Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part II

2021 ◽  
Vol 20 (2) ◽  
pp. 26-32
Author(s):  
Yu.S. Raspopin ◽  
◽  
E.M. Shifman ◽  
A.A. Belinina ◽  
A.V. Rostovtsev ◽  
...  
Keyword(s):  
High Risk ◽  
Caesarean Section ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Research Work ◽  
Control Group ◽  
Non Invasive ◽  
Group I ◽  
Significant Difference ◽  
Invasive Hemodynamics

Severe and massive bleeding remains one of the main causes of maternal mortality and morbidity. The use of terlipressin has proved to be effective in the prevention of postpartum haemorrhage in the high-risk group. Given that terlipressin is a potent vasopressor, there are concerns about its use in parturient women with hypertension. Objective. To evaluate the hemodynamic effects of terlipressin when it is injected into the myometrium during caesarean section. Patients and methods. This publication is a continuation of the research work on the effectiveness of terlipressin in the prevention of postpartum haemorrhage in high-risk pregnant women, which was conducted between February and December 2020 with the participation of 5 medical centers. The study included 454 pregnant women who delivered by caesarean section. They were divided into two groups: control group I (n = 351) and study group II (n = 103), with local application of terlipressin injected into the thickness of the myometrium. During the study, the parameters of non-invasive hemodynamics were assessed. Results. When assessing the indicators of non-invasive blood pressure, no statistically significant difference was found between the groups. The analysis of heart rate showed slight statistical difference at the stage of operation and in the postoperative period. A significant difference in values of shock index in dynamics was found between the groups, which, nevertheless, were within acceptable limits, and the difference had no clinical significance. Conclusion. The study showed that the use of terlipressin does not significantly affect the parameters of non-invasive hemodynamics, which can complicate the operation or the labor outcome. Key words: obstetric haemorrhage, terlipressin, hemodynamics

Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I

2021 ◽  
Vol 20 (1) ◽  
pp. 11-20
Author(s):  
Yu.S. Raspopin ◽  
◽  
E.M. Shifman ◽  
A.A. Belinina ◽  
A.V. Rostovtsev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
High Risk ◽  
Caesarean Section ◽  
Blood Loss ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Control Group ◽  
Study Group ◽  
Group I

Prevention of postpartum haemorrhage is one of the important tasks of modern obstetrics, anesthesiology and intensive care. Objective. To assess the efficacy and safety of terlipressin usage as a means of postpartum haemorrhage development prevention during caesarean section in high-risk pregnant women. Patients and methods. From February to December 2020, a multicenter comprehensive cohort study, in which 5 medical centers participated, was conducted. The study included 454 pregnant women who underwent caesarean section and who were divided into two groups: control group I (n = 351) and study group II (n = 103), with the use of terlipressin injected into myometrium. Evaluation of the preventive effect of the drug was carried out in several main directions: the volume of blood loss, the need for additional methods of surgical hemostasis, the safety of intraoperative use. Results. Considerable differences were found in the assessment of significant risk factors for the development of postpartum haemorrhage, associated pathologies and comorbidity between the groups. The study group turned out to be more threatened by the postpartum haemorrhage development. In the control group, additional measures of surgical hemostasis were more often used, including hysterectomy (2.6% versus 1.9%) and relaparotomy (1.9% versus 1%). The median blood loss was statistically lower in the study group (700 ml versus 800 ml). Nevertheless, the considerable spread of data on the volume of blood loss should be noted, with a maximum blood loss of 10,000 ml in the control group and 4,500 ml in the study group. There were no serious complications in both groups. Conclusion. The study showed that the use of terlipressin can reduce the volume of blood loss in women with high risk factors for postpartum haemorrhage, as well as reduce the number of hysterectomies and relaparotomies. It is necessary to continue the prospective part of the study with an increase in the randomized sample of patients. Key words: obstetric haemorrhage, caesarean section, terlipressin

scholarly journals Ultrasound elastography capabilities in studying uterine cerviх state in pregnant women of high-risk group in the first trimester of pregnancy

2016 ◽  
Vol 97 (4) ◽  
pp. 656-661
Author(s):  
M G Tukhbatullin ◽  
K V Yanakova
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Chromosomal Abnormality ◽  
Chromosomal Abnormalities ◽  
Ultrasound Examination ◽  
Risk Group ◽  
First Trimester ◽  
High Risk Group ◽  
Control Group ◽  
Significant Difference

Aim. To study capabilities of quantitative elastographic study to assess the elasticity of the uterine cervix in women with a fetal chromosomal abnormality in the first trimester of pregnancy.Methods. 230 pregnant women of high-risk group at 11-13.6 weeks of pregnancy (parietal-coccygeal length 45-84 mm) were included in this study. The first group consisted of 213 women without fetal pathology. The second group included 17 women, in whose fetuses different chromosomal abnormalities were detected. In ultrasound examination of pregnant women in the I trimester of pregnancy, in addition to standard methods of examination, quantitative cervical elastography was performed.Results. According to results of quantitative elastography in 14 (82.35%) out of 17 pregnant women (second group) one or another degree of the cervical tissue softening was found, and 3 (17.64%) pregnant women with fetal chromosomal pathology had stiff cervix (all 3 cases with Down syndrome). In the control group in 10 (4.7%) of 213 pregnant women relatively soft cervix was identified, and in 203 (95.3%) women cervical density was higher than the myometrial density. A statistically significant difference between the indices of SWE-Ratio in groups was revealed. Quantitative elastography, as a diagnostic test predicting the risk of miscarriage due to chromosomal abnormalities, has a high sensitivity (84.38%) and even higher specificity (95.26%) of negative predictive value 97.57%.Conclusion. Quantitative elastography reveals a significant decrease in the cervical elasticity (softening) in pregnant women with fetal chromosomal abnormality in the I trimester of pregnancy, which allows us to recommend this method of ultrasound examination as an additional marker for early diagnosis of miscarriage due to fetal chromosomal abnormality.

scholarly journals Use of Noninvasive Cerclage in Combination of Micronized Progesterone in Miscarriage Of Multifetal Pregnancy

2017 ◽  
Vol 24 (4) ◽  
Author(s):  
Iryna Nikitina ◽  
Alla Boychuk ◽  
Valentina Kondratiuk ◽  
Tatyana Babar
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
The State ◽  
Control Group ◽  
Group I ◽  
Prophylactic Measures ◽  
Neonatal Adaptation ◽  
Group Ii ◽  
Multifetal Pregnancy ◽  
Micronized Progesterone

We represent the results of the combined method of treatment and prevention of miscarriage in women with a multiple pregnancy and a high risk of the threat of termination the pregnancy because of using the obstetric unloading pessaries, combined with micronized progesterone. The efficiency of this method of treatment is evidenced by the rapid elimination of clinical symptoms of threatened abortion, accelerating the regression of ultrasound markers, reducing the number of complications in of pregnant women and reducing the time of their stay in hospital.Goal: To evaluate the effectiveness of the handling the obstetric pessary in combination with micronized progesterone at women with multifetal pregnancy and a high risk of miscarriage.Materials and methods. We analyzed 120 cases of multifetal pregnancies with signs of miscarriage within the terms from 16 to 28 weeks. The first group of the examined women was: 40 pregnant women with twins and signs of miscarriage, who in the scheme of treatment and prophylactic measures were offered to use the unloading obstetric pessaries in combination with continuous therapy by natural micronized progesterone until 36 weeks of pregnancy. The second group included 40 pregnant women with twins, who were laid seam on the cervix because of istmicocervical insufficiency and were applied short-term courses of therapy by gestagens. The control group comprised 40 pregnant women with twins at the age of 16-28 weeks of pregnancy who were conducted the therapy about the threat of miscarriage according to the current clinical protocols (Order of the Ministry of Health of Ukraine No. 624). It was carried out the analysis of the course of pregnancy, childbirth, the postpartum period and the state of neonatal adaptation in the surveyed groups.Results of the research and their discussion. In the first group, urgent childbirth occurred in 34 (85%) cases, in group II in 29 (72.5%) cases, in control group – in 25 (62.5%) cases. Cesarean delivery was performed in 7 (17.5%) patients of group I pregnant women, in 9 (22.5%) of group II patients and in 11 (27.5%) in the pregnant group. When studying the state of neonatal adaptation of newborns in the examined groups, the following results were obtained. The average weight of the newborns in group I was 3245 ±280 g, in group II 2865 ±365 g, in the control group - 2975 ±325 g (p>0.05). The evaluation of the state of newborns on the Apgar scale, respectively at the 1st and 5th minutes, was respectively: in newborns of the I group, 7.5 ± 1.4 and 8.4 ± 1.3 points, in group II - 7.3 ± 1.6 and 8.2 ± 1.1 points, in the control group – 7.2 ± 1.6 and 8.6 ± 1.2 (р 1-р 2> 0.05).Conclusions. Comprehensive prophylaxis of non-pregnancy in multiple pregnancies, combining the use of a traumatic cardiac cervix with the help of unloading obstetric pussies with progesterone preparations, allows prolonging pregnancy, preventing the development of prematurity, contributes to the improvement of perinatal indicators.

scholarly journals Hematological Parameters in Pregnant Women with Special Reference to Iron

2021 ◽  
pp. 137-142
Author(s):  
Shubhranshu Shekhar
Keyword(s):  
Pregnant Women ◽  
Hematological Parameters ◽  
First Trimester ◽  
Control Group ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Cross Sectional ◽  
Hematological Indices ◽  
Group I ◽  
Significant Difference

Several biological factors, particularly haematological, are physiologically altered during normal pregnancy. Biologists and doctors who are aware of these changes in the maternal body can screen for potential abnormalities. The aim of this research is to find healthy pregnant women's reference values. This was a cross-sectional research of pregnant women who attended an antenatal clinic at Sree Balaji Medical College, with anaemic and non-anemic pregnant women. Pregnant women were categorized into three groups -Group I - First Trimester (50 cases); Group II - Second Trimester (50 cases) and Group III - Third Trimester (72 cases) while non­ pregnant women formed the fourth group (30 cases). A statistically significant difference between the pregnant women and control group was noted (p < 0.05) for all the hematological parameters: red blood cells, hematocrit, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, leukocytes, neutrophils, basophils, eosinophils, lymphocytes, monocytes, platelets and mean platelet volume. The present study provides additional baseline data for basic hematological parameters in healthy pregnant women and concluded that pregnancy in women has the tendency to alter some hematological indices.

scholarly journals Carbetocin Or Oxytocin To Prevent Postpartum Haemorrhage Due To Uterine Aony In Cases Of Elective Caesarean Section

2020 ◽  
Vol 7 (7) ◽  
pp. 739-745
Author(s):  
Mohamed S. A. Emarah
Keyword(s):  
Caesarean Section ◽  
Postpartum Haemorrhage ◽  
Elective Caesarean Section ◽  
Active Management ◽  
Technological Advancement ◽  
Uterine Arteries ◽  
Group I ◽  
Significant Difference ◽  
Prophylactic Drug ◽  
Long Acting

Background: Despite the technological advancement made in the past few decades, postpartum haemorrhage (PPH) remains one of the principal causes of maternal deaths in developing nations. The administration of uterotonic drugs widely prevents the PPH; therefore, it is the main point of active management. Among uterotonics, oxytocin has proven to be very effective in reducing the incidence of PPH. One prophylactic drug which has been introduced in recent times is carbetocin, a synthetic long-acting oxytocin analogue. It has a longer half life of 41 min, allowing it to stimulate a prolonged uterine response of up to an hour after a single intravenous dose, obviating the need for infusion. Methods: A total of 120 pregnant women divided into two groups; Group I (Carbetocin group) included 60 women who received carbetocin and delivered by caesarean section (CS), Group II (Oxytocin group) included 60 women who received oxytocin and delivered by caesarean section (CS). Results: Our result showed that, there was a statistically significant difference for the prevention of atonic postpartum hemorrhage between the two groups (p<0.01), for carbetocin group. There was also a statistically significant difference between the two groups (p < 0.01), according to need to additional procedures, such as need to modified B-lynch sutures and need to bilateral uterine arteries ligation for carbetocin group. Conclusion: We concluded that carbetocin was a better alternative to traditional oxytocin in the prevention of PPH after elective caesarean section.

scholarly journals Urinary Nephrin and Podocalyxin Levels as Predictors of Pre-eclampsia in High-Risk Pregnant Women

Folia Medica ◽  
2021 ◽  
Vol 63 (6) ◽  
pp. 948-957
Author(s):  
Irena Kostovska ◽  
Katerina Tosheska Trajkovska ◽  
Ognen Kostovski ◽  
Danica Labudovic
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Gestational Age ◽  
High Risk Pregnancy ◽  
Renal Diseases ◽  
Control Group ◽  
Inclusion Criteria ◽  
Risk Pregnancy ◽  
Significant Difference ◽  
History Of

Introduction: Pre-eclampsia (PE) is characterized by new-onset hypertension and proteinuria. Damage of podocyte cells has been reported in pre-eclamptic women, thus podocyte specific proteins such as nephrin and podocalyxin could be useful biomarkers in PE. Aim: To investigate the role of urinary nephrin (u-nephrin) and urinary podocalyxin (u-PDX) levels in predicting PE in women with a high-risk pregnancy. Materials and methods: We included 101 pregnant women in this study and allocated them into three groups: group 1 included pregnant women at high risk of developing PE (n=41), group 2 - pregnant women with PE (n=30), and group 3 was the controls including healthy pregnant women (n=30). The inclusion criteria for women with PE were de novo hypertension >140/90 mm Hg, proteinuria >300 mg/24 hours, and presence of edema after 20 weeks of gestation, while the exclusion criteria were a history of renal diseases and pregnant women younger than 18. Inclusion criteria for the group of women with a high-risk pregnancy was gestational week >15, a history of PE in a previous pregnancy, pre-existing diabetes type 1 or 2, pre-existing hypertension, multiple gestations, prior placental abruption, obesity women, nulliparity, maternal age >35 years, and a family history of PE. The study was conducted from March 2016 to May 2017 in the Medical Faculty at the Institute of Medical and Experimental Biochemistry in Skopje. Urine samples were used to measure the nephrin and podocalyxin levels using immunoenzyme assay, creatinine and microalbumin. Blood samples were collected for biochemical analyses. Results: U-nephrin levels were elevated in 96.7% of women with PE, and 73% of women with a high-risk pregnancy. U-PDX levels were elevated in 63% of the women with PE and 100% of the women with a high-risk pregnancy. U-nephrin and u-PDX levels were significantly increased in women with a high-risk pregnancy and women with PE compared with a control group (p<0.001). A significant difference was found between the subgroups of pregnant women classified according to gestational age in their u-nephrin and u-PDX levels. There was a significant positive correlation between the levels of both markers and glomerular filtration rate, and significant negative correlation between the levels of both markers and gestational age. ROC analysis revealed that the cut-off value of 304.6 ng/ml of u-nephrin had a sensitivity (Se) of 96.7%, specificity (Sp) of 96.7% (for both Se and Sp 95% confidence interval (CI) 82.8-99.9), while the cut-off value of 59.5 ng/ml of u-PDX had a sensitivity of 100% and Sp of 93.3% (Se - 95% CI 88.4-100, Sp - 95% CI 77.9-99.2), in distinguishing women with PE and healthy pregnancies. Both markers showed excellent clinical utility (CUI&ge;0.81), for u-nephrin (CUI+ and CUI&minus; is 0.934), for u-PDX (CUI+ is 0.938; CUI&minus; is 0.933). Conclusions: U-nephrin and U-PDX levels could be useful as predictors of PE in women with a high-risk pregnancy.

scholarly journals Comparison of the Mode of Delivery between COVID and Non-COVID Pregnancies

2021 ◽  
Vol 11 (9) ◽  
pp. 277-283
Author(s):  
Saima Najam ◽  
Shehla Aqeel ◽  
Syeda Ifra Hassan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Null Hypothesis ◽  
Mode Of Delivery ◽  
Active Phase ◽  
Current Evidence ◽  
Control Group ◽  
Significant Difference ◽  
Third Stage ◽  
Study Population

Background: The pregnant women and the newborn infants represent the vulnerable population in every society. Therefore Improvement efforts for the survival and the well being of the mothers and the neonates is indisputably a global priority especially during this pandemic of severe acute respiratory syndrome caused by a novel corona virus, called Covid-19. declared by the WHO ( World Health Association ) as global pandemic on March 11,2020. This pandemic has significantly altered the life styles of the pregnant women, boosting their apprehensions and concerns and importing great impacts on their health management. Current evidence suggests that the pregnant women are not at increased risk of Covid -19 as compared to the other adults. Similarly the condition is not severe in them. At the place of the current study the mode of delivery of the Covid patients is individualized and based on severity of the Covid infection and purely on the obstetric indications, as the evidence suggests that no mode of delivery is superior in terms of prevention of the vertical transmission. Objective: We performed this study to compare the mode of delivery between the pregnant Covid and the non Covid pregnant population with the null hypothesis that the Covid effected pregnant patients are more prone to have caesarean section as compared to non Covid pregnant females and they are more prone to have CTG (cardiotocographic) abnormalities. Material and Methods: It was a retrospective observational study done to compare the mode of delivery and the rate of CTG abnormalities in the study and the control group as the primary outcome. The secondary outcome was duration of active phase of the first stage, second and third stage of the labour between the pregnant Covid and the non Covid pregnant population for a period of 6 months (First January 2021 -30th June 2021) in labor ward of Dr. Sulaiman Al-Habib Hospital, Sweidi, Riyadh, Saudi Arabia. The study population comprised of 100 pregnant patients meeting our inclusion and exclusion criteria. The number of patients in each group was equal. Results: No statistically significant difference was observed in the age, parity and ethnicity of both the groups. The rate of caesarean section was 38% (n=19) in the Covid group while in the control group it was 10% (n=05), the difference is statistically significant as shown by the P-Value of 0.004. No significant difference in the CTG abnormalities was found in both the groups. However statistically significant reduction in the active phase of the first, second and third stage of labour was noted in the study population. Conclusion: We hereby prove our null hypothesis that the Covid-19 effected pregnant patients are prone to have higher caesarean section rate, however no difference in rate of CTG (cardiotocographic) abnormalities was observed in both the groups. Significant reduction in the duration of all stages of the labour was also noticed which is a fruit of thought for the upcoming research. Key words: Pregnancy, labour, caesarean section, Covid-19, duration of labour.

scholarly journals Serum Zinc and Copper Levels in Gestational Diabetes Mellitus in a Tertiary Care Hospital of Bangladesh

2017 ◽  
Vol 8 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Farzana Akonjee Mishu ◽  
MA Muttalib ◽  
Bilkis Sultana
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Serum Zinc ◽  
Control Group ◽  
Case Group ◽  
Third Trimester ◽  
Group I ◽  
Significant Difference

Background: The term gestational diabetes mellitus (GDM) is becoming a major health problem in developing countries undergoing rapid changes in lifestyle, dietary habits and body mass index. GDM is associated with an increased incidence of congenital abnormalities which is also aggravated by mother’s zinc and copper deficiency. Zinc and copper are essential trace elements for normal embryogenesis and fetal growth and their deficiency increase mortality and morbidity of mothers, embryos and neonates. This study was designed to evaluate the association of serum zinc and copper with GDM in second and third trimester.Methods: It was a case-control study. This study was conducted in Mymensingh Medical College Hospital during the period from July 2013 to June 2014 to evaluate the association of zinc and copper levels of pregnant women with GDM. A total induded of 172 subjects were participated in this study; among them 86 women diagnosed with GDM were selected as case (Group-I) and 86 healthy pregnant women were control (Group- II).The case group was again subdivided as Group Ia and Ib according to second and third trimester respectively. Control group was also subdivided as Group IIa and IIb according to second and third trimester respectively. Student’s unpaired ‘t’ test was used to analyse the data between groups. For analytical purpose 95% confidence limit (p<0.05) was taken as level of significance.Results: There was significant difference in serum zinc and copper levels in cases compared to control group. Highly significant difference (p<0.001) was found when serum zinc was compared between women with GDM and normoglycemic pregnant women in second and third trimester. Serum copper level was significantly increased in cases compared to control group in second trimester and the difference was found highly significant (p<0.001) and significant difference (p<0.01) was found in GDM compared to normoglycemic pregnant women in third trimester.Birdem Med J 2018; 8(1): 52-55

scholarly journals Significance of pregnancy-associated plasma protein a (PAPP-a) concentration determination in the assessment of final outcome of pregnancy

2013 ◽  
Vol 70 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Dragan Loncar ◽  
Mirjana Varjacic ◽  
Slobodan Arsenijevic
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Plasma Protein ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Protein A ◽  
Growth Restriction ◽  
Control Group ◽  
Group I ◽  
Significant Difference

Background/Aim. Pregnancy-associated plasma protein A (PAPP-A) is high molecular matrix metalloproteinase originally isolated in the serum of pregnant women. The aim of this study was to analyze the values of concentration of PAPP-A in assessment of progress and outcome of pregnancy in pregnant women diagnosed with threatening preterm delivery, preeclampsia and fetal growth restriction in relation to physiological pregnancy of the same gestational age. Methods. The study included 60 pregnant women that were divided into three groups according to gestational age and the diagnosis of imminent premature birth upon reception, preeclampsia and fetal growth restriction as follows: the group I from 28 to 32 weeks of gestation, a total of 25 pregnant women, the group II from 33 to 36 weeks of gestation, a total of 23 pregnant women, and the group III from 37 to 41 weeks of gestation, a total of 12 pregnant women. The control group consisted of 60 pregnant women without complications of pregnancy that were identically divided into three groups according to gestational age as in the sample. We performed quantitative determination of PAPP-A from the venous blood of patients by using commercial tests of the company Diagnostics Product Corporation (DPC), Los Angeles, California, USA. Results. There was a statistically significant difference in PAPP-A values in the examined groups in all gestational ages (p < 0.01). The value of the PAPP-A concentration in different gestational ages with equal statistical significance indicated the possibility of complications, which was examined during pregnancy in relation to the control group of pregnant women with physiological pregnancies. This study confirmed that there was a statistically significant difference in fetal body weight at birth (p < 0.05), Apgar score in 5 min after birth (p < 0.05), and gestational age at birth (p < 0.05), as parameters of the outcome of pregnancy course, between the examined groups of pregnant women in relation to the value of PAPP-A concentration. The age of pregnant women was not statistically different in the examined groups (p > 0.05). Conclusion. Differences in PAPP-A concentration should point out to the obstetrician the need for more intensive antepartum fetal surveillance in order to increase the chances of favorable perinatal outcome, regardless gestational age.

Anamnestic factors that shape reproductive health of women with repeated unsuccessful popygamy in vitro fertilization

2016 ◽  
pp. 140-143
Author(s):  
N.V. Cotsabin ◽  
◽  
O.M. Makarchuk ◽  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Polycystic Ovary ◽  
High Risk Group ◽  
Stress Factors ◽  
Control Group ◽  
Fertilization In Vitro ◽  
Infertile Women ◽  
Group I

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.

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