Changes in the hemocoagulation system in pregnant women, after pre-gravid preparation before the DRT program, with a history of sexually transmitted infections

Abstract

DOI: 10.52705/2788-6190-2023-02-2
УДК 618.177-089.888.11:618.3:616.151.5]-036-07-08:616-055.2-022.8:613.88-071.1

The objective: to analyze the dynamics of laboratory parameters of the functioning of thehemocoagulation system in pregnant women with a history of sexually transmitted infections(STIs) after pre-gravid preparation before cycles of assisted reproductive technologies (ART).

Materials and methods. An analysis of the functioning of the hemocoagulation system wascarried out in women with infertility who had a history of STIs after the DRT program: GroupI – 56 pregnant women received our proposed treatment and prevention measures in the pregravidperiod; II group – 55 pregnant women received generally accepted medical and preventivemeasures.The assessment of the state of the hemostasis system was determined by the following indicators:fibrinogen concentration (Fg), activated recalcification time (ACR), activated partial thromboplastintime (ATP), integrative indicator «Thrombodynamic Potential Index» (TIP), concentration of fibrinand fibrinogen degradation products (FRP). and the level of more stable, but less biologicallyactive metabolites of prostacyclin and thromboxane – 6-keto-PGF1α and T×B2.Statistical processing of research results was carried out using standard programs «MicrosoftExcel 5.0» and «Statistica 8.0».

Results. In the period of the final formation of the placental barrier, in pregnant women of the Igroup, the APTC slowly lengthened (31.3±1.6 s in the II trimester, 34.3±2.9 s in the III trimester)with an increase in gestational age and probably differed from the indicators in the II group(27.6±3.0 s and 30.2±1.7 s respectively; p<0.05); there was a slow reduction of AChR duringthe II and III trimesters of pregnancy in pregnant women of the I group (63.1±2.8 s, 59.3±2.8 s);gradual decrease in the level of PDFF (5.8±0.27×10-2 g/l, 5.1±0.22×10-2 g/l) in contrast to the levelof PDFF in the II group, where a gradual increase of this indicator was observed (9.4 ±0.17×10-2 g/l, 11.6±0.27×10-2 g/l) (р<0.01). The level of a stable metabolite of thromboxane (T×B2) in theII trimester decreased by 2 times and was found to be lower (p<0.05) than in the II study group;the level of a stable metabolite of prostacyclin (6-keto-PGF1α) also increased in the III trimester(p<0.05). This led to an increase in the PgI2/T×A2 balance in group I from 0.34±0.02 to 1.16±0.03,which corresponded to the physiological needs of systemic and organ hemodynamics duringpregnancy.

Conclusions. The development and implementation of effective pre-gravid preparation beforeDRT cycles in women with a history of STIs and medication correction during pregnancycontributes to increasing the adaptive compensatory and adaptive potential of the mother’shemocoagulation homeostasis and perinatal protection of the fetus.