A role of violations of the system to haemostasis is in genesis of recurrent of retrochorial haematomas

Abstract

DOI: 10.52705/2788-6190-2026-01-3
УДК618.344-003.215-005.2-036.87

The objective: to estimate the role of violations of the system to haemostasis in genesis of recurrent of retrochorial haematomas.
Materials and methods. For the decision of the put purpose it was conducted complex clinical-andlaboratory and instrumental inspection 90 women which were up-diffused on three groups on the basis of results of clinical inspection and information of ultrasonic research: 30 pregnant of woman with a recurrent retrochorial haematoma (basic group), 30 pregnant with a retrochorial haematoma, which appeared only on the early terms of pregnancy (6–12 weeks inclusive) (group of comparison) and 30 the prospective inspected patients with uncomplicated pregnancy, which do not have meaningful extragenital pathology and burdened factors obstetric-gynaecological to anamnesis (control group). To the complex of the conducted researches were included clinical, biochemical and statistical.
Results. At the inspection of pregnant on the genetic markers of thrombophilia were found out next results. The incurrence of pregnant with the genetic markers of thrombophilia was reliable higher in a basic group (the pregnant are with a recurrent retrochorial haematoma) – 79 (76,0 %) against 37 (46,25 %) women in the group of comparison [Or = 2,391: 95% CI 1,181–4,843 (р = 0,013)]. Meaningfully more frequent for patients with recurrent uteroplacental hemorrhages appeared mutation of FV Leiden G1691A, polymorphism of platelet receptor of Gp IIIa 1565T/C, polymorphism of gene of Fibrinogenum, polymorphism of gene of PAI-1, mutation of MTHFR C677T. For 62 (59,6 %) women with the repeated retrochorial haematomas found out the multigenic form of thrombophilia against 9 (11,25 %) women with a haematoma sporadic of early terms [Or= 2,391: 95% CI 1,181–4,843 (р = 0,013)]. In addition, in 11 (10,6%) women of basic group was found out combination of laboratory signs of antiphospholipid syndrome and genetic markers of thrombophilia. It should be noted that even at the sporadic haematoma of early terms for certain more frequent than different mutations of genes, supervisory haemostasis appeared in a control group. It should be noted that at combination of 3-4 mutations the permanent recurrent of haematomas were clinically marked during first-second trimesters, and also uncompensated placenta dysfunction, premature births, fetal growth retardation.
Conclusions. To the patients with the high risk of retrochorial haematoma very much it is necessary from early terms for the prophylaxis of severe placenta associations complications of setting of anticoagulants in a dose, neat individually. At multiple mutations or at the mutations of high throombogenic risk in combination with the procoagulant activating to haemostasis, by violations of blood stream in uterine arteries a dose makes not less than 0,8 ml of clexane in combination with antiplatelet (aspirin, curantyl). The got results must be taken into account at development of algorithm of diagnostic and treatment-and-prophylactic measures.