Complex estimation of mitochondrial changes of immunocompetent blood cells in pregnant women with urgent and premature birth

Inflammation is among the factors promoting development of premature rupture of the membranes (PPROM). Upon the conditions of physiological immune imbalance in pregnancy, inflammation modifies its course and can even change the immune response. Appropriate indexes may be quantitative and functional. We used a marker of mitochondrial membrane potential (MPM, Ay) as an integral index of the functional state of immunocompetent blood cells (IBC) in 159 women who were examined at 8-14 weeks of gestation; they were observed up to 34-36 weeks. Of these cohort, 121 women were referred to a comparison group. The main group (n = 46) consisted of pregnant women with PPROM at the term of 28-33 weeks. The examination was carried out according to current medical standards, with informed consent, being approved by the Ethics committee at the Khabarovsk branch of Far Eastern Scientific Centre of Physiology and Pathology of Respiration — Research Institute of Maternity and Childhood Protection. Additionally, MPM and lymphocyte populations were determined by flow cytometry. The degree of disturbed energy supply in the IBC was based on the data of simultaneous determination of lymphocyte, granulocyte and monocyte numbers with reduced MPM values (application for invention No. 2020115963), thus revealing 3 degrees of energy deficiency: 1st degree, monovariant IBC composition with reduced MPM; 2nd degree, bivariant composition, 3rd degree, total changes. A relative and absolute decrease in CD3 (72% vs 78% and 1624 vs 1980), CD8 (28% vs 33% and 651 vs 851), an increase in CD19 (14% vs 9% and 304 vs 219) were revealed in pregnant women with PPROM. When assessing MPM values in the IBC populations, a decreased proportion of women without energy deficiency from the 1st to the 2nd trimester (from 41% to 30%), due to the 3rd degree of energy deficiency (from 17% to 26%) was detected. A shift of affected pools at the 2nd degree of energy deficiency in favor of lymphocytic-granulocytic association (from 7% to 25%) from lymphocytic-monocytic compartment (from 73% to 50%) was found. From the 2nd to 3rd trimester, we have detected redistribution of granulocyte pools at the 1st degree (0 to 8%) and from the lymphocytic-granulocytic association (25% and 5%) to monocytic-granulocytic (25% and 40%). In the group with PPROM, there was a decreased proportion of pregnant women without energy deficiency (13% and 27%), as well as with the 1st and 2nd degrees (17% vs 31% and 9% vs 17%), due to the 3rd degree of energy deficiency (61% and 26 %), relative to the comparison group. The IBC pools of in the main group were redistributed at the 1st degree in favor of granulocytes (25% and 8%), at the 2nd, in favor of the lymphocytic-monocytic association (100% and 55%) from the granulocytic-monocytic (0% and 40%). Such imbalance of bioenergetic processes in the IBC can be an important factor of pathologically ongoing inflammation. These changes could be caused by both higher incidence of infections in such patients and by alloimmune interactions between mother and fetus. However, they may also determine the pathological course of inflammation. Preterm birth, which is usually caused by PPROM, is a multifactorial pathological condition. However, independent on specific triggers, the changes in energy supply of IBC, at least, may serve as a significant biomarker of probability for this disorder.

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Hormonal and ultrasound features of formation of feto-placental complex in women with beneficial tumours of the uterus

Medical Council ◽

10.21518/2079-701x-2019-13-184-190 ◽

2019 ◽

pp. 184-190

Author(s):

E. F. Khamidullina ◽

L. Yu. Davidyan ◽

D. R. Kasymova ◽

A. Yu. Bogdasarov

Keyword(s):

Pregnant Women ◽

Ultrasound Imaging ◽

Comparison Group ◽

Clinical Manifestations ◽

Uterine Fibroids ◽

Genetic Mutation ◽

Main Group ◽

Biochemical Tests ◽

Almost All ◽

Ultrasound Features

The purpose and objectives of the study is to identify the hormonal, biochemical and ultrasound features of the gestation course in women with beneficial tumours of the uterus. Results. We conducted a complete clinical examination and prospective observation of 182 pregnant women. Of which, 98 puerperas with a verified diagnosis of uterine fibroids and/or endometriosis, which developed before gestation, but did not prevent the onset of pregnancy, were included into the main group. The comparison group included 84 women with physiological pregnancy. The studies showed that 14 pregnant women in the main group had C677T (Ala222Val) T/T mutation, while only 2 women in the comparison group had a decrease in enzyme activity due to genetic mutation. Accordingly, the homocysteine level was almost 3 times lower in the comparison group than in the main group. The women with hyperhomocisteinemia (HHC) and uterine fibroid in the main group showed the lowest estriol level and hCG level, while women without HHC had higher estriol level and hCG levels. It was found that almost all patients with HHC had subclinical hypothyroidism. Ultrasound imaging and biochemical tests at the beginning of the 2nd trimester: no ultrasound markers of fetal anomalies were identified in women from both groups; however, signs of retrochorial hematoma were detected in 57 women from the main group, which was confirmed by clinical manifestations and previous ultrasound imaging in earlier gestation periods. Conclusion. Thus, placenta formation in women with HHC and uterine fibroids is accompanied by relative hormonal insufficiency, which is clinically manifested as a threat of miscarriage in the early stages, but carrying a child is possible due to appropriate management of a patient as part of the preserving therapy. However, the issue of preventing the development of fetoplacental insufficiency is a valid one for further investigation.

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Specific Characteristics of Bioelectric Activity of the Brain in Women with Placental Dysfunction Considering the Type of Psychological Component of Gestation Dominant

Archive of Clinical Medicine ◽

10.21802/acm.2018.2.2 ◽

2018 ◽

Vol 24 (2) ◽

Author(s):

Nataliya Henyk ◽

Nataliya Yakumchuk

Keyword(s):

Pregnant Women ◽

Comparison Group ◽

Clinical Symptoms ◽

Gestational Hypertension ◽

Fetal Distress ◽

Main Group ◽

Software Complex ◽

Placental Dysfunction ◽

Psychological Component ◽

Attitude Test

The study of the influence of the autonomic nervous system on the course of pregnancy, childbirth and fetal state remains relevant. Changes in the parameters of electroencephalography may be detected long before the onset of clinical symptoms in the complicated course of pregnancy. The objective of the research was to evaluate electroencephalography in women with placental dysfunction and gestational complications taking into account the type of psychological component of gestation dominant. Materials and methods. Electroencephalography was performed in 60 pregnant women at the age of 19 to 45 years with gestational hypertension and fetal distress during pregnancy. The main group included 40 patients, who were stratified according to the type of psychological component of gestation dominant: 10 patients with euphoric type, 20 pregnant women with anxious and depressive type, 10 patients with hypogestognostic type. The comparison group comprised 20 patients with optimal type of psychological component of gestation dominant and normal course of the first half of pregnancy. The assessment of psychological component of gestation dominant was carried out according to the method proposed by Dobriakov I.V. - "Pregnant woman attitude test". Registrations, spectral and coherent analysis of electroencephalography were performed using BrainTest-24 hardware and software complex. \textbf{Results and discussion. }Electroencephalography of the patients of the comparison group was in line with current concepts regarding the physiological norm. In the main group, there were the following changes in electroencephalography: non-sinusoidal forms of alpha-oscillations (77.5%), high index of fast rhythms, flashes of spike waves under load, disturbances of the frontal occipital gradient with the focus on the anterior sections of the hemispheres. Conclusions. The use of electroencephalography in women with different types of psychological component of gestation dominant in case of progressive placental dysfunction and preeclampsia on its background allows identifying characteristic changes, modifying the program of therapeutic measures, differentiating obstetric tactics and terms of delivery.

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Peculiarities of early diagnosis and tactics of treatment in an acute pancreatitis in pregnant women

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2018.06.13 ◽

2018 ◽

Vol 85 (6) ◽

pp. 13-17

Author(s):

Ya. P. Feleshtynskyi ◽

О. V. Golyanovskyi ◽

Т. P. Pavliv

Keyword(s):

Acute Pancreatitis ◽

Early Diagnosis ◽

Pregnant Women ◽

Comparison Group ◽

Early Stage ◽

Treatment Algorithm ◽

Main Group ◽

Diagnosis And Treatment ◽

Treatment Results ◽

Standard Methods

Objective. Improvement of the treatment results of an acute pancreatitis in pregnant women, using enhanced early diagnosis and tactics of treatment. Маterials and methods. Analysis of the diagnosis and treatment results was conducted in 123 pregnant women, suffering an acute pancreatitis. In the main group (61 pregnant women) the elaborated algorithm of diagnosis and treatment for an acute pancreatitis in the period 2012 - 2018 yrs was applied, while in a comparison group (62 pregnant women) - the standard methods of diagnosis and treatment in an acute pancreatitis for the period of 2006 - 2012 yrs. Results. In the main group in 100% of the patients an acute pancreatitis was revealed on early stage. This have had guaranteed the effect obtaining from the conservative therapy in 27 (44.3%) pregnant women, using miniinvasive surgical interventions - in 31 (50.8%) and to prevent postoperative lethality. In a comparison group in 26 (41.9%) patients an acute pancreatitis diagnosis was established in (8 ± 2.1) days after the disease beginning. In a comparison group the conservative treatment effect was observed in 21 (33.9%) patients only. Two (3.2%) pregnant women died. Conclusion. Application of the diagnostic-treatment algorithm, comparing with standard methods, permits to diagnose an acute pancreatitis in pregnant women on early stage, to reduce the complications and lethality rate.

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Clinical Features of Urinary Infections in Pregnant Women with Type 1 Diabetes Mellitus

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2020-27-3-18-31 ◽

2020 ◽

Vol 27 (3) ◽

pp. 18-31

Author(s):

I. V. Alekseenko ◽

L. A. Ivanova

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Urinary Tract ◽

Type 1 Diabetes Mellitus ◽

Pregnant Women ◽

Comparison Group ◽

Pregnancy Termination ◽

Main Group ◽

Tract Infections

Aim. To study clinical manifestations of urinary tract infections in pregnant women with type 1 diabetes mellitus (DM).Materials and methods. Pregnant women with urinary tract infections (UTIs) were examined: 110 with type 1 diabetes mellitus (main group) and 133 without diabetes mellitus (comparison group). The diagnosis of UTI was based on the clinical picture (for manifestation forms) and confirmed by a dual culture method using both the classical approach and DipStreak tests. The determination of the sensitivity of the isolated microorganisms to antibacterial drugs was carried out by the disk diffusion test on Mueller-Hinton agar using paper disks. Instrumental research included ultrasound of the kidneys, urinary tract and fetoplacental complex.Results. In the main group, UTIs were pyelonephritis, asymptomatic bacteriuria (AB) and low AB (102–104 CFU/ml) was detected in 38, 69 and 31 patients, respectively. In the comparison group, pyelonephritis, AB and low AB was detected in 41, 63 and 29 patients, respectively. In the main group, the classic course of pyelonephritis was observed in 44.7%, low-symptomatic — in 26.3%, “according to the type of carbohydrate metabolism decompensation” — in 21%, and the obstetric variant — in 7.9% of patients. In the comparison group, the classic version of pyelonephritis was in 70.7%, low-symptomatic — in 24.4%, asymptomatic — in 4.9%. Bilateral pyelonephritis in pregnant women with type 1 diabetes mellitus prevailed over unilateral: 65.8 vs 34.2%. During AB, in patients with type 1 diabetes mellitus, hyperglycemia was observed in 23.1% (n = 16), the threat of pregnancy termination in 53.6% (n = 37), and moderate preeclampsia in 17.4% (n = 12). In patients with low AB, glycemia above the target values was recorded in 16.1% (n = 5), the threat of pregnancy termination in 38.7% (n = 12), and moderate preeclampsia in 12.9% (n = 4).Conclusion. Based on the specifics of the clinical manifestations of UTIs in pregnant women with type 1 diabetes mellitus, the following types of pyelonephritis can be distinguished: classic, low-symptom, “decompensation of carbohydrate metabolism” and obstetric. The classical course of pyelonephritis in pregnant women with type 1 diabetes mellitus is statistically significantly less common (p <0.05) as compared with pregnant women without diabetes mellitus. The features of AB in pregnant women with type 1 diabetes mellitus are the development of hyperglycemia and obstetric complications.

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A Disorder of Menstrual Function Regularization and its Influence on a Female Reproductive Potential

Galician Medical Journal ◽

10.21802/gmj.2017.3.9 ◽

2017 ◽

Vol 24 (3) ◽

Author(s):

Oksana Makarchuk ◽

Volodymyr Dziombak

Keyword(s):

Risk Factors ◽

Menstrual Cycle ◽

Pregnant Women ◽

Luteal Phase ◽

Comparison Group ◽

Inflammatory Diseases ◽

Main Group ◽

The Body ◽

Obstetric Complications ◽

Menstrual Function

Obstetric complications in women of reproductive age are often the result of puberty disorders which remain underestimated and not taken into account in pregnancy monitoring programs in such patients, leading to an increase of habitual non-carrying of pregnancy and negative obstetric effects.The objective of the research is to carry out a comprehensive multivariate assessment of the disturbances of the body adaptive processes in teenage girls, taking into account the data of anamnesis regarding the specifics of menstrual function regularization during puberty, and to determine the main factors of complicated pregnancy in this category of patients.Materials and methods. To carry out the task, 110 pregnant women with a disorder of menstrual function regularizationhave been prospectively examined (the main group); the examination was performed at the preconception stage and in the periods of 6-12, 22-24 and 32-36 weeks of pregnancy. The comparison group consisted of 30 patients with a normal menstrual cycle. In order to identify risk factors and predict complications, the odds ratio (OR) and its 95% confidence interval were used.Results. Extragenital pathology plays a significant role in the formation of pathological course of puberty and obstetric complications; 87.27% ofsuch cases were demonstrated in our study. Among the disorders of the ovarian-menstrual cycle, the structural significance is characteristic to the failure of the luteal phase and anovulatory disorders (78.18% of cases). Gynaecologic pathology includes inflammatory diseases of the pelvic organs (35.45%), cervical background processes (41.66%), ovarian tumour lesions (21.81), and primary infertility(14.54%). The obtained results of the structure of pregnancy complications in patients of the main group show reproductive losses in early pregnancy (11.8%), subchorionic hematoma (28.18%) and the threat of late spontaneous abortion; these data are notedthree times more often than in the comparison group. Many cases of preeclampsia (28.18%), gestational anaemia in more than half of the observations, fetal distress during pregnancy (32.72%) and birth of children with a low weight (17.27%) are associated with the development of the primary placental dysfunction and pathology of vascular and thrombocytic component of haemostasis.Conclusions. Analysis of the obtained data confirmed that pregnant women with a disorder of menstrual function regularization in puberty are characterized by a significant number of complications during pregnancy and delivery, high rates of spontaneous abortions and missed miscarriages; all these factsshould be considered as potential risk factors. The key factors are the following: endocrine imbalance by type of oligomenorrhea and luteal phase deficiency (OR – 9.16; 2.21-23.24), inflammatory diseases of the genital tract, such as asymptomatic bacteriuria and bacterial vaginosis (OR – 14.26; 3.26-32.12), premature deliveryin past medical history, the risk of spontaneous miscarriages and subchorionic hematoma.

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Features of endocrinological status and fetoplacental complex in pregnant women with adenomyosis

HEALTH OF WOMAN ◽

10.15574/hw.2018.129.104 ◽

2018 ◽

pp. 104

Author(s):

N.Y. Skripchenko ◽

◽

O.M. Pavlova ◽

T.M. Mazur ◽

◽

...

Keyword(s):

Pregnant Women ◽

Comparison Group ◽

Diet Therapy ◽

Main Group ◽

Placental Lactogen ◽

Control Group ◽

Metabolic Therapy ◽

Pregnancy And Childbirth ◽

Fetoplacental Complex ◽

Treatment And Prevention

The objective: to study the features of the endocrinological status and the fetoplacental complex in pregnant women with adenomyosis, the course of pregnancy and childbirth in these women, to develop new, systematize and improve the existing methods of diagnosis, treatment and prevention of complications and reproductive losses. Materials and methods. We examined 90 pregnant women who were divided into groups: 30 healthy women – control group, a comparison group of 30 women with adenomyosis receiving classic progesterone therapy and the main group of 30 women with adenomatosis who received advanced preserving, metabolic therapy and diet therapy. The condition of the feto-placental complex, the frequency of IUGR, hemodynamic disturbances on the part of the fetus, and the level of estriol, progesterone, cortisol, chronic gonadotropin (CGL), placental lactogen were evaluated. Results. The main complication in pregnant women with adenomyosis was placental dysfunction (the comparison group was 60.0% and the main group was 33.3%), whose structure was performed by compensated (58.2%) and subcompensated forms (35.8%). The frequency of preterm labor threat was 20.0% in comparison group and 13.3% in main one, while in the control group – 1 case, which is 3.3%. Frequency of SCR was in the comparison group – 20.0% and in the main – 3.3%. Low levels of estriol, progesterone, HHG, placental lactogen, increased cortisol levels in comparison and main groups were determined, and after treatment the indicators of the main group significantly improved. Conclusions. With timely correction of violations, prevention of fetoplacental insufficiency and complex treatment with the use of advanced classical progesterone therapy in combination with metabolic and diet therapy we can significantly reduce the frequency of various complications in pregnant women with adenomyosis. Key words: adenomyosis, pregnancy, non-pregnancy, diet therapy, metabolic therapy, preservation therapy, preventive care.

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ASSESSMENT OF SEASONAL CHANGES IN ENERGY SUPPLY OF IMMUNOCOMPETENT BLOOD CELLS IN PREGNANT WOMEN FROM DIFFERENT AREAS OF THE AMUR REGION

Bulletin physiology and pathology of respiration ◽

10.12737/article_5c1267aba61dd6.59280690 ◽

2018 ◽

Vol 1 (70) ◽

pp. 55-60

Author(s):

Стефания Супрун ◽

Stefaniya Suprun ◽

Наталья Кудерова ◽

Natalia Kuderova ◽

Ольга Морозова ◽

...

Keyword(s):

Pregnant Women ◽

Rural Areas ◽

Blood Cells ◽

Urban Areas ◽

Seasonal Changes ◽

Energy Supply ◽

Amur Region ◽

Diagnostic Methods ◽

Seasonal Effects ◽

Simultaneous Increase

In order to study the seasonal effects on the energy supply of immunocompetent blood cells (IBC) in pregnant women living in different conditions of the Amur region, and to substantiate additional methods of diagnosis, prevention and treatment of the identified disorders, a study of the mitochondrial membrane potential (MMP) by flow laser cytometry was conducted in 198 subjects. The data of different types of IBC (lymphocytes, granulocytes and monocytes) at early gestation of women living in urban (Khabarovsk) and rural (Jewish Autonomous region) areas of the Amur region were analyzed. Eight (8) groups were formed according to seasons: winter, spring, summer and autumn. The results of a comprehensive survey indicate some features of intracellular bioenergy processes of IBC depending on the environmental conditions in different seasonal periods. Conditions of women from urban areas are characterized by a significant increase in lymphocytes with reduced MMP which was more pronounced in winter, and by a tendency to increase monocytes in spring-and-summer season. The state of low energy supply of IBC in rural residents differs significantly by means of granulocytes in all presented periods of a year, combinations of various types of IBC in winters and tendency to simultaneous increase in the number of all IBCs with the reduced MMP. The number of IBC with optimal MMP content in urban environment was observed in pregnant women in autumn (23.3%), in rural areas in summer (57.1%). Thus, the study has shown the need to expand the range of diagnostic methods for the formation of pregnancy complications risk groups. Determination of the substrate-energy value in the cells of the immune system is an indication for the individual selection of complex vitamin and mineral medications taking into account seasonal changes. MMP studies allow to monitor the dynamics and evaluate the effectiveness of preventive and therapeutic prescriptions.

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Combined prevention of fetal growth restriction based on determination of diagnostic markers

EUREKA Health Sciences ◽

10.21303/2504-5679.2021.001849 ◽

2021 ◽

pp. 9-15

Author(s):

Vladimir Golyanovskyi

Keyword(s):

High Risk ◽

Pregnant Women ◽

Preventive Measures ◽

Comparison Group ◽

Fetal Distress ◽

Main Group ◽

Growth Restriction ◽

Control Group ◽

High Risk Women ◽

Micro Elements

Due to the morbidity of mothers and newborns caused by fetal growth restriction (FGR) and preeclampsia, preventive measures should be taken, especially in women at high risk of developing these conditions. Many studies have been conducted on the prevention of FGR and preeclampsia in high-risk women, especially anticoagulants, aspirin, paravastatin, nitric oxide, microelements (L-arginine, folic acid, vitamins E and C, phytonutrients, vitamin D) and calcium. The aim is to improve perinatal consequences by preventing FGR in high-risk women. Materials and methods: A prospective study of 137 pregnant women in the period of 110–136 weeks was conducted at the Perinatal Center in Kyiv. Pregnant women were divided into 3 groups. The main group included 47 women at high risk of FGR who received therapy (low doses of aspirin, low molecular weight heparin (LMWH) and vitamin and micro elements drugs). The comparison group included 45 women who had a high risk of FGR but did not receive treatment. The control group consisted of 45 women who were not at risk of FGR. The frequency of FGR and placental dysfunction were analyzed as well as a fetal distress was analyzed ante- and intranatally. Results: Therapy with low doses of aspirin, LMWH and a complex preparation of vitamins and micro elements improves the course of pregnancy and gestational complications. In the main group FGR was detected in 8.5 %, in the comparison group – in 17.8 %, in the control group – 4.4 %. Placental dysfunction was detected in 13.3 % in the control group, and only 6.4 % in the main group that was close to the control group – 2.2 %. Similar tendencies were found for fetal distress ante- and intranatally. Conclusions: The proposed prophylactic measures can improve maternal outcomes by reducing the level of gestational complications in pregnant women with biochemical signs of risk of FGR development. In addition, these preventive measures can reduce the frequency of children births with growth restriction, which significantly reduces early neonatal and perinatal morbidity and mortality.

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Effectiveness of tranexamic acid in the therapy of bleeding in the first trimester of pregnancy

HEALTH OF WOMAN ◽

10.15574/hw.2018.130.59 ◽

2018 ◽

pp. 59-62

Author(s):

T.G. Romanenko ◽

◽

O.M. Sulimenko ◽

Keyword(s):

Tranexamic Acid ◽

Pregnant Women ◽

Inpatient Treatment ◽

Comparison Group ◽

First Trimester ◽

Main Group ◽

Primary Group ◽

First Trimester Of Pregnancy ◽

Bed Days ◽

Hemostatic Therapy

The objective: to study the effectiveness of hemostatic therapy with tranexamic acid in pregnant women with miscarriage that started. Materials and methods: The study group included 110 pregnant women with a miscarriage that began with the onset of retrochoric hematoma, from 5 to 22 weeks of gestation. The main group was 60 pregnant women who received hemostatic therapy with the drug tranexamic acid Vidanol in a daily dose of 1000–1500 mg until stopping the bleeding. The comparison group consisted of 50 pregnant women who received standard hemostatic therapy with etamsylatum. On ultrasound, retrochorionic / retroplacental hematomas were noted in 27 women of the main group (45%) and 22 patients in the comparison group (44%), extramembrane hematomas were diagnosed in 8 (13.3%) and 9 (18%) women, respectively. Placenta presentation was observed in 7 (11.7%) and 8 (16%) women of both groups, respectively. In the rest of pregnant women there was a bloody discharge from the genital tract as a result of detachment of the chorion / placenta or membranes without formation of hematoma. The obtained data are processed by the statistical method using the Microsoft Excel computer program. Results. Stopping bleeding with the use of tranexamic acid averaged over 2 days from the start of therapy, the duration of bleeding was 2.1±0.2 days, whereas in the comparison group, the duration of bleeding was significantly higher than 5.7±0.3 (p<0,01). The need for inpatient treatment was in the main group of 9.7±0.8 bed-days and 15.6±2.7 bed-days, respectively (p<0.05). When using the drug tranexamic acid, the organization and resorption of hematomas in the uterus occurred in a shorter time – 19 of 35 (54.3%) women in the primary group and 10 in 31 (32.3%) women in the comparison group. The total absence of hematoma is noted in the main group for 1.2±0.4 weeks, in the comparison group for 4.8±0.5 weeks (p<0.05). Conclusion. The use of tranexamic acid, as hemostatic therapy in pregnant women with a miscarriage, significantly reduces the duration of bleeding, promotes the accelerating the organization and resorption of intrauterine hematomas, reduces the duration of inpatient treatment. Key words: pregnancy, miscarriage, risk of miscarriage, retrochorionic hematoma, bleeding in the first trimester of pregnancy.

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REGULATION OF PERIPHERAL B-LYMPHOCYTE DIFFERENTIATION IN RECURRENT MISCARRIAGE

Medical Immunology (Russia) ◽

10.15789/1563-0625-rop-2295 ◽

2021 ◽

Vol 23 (4) ◽

pp. 711-716

Author(s):

A. I. Malyshkina ◽

N. Yu. Sotnikova ◽

A. V. Kust ◽

D. N. Voronin

Keyword(s):

Pregnant Women ◽

B Lymphocytes ◽

B Lymphocyte ◽

Comparison Group ◽

Recurrent Miscarriage ◽

Main Group ◽

Lymphocyte Differentiation ◽

Spontaneous Miscarriage ◽

Threatened Miscarriage ◽

History Of

The important role of immune disorders in recurrent miscarriage has been proven. Clarification of the character of B-lymphocyte differentiation and its regulation factors in women with threatened miscarriage and recurrent miscarriage in history is an urgent problem, since it will reveal the immune mechanisms of the pathogenesis of this pathology. Purpose: to establish the features of B-lymphocyte differentiation and factors of its regulation in women with a history of recurrent miscarriage and threatening spontaneous miscarriage at the time of examination.Were examined pregnant women aged 18-40 years at a gestation period of 5-12 weeks. The main group consisted of 60 pregnant women with a threatening spontaneous miscarriage at the time of examination and a history of recurrent miscarriage. As a control, 35 pregnant women with uncomplicated pregnancy were examined. The comparison group consisted of 25 primary pregnant women with threatened spontaneous miscarriage at the time of examination. The material for the study was peripheral venous blood. Subpopulations of B-lymphocytes CD19+, CD19+ IgD+, CD20+IgM+, CD20+IgG+ were determined by flow cytometry; CD19+CD20- CD38+, CD19+CD27- , CD19+CD27+. Serum levels of BAFF and APRIL were assessed by enzyme-linked immunosorbent assay.In the main group, an increase in the proportion of B-cells, CD20+IgM+-lymphocytes and memory cells was recorded in the peripheral blood, along with a decrease in the level of naive cells and plasma cells. In the comparison group, an increase in the proportion of immature IgM+B-cells, circulating memory cells, along with a decrease in naive B-lymphocytes, was registered. in the main group there was a pronounced decrease in the serum BAFF level compared with the control and comparison groups. Analysis of the APRIL content showed a pronounced downward trend in groups with threatened miscarriage relative to healthy pregnant women. Thus, threatening habitual and sporadic miscarriages were associated with a shift in the differentiation of B-lymphocytes towards immature forms and a lack of regulatory influence of BAFF and APRIL, which is reflected in the disruption of B-cell homeostasis and weakening of humoral effector mechanisms at the systemic level. The revealed changes may indicate a single mechanism for the development of a threatening spontaneous miscarriage, the severity of which increases with repeated loss of pregnancy. These changes can lead to an increase in effector cytotoxic mechanisms and an increase in proinflammatory cytokines, which can lead to the development of damaging reactions in the fetoplacental complex, which can be reflected in the clinical picture of the threat of termination of pregnancy.

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