Abstract
Hypothesis/aims of study. The aim of this study was to evaluate the features of the medical history and pregnancy outcomes in women with miscarriage and antiphospholipid syndrome depending on the methods of its correction.
Study design, materials and methods. A prospective cohort study was conducted, in which a total of 137 pregnant women with a history of abortion and antiphospholipid syndrome were examined. The women were divided into two groups according to the principle of the presence or absence of plasmapheresis procedures in the scheme of miscarriage therapy at the pregravid stage. Group I (main) consisted of individuals (n = 73), who were treated with the inclusion of plasmapheresis at the pregravid stage; group II (comparison) included women (n = 64), who were not given efferent therapy.
Results. Antiphospholipid syndrome was more common in patients with a complicated obstetric and gynecological history. As a result of persistent infection, chronic endometritis and salpingo-ooparitis were more often observed in patients with TORCH infection. The titer of antiphospholipid antibodies, regardless of the presence or absence of TORCH infection, decreased after plasmapheresis, such positive dynamics being observed only in patients with a history of gestational losses of less than four.
Conclusion. The level of reduction of antiphospholipid antibodies in relation to the initial values was 6095%, which indicates the optimal choice of the characteristics of plasmapheresis therapy and its duration.
Subject
Obstetrics and Gynaecology
Reference16 articles.
1. Miyakis S, Lockshin MD, Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost. 2006;4(2):295-306. https://doi.org/10.1111/j.1538-7836.2006.01753.x.
2. Гри Ж.-К., Макацария А.Д., Бицадзе В.О., и др. Антифосфолипидный синдром и беременность // Акушерство и гинекология. – 2018. – № 10. – С. 5−11. [Gris J-C, Makatsariya AD, Bitsadze VO, et al. Antiphospholipid syndrome and pregnancy. Obstetrics and gynecology. 2018;(10):5-11. (In Russ.)]. https://doi.org/10.18565/aig.2018.10.5-11.
3. Шляхтенко Т.Н., Алябьева Е.А., Аржанова О.Н., и др. Антифосфолипидный синдром при невынашивании беременности // Журнал акушерства и женских болезней. – 2015. – Т. 64. – № 5. – С. 69−76. [Shlyaxtenko TN, Alyab’eva EA, Arzhanova ON, et al. Antiphospholipid syndrome in miscarriage. Journal of obstetrics and women’s diseases. 2015;64(5):69-76. (In Russ.)]
4. Berg TG, Ramus RM. Antiphospholipid syndrome and pregnancy. Medscope [Internet]. 2017. Available from: https://emedicine.medscape.com/article/261691-overview.
5. Макаров О.В., Керчелаева С.Б., Бурденко М.В., Тамразян А.А. Клинические и гемостазиологические особенности течения беременности у женщин с различным генезом угрозы ее прерывания // Российский вестник акушера-гинеколога. – 2012. – Т. 12. – № 4. – С. 4−7. [Makarov OV, Kerchelaeva SB, Burdenko MV, Tamrazyan AA. Clinical and hemostasiological features of the course of pregnancy in women with threatened miscarriage of different genesis. Rossiiskii vestnik akushera-ginekologa. 2012;12(4):4-7. (In Russ.)]