of miscarriage, when other reasons are excluded, it is necessary to conduct a study of gene polymorphisms of coagulation system and folate cycle

THE UTERINE AND FETOPLACENTAL HEMODYNAMICS IN PREGNANT WOMEN WITH PLACENTA PREVIA AND PLACENTA ACCRETA

The aim of the study was to analyze the uterine and fetoplacental hemodynamics in pregnant women with placenta abnormalities. Materials and methods. Fifty pregnant women with normal placentation (Group 1), 50 women with placenta previa (Group 2) and 28 women with placenta accreta (Group 3) were examined in this study. The ultrasound examination included the traditional fetometry and an assessment of fetus anatomy and localization of the placenta. In addition, the Doppler ultrasound was used to examine the blood flow in the uterine arteries as well as the umbilical artery and the middle cerebral artery of the fetus. The measurements were performed on the 20-22nd, 30-32nd and 35-36th weeks of gestation.Results. According to the data obtained, the blood flow in the uterine arteries of patients with placenta pervia was much higher as compared with women with normal placental localization. The right uterine artery blood flow indices in the placenta previa cases significantly differed from those in women with placenta accreta. The pulsatility index in the right uterine artery was significantly lower in patients with placenta accreta as compared with the two other groups. The data on fetoplacental hemodynamics indicated differences in the umbilical artery blood flow between women with placenta accreta, placenta previa and normal placental localization on the 20-22nd and 35-36th weeks of gestation. Along with the above findings in the uterine and fetoplacental hemodynamics, the parameters of blood flow in the fetal middle cerebral artery did not differ significantly between the three groups of women at any period of gestation.Conclusion. The conditions of placenta accreta and placenta previa are associated with a decrease in the peripheral vascular resistance in both uterine arteries during all periods of gestation. This conclusion is supported by the lower values of the pulsatility index in these blood vessels in comparison to the values in patients with normal placental localization

HEMOSTASIS IN PATIENTS WITH HEMATOMA RETROCHORIAL

The aim of this study is assessment of hemostatic parameters in pregnant women with retrochorial hematoma (RCH).Materials and Methods. The study involved 153 pregnant women during the first trimester. The first group comprised 90 patients with RCH, and the second group is the control group, comprised 63 pregnant women with normal pregnancy.Results. The research results show, that soluble fibrin monomer complex (SFMS) and D-dimer indicators of pregnant women with RCH were higer in comparison with data of the second group (p<0,001).Conclusion. Higher values of SFMC and D-dimer tend to be high probability predictors of retrochorial hematoma and have a great meaning for preclinical diagnosis of retrochorial hematoma