• Pathogenetic mechanisms of miscarriage in women with a multiple pregnancy, due to the use of ART

Pathogenetic mechanisms of miscarriage in women with a multiple pregnancy, due to the use of ART

HEALTH OF WOMAN. 2016.6(112):173–176 
 

Pathogenetic mechanisms of miscarriage in women with a multiple pregnancy, due to the use of ART 
 

Ventskivsky B. M., Poladych I. V.

A.A. Bogomolets National Medical University, Kiev 
 

Multiple pregnancy (MP) is one of the most of actual problems of modern obstetrics,, due to the widespread introduction of public health practice effective methods of infertility treatment, including the modern means of assisted reproductive technology. Miscarriage is the most common complication of gestational progress in women with multiple pregnancy resulting from IVF. Questions about mechanisms of development can not be considered fully resolved, so the subject of our study.


The оbjective: to study the main causes of miscarriage in pregnant women with bihorialnoyu, biamniotychnoyu twins that due to the use of ART.


Patients and methods. We examined 130 patients who had multiple pregnancy, including 68 (and group) pregnancy was the result of the use of ART, 62 (Group II) – spontaneous BV. The control group – 38 formed pregnant with singleton pregnancies. The research conducted clinical and laboratory examination methods, namely the determination of proinflammatory cytokines, research hormonal function FPC imunofermentym analysis; imunohisothimichne research receptor system placentas. Statistical analysis of the results vynonuvalas using standard packages of applied statistical analysis (Statistic 6.0 for Windows, Statgraphics v. 7.0).


Results. During the study, found burdened somatic and obstetric and gynecological history in women with multiple pregnancy caused by ART. When hormonal research found elevated concentrations of progesterone, alpha-fetoprotein and placental lactogen normal levels, indicating that sufficient data nasynechist pregnancy hormones in the body for normal functioning of the FPC women with multiple pregnancy resulting from IVF. Elevated levels of proinflammatory cytokines found in patients in group I compared with group II and controls (p<0.05). Disturbed cytokine balance can be pathogenetic mechanism leading to the development of premature labor. In analyzing the vaginal microbiota, found more pronounced dyzbiotychni disorders in women are caused by multiple pregnancies IVF compared to women the second group and the control group (p <0.05). Immunohistochemical researches placental barrier, found increased expression capable of progesterone receptors in women with a multiple pregnancy resulting from IVF (p <0.05).


Conclusions. Thus, the results showed the presence of a consistent chain of changes in women with MP ART determined that the starting point in the development of not carrying MP is a violation of local factors immune defense and not hormonal imbalance.


Key words: multiple pregnancy, assisted reproductive technologies, fertility, progesterone miscarriage.


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