Journal Health of Woman. 2025. 6(181): 44-55. doi: 10.15574/HW.2025.6(186).4455

Duka Yu. M., Panov V. V.
Dnipro State Medical University, Ukraine

For citation: Duka YuM, Panov VV. (2025). Analysis of the clinical efficacy of pathogenetically justified secondary prevention of early reproductive losses in women with РАІ-1 gene polymorphism. Ukrainian Journal Health of Woman. 6(181): 44-55. doi: 10.15574/HW.2025.6(186).4455
Article received: Oct 06, 2025. Accepted for publication: Nov 20, 2025.
Aim – to analyse the clinical efficacy of a pathogenetically justified method of secondary prevention of early reproductive losses in women with РAІ-1 gene polymorphism.
Materials and methods. The selected patients (n=115) were divided into three groups according to their genotype: Group I (n=20) – patients with the wild-type 675 5G>5G genotype of the PAI-1 gene; Group II (n=53) – women with the heterozygous 675 5G>4G polymorphism; Group III (n=42) – women with the homozygous 675 4G>4G polymorphism. Based on the study results and identified associative links, a method for secondary prevention of early reproductive losses was developed to reduce the manifestations and impact of endothelial dysfunction.
Results. The average age of women in the thematic groups was comparable and amounted to 32,5±0,9, 33,9±0,7 and 33,6±0,7 years, respectively. Correlation analysis revealed significant associations between hemostatic parameters, lipid metabolism, immunological factors, and pregnancy loss, depending on the PAI-1 gene polymorphism type. It was demonstrated that early pregnancy loss results from a complex interaction of genetic, metabolic, immune, and hemostatic factors.
Conclusions. Timely correction of endothelial dysfunction manifestations at the pre-pregnancy stage with a combination of sulodexide and ezetimibe appears to be a promising approach in terms of minimizing pregnancy complications due to their ability to restore the endothelium and promote normalization of PAI-1 production at the level of its genotype transcription.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
Keywords: miscarriage, thrombophilia, pre-gravid preparation, haemostasis, oxidative stress, anticoagulants, lipids, immunological factors, prevention, complications, perinatal outcomes.

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