Ukrainian Journal Health of Woman. 2026. 1(182): 91-105. doi: 10.15574/HW.2026.1(182).91105
Дука Ю. М., Панов В. В., Плиг О. О.
Дніпровський державний медичний університет, Україна

Для цитування: Дука ЮМ, Панов ВВ, Плиг ОО. (2026). Основні «red flags» у структурі причин звичного невиношування вагітності: останні рекомендації та аналіз нових «конфліктів» (огляд літератури). Український журнал Здоров'я жінки. 1(182): 91-105. doi: 10.15574/HW.2026.1(182).91105.
Стаття надійшла до редакції 16.11.2025 р.; прийнята до друку 28.01.2026 р.

Невиношування вагітності (НВ) залишається однією з найбільш складних і дискусійних проблем сучасної репродуктивної медицини, що зумовлено багатофакторністю його патогенезу та значною часткою ідіопатичних випадків. Відмінності та розбіжності у визначеннях рецидивних викиднів призводять до труднощів в оцінюванні реальної поширеності. Частота рецидивних викиднів може бути занижена, оскільки не в багатьох країнах слід реєструвати втрати вагітності як окремий показник у національних базах даних охорони здоров’я. Усі ці фактори призводять до недооцінювання поширеності рецидивних викиднів у деяких регіонах світу.
Мета – проаналізувати динамічні зміни сучасних уявлень про етіопатогенетичні фактори виникнення рецидивних повторних втрат вагітності і сучасні алгоритми їхнього діагностування.
Наведено огляд сучасної медичної літератури щодо етапності змін поглядів на критерії встановлення діагнозу рецидивних повторних втрат вагітності, проаналізовано порівняння діагностичних критеріїв звичного невиношування світових товариств. За результатами аналізу виявлено, що сьогодні лікарям рекомендують керуватися власним клінічним судженням і призначати всебічне обстеження після двох викиднів у першому триместрі, якщо є підозра, що викидні мають патологічний, а не спорадичний характер. До обстеження сьогодні слід додавати скринінг на генетичні фактори (каріотип батьків) та антифосфоліпідний синдром (скринінг на вовчаковий антикоагулянт, антикардіоліпінові антитіла та антитіла до β2-глікопротеїну I), оцінювання анатомії матки (соногістерографія, гістеросальпінгографія і/або гістероскопія), визначення гормональних і метаболічних факторів (скринінг на порушення функції щитоподібної залози або рівня пролактину), а також факторів способу життя. Обстеження на спадкові тромбофілії потрібно проводити в рамках наукового дослідження через високу вартість такого обстеження у світі.
Автори заявляють про відсутність конфлікту інтересів.
Ключові слова: вагітність, рецидивні повторні втрати, генетичні дослідження, тромбофілія, гормональні порушення, хромосомні аномалії, вади розвитку матки, діагностичні критерії.

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