Clinical and Anamnestic Characteristics and Medical Accompanying of Pregnant Women with a Burdened Obstetric History and Thrombophilia

Abstract

The purpose of the study was to determine the clinical and anamnestic features (age characteristics of women and anamnestic features of previous pregnancies) of pregnant women with burdened obstetric history and thrombophilia with the establishment of the main pharmacological mechanisms of therapeutic support. Materials and methods. The study was performed at the Department of Clinical Laboratory Diagnostics of Kharkiv National Medical University and at the Kharkiv Clinical Laboratory Center in the period from 2017 to 2021. We examined 137 pregnant women: the main group (101 women – pregnant women with a burdened obstetric history and thrombophilia aged 29.0 to 37.0 years) and the control group (36 women – pregnant women with a burdened obstetric history without thrombophilia aged 26.0 to 30.0 years). In general, the predominance of one (35.8 %) and two (46.7 %) pregnancies in the history of women with a burdened obstetric history compared to three (17.5 %) was noted. Results and discussion. An increase (U = 706.0; p <0.001) in the chances of developing negative consequences of pregnancy in thrombophilia with increasing age due to negative idiopathic thromboembolic effects due to thrombophilia was noted. A higher mean age of pregnant women with a burdened obstetric history in the presence of thrombophilia (33.0 [29.0; 37.0] years) was determined compared with the control (28.0 [26.0; 30.0] years). The maximum negative manifestations of idiopathic thromboembolic effects due to thrombophilia in the first pregnancy were found. The predominance of cases of fetal death in the first pregnancy of women with two (94.1 %) and three (78.3 %) pregnancies was determined. In general, the need for antiplatelet therapy in thrombophilia was stated. Its use (χ2 = 46,950; p <0.001) was determined in 85.1 % of cases, the majority (65.3 %) of one drug (probably (χ2 = 164.54; p <0.001) more often (52.5 %) acetylsalicylic acid compared with dipyridamole (5.9 %)). It was found that anti aggregate therapy, which included two drugs (combination: acetylsalicylic acid, dipyridamole or klexan) was most often used in the first (40.7%) pregnancy in contrast to the second (11.8%) and third (13.0 %). Conclusion. The study found that antiplatelet therapy with only one drug (acetylsalicylic acid, dipyridamole or klexan) was more commonly used in the second (74.5%) and third (73.9%) pregnancies than in the first one (40.7%). It was naturally determined that the absence of any medication was noted most often by pregnant women in the first (18.5%) pregnancy in contrast to the second (13.7%) and third (13.0%)