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Клинико-Функциональные И Гормональные Причины Раннего Невынашивания Беременности При Цитомегаловирусной Инфекции

Клинико-Функциональные И Гормональные Причины Раннего Невынашивания Беременности При Цитомегаловирусной Инфекции

Abstract

Цель исследования – установить зависимость угрозы ранних самопроизвольных выкидышей от клинико-функциональных и гормональных факторов при различной активности ЦМВ инфекции в первом триместре беременности. В проспективный анализ по типу случай-контроль включены 150 женщин на первом триместре беременности, из них 100 ЦМВ-серопозитивных (основная группа), из них с обострением ЦМВ инфекции – 1 подгруппа (50 случаев) и латентным течением заболевания – 2 подгруппа (50 случаев) и 50 ЦМВ-серонегативных (контрольная группа). Оценка маркеров активности ЦМВ инфекции в биологическом материале проводилась сероиммунологическими методами и ПЦР-анализом, определение уровней плацентарных гормонов в крови исследуемых проводилось серологическими методами. В ходе обследования ЦМВ-серопозитивных женщин на первом триместре беременности установлена прямая зависимость частоты невынашивания и характера клинических проявлений от специфического иммунного ответа. У ЦМВ-серопозитивных женщин, чья беременность закончилась самопроизвольным абортом на сроке до 12 недель выявлены маркеры высокоактивной инфекции. При более низком уровне активности показателей специфического иммунного ответа в 60% случаев диагностирована угроза прерывания с пролонгацией беременности; при латентном течении заболевания риск развития осложнений беременности минимален (у 18%) и статистически не отличается от контрольной группы (у 15%). При анализе содержания в крови беременных ДГЭАС и прогестерона определялось однонаправленное снижение показателей в исследуемых группах по сравнению с группой контроля. На основании полученных результатов исследования можно заключить, что ЦМВ инфекция приводит к дисбалансу в системе специфический иммунитет-синтез прогестерона, вызывает нарушение формирования фето-плацентарного комплекса и угрозу прерывание беременности на ранних сроках. The aim of the study was to establish the dependence of threatened abortion in early pregnancy from clinical-functional and hormonal factors in women with different activity of CMV infection in the first trimester of pregnancy. Prospective case-control analysis included 150 women in the first trimester of pregnancy, 100 of them were CMV seropositive (main group), of whom subgroup 1 (50 cases) were with aggravation of CMV infection, subgroup 2 (50 cases) with latent course of the disease and 50 of women were CMV-seronegative (control group). The evaluation of CMV infection activity markers in biological material was performed by seroimmunological methods and PCR analysis, and determination of placental hormones’ blood levels were conducted by serological methods. The direct dependence of the frequency of miscarriage and the nature of clinical manifestations on a specific immune response was established in the course of a study of CMV-seropositive women in the first trimester of pregnancy. Markers of highly active infection were detected in CMV-seropositive women, whose pregnancy ended in spontaneous abortion for up to 12 weeks of pregnancy. At a lower level of activity of the specific immune response parameters, it was diagnosed the threatened abortion with prolongation of pregnancy in 60% of cases; with the latent course of the disease, the risk of pregnancy complications was minimal (in 18%) and statistically does not differ from the control group (in 15%). When analyzing the blood levels of DHEAS and progesterone, a unidirectional decrease in the indices in the study groups was determined in comparison with the control group. Based on the obtained results of the study, it can be concluded that CMV infection leads to an imbalance in the system of specific immunity-synthesis of progesterone, causes a violation of the formation of the feto-placental complex and the threat of termination of pregnancy in the early stages.

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popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
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influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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impulse
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