Preview

Fundamental and Clinical Medicine

Advanced search

Ultrasound markers informative of efficient non-pharmacological correction of hypofibrinolysis at preconception period in patients with recurrent pregnancy loss

https://doi.org/10.23946/2500-0764-2021-6-2-31-40

Abstract

Aim. To find reliable ultrasound markers of efficient non-pharmacological correction of hypofibrinolysis at preconception period in patients with recurrent pregnancy loss.

Materials and Methods. We conducted a single-center, prospective, non-randomized study in patients with recurrent pregnancy loss and hypofibrinolysis (n = 120), who received intermittent pneumatic compression during preconception care. During the pregnancy, we performed a comprehensive 3D ultrasound examination of the endometrium and corpus luteum in the VOCAL mode. Then, we compared patients with (n = 97) and without (n = 23) favorable outcome. Predictive power of the ultrasound parameters was evaluated by a calculation of the area under the receiver operating characteristic (ROC) curve (AUC) and ROC curve comparison.

Results. Vascularization flow index of endometrial perfusion (AUC = 0.566) and corpus luteum (AUC = 0.639) was identified as a potential marker of efficient intermittent pneumatic compression at preconception period.

Conclusions. Adequate perfusion of endometrium and corpus luteum, reflected by vascularization flow index, may indirectly indicate successful trophoblast invasion and minimize the risk of recurrent pregnancy loss. 

About the Authors

E. I. Lebedeva
Altai State Medical University
Russian Federation

PhD Student, Department of Obstetrics and Gynecology,

40, Lenina Prospekt, Barnaul, 656038



S. D. Yavorskaya
Altai State Medical University
Russian Federation

MD, PhD, Рrofessor, Department of Obstetrics and Gynecology,

40, Lenina Prospekt, Barnaul, 656038



A. P. Momot
National Research Center for Hematology
Russian Federation

MD, DSc, Professor, Chief Executive Officer,

1, Lyapidevskogo Street, Barnaul, 656024



N. I. Fadeeva
Altai State Medical University
Russian Federation

MD, PhD, DSc, Professor, Department of Obstetrics and Gynecology,

40, Lenina Prospekt, Barnaul, 656038



References

1. Yakut S, Toru HS, Çetin Z, Özel D, Şimşek M, Mendilcioğlu İ, Lüleci G. Chromosome abnormalities identified in 457 spontaneous abortions and their histopathological findings. Turk Patoloji Derg. 2015;31(2):111-118. https://doi.org/10.5146/tjpath.2015.01303

2. Sidel'nikova VM. Podgotovka i vedenie beremennosti u zhenshchin s privychnym nevynashivaniem : metodicheskie posobiya i klinicheskie protokoly. 3nd ed. Мoscow: Medpress-inform Publ; 2013. (In Russ.).

3. Ye Y, Vattai A, Zhang X, Zhu J, Thaler CJ, Mahner S, Jeschke U, von Schönfeldt V. Role of Plasminogen Activator Inhibitor Type 1 in Pathologies of Female Reproductive Diseases. Int J Mol Sci. 2017;18(8):1651. https://doi.org/10.3390/ijms18081651

4. Momot AP Physiological pregnancy as a model of incomplete thrombosis. Obstetrics and gynaecology of St. Petersburg. 2017;(2):44-52. (In Russ.).

5. Momot A.P., Tomilina O.P., Molchanova I.V., Shipulina V.G., Tsyvkina L.P., Serdyuk G.V., Borisova O.G, Semenova N.A. Znachenie terapevticheskoy korrektsii narusheniy gemostaza i fibrinoliza dlya iskhodov ekstrakorporal'nogo oplodotvoreniya i nalichiya rannikh reproduktivnykh poter'. Gemorragicheskie diatezy, trombozy, trombofilii. 2014;(1). (In Russ.).

6. Brosens I, Pijnenborg R, Vercruysse L, Romero R. The "Great Obstetrical Syndromes" are associated with disorders of deep placentation. Am J Obstet Gynecol. 2011;204(3):193-201. https://doi.org/10.1016/j.ajog.2010.08.009

7. Bojarintzev VV, Alencheva EV, Lobastov KV, Barinov VE. The intermitting pneumatic compression as a component of complex prophylactic measures to prevent postoperative venous thromboembolytic complications. Kremlevskaja medicina. Klinicheskij vestnik. 2016;(2):12- 19. (In Russ.).

8. Christen Y, Wütschert R, Weimer D, de Moerloose P, Kruithof EK, Bounameaux H. Effects of intermittent pneumatic compression on venous haemodynamics and fibrinolytic activity. Blood Coagul Fibrinolysis. 1997;8(3):185-90. https:/a/doi.org/10.1097/00001721-199704000-00005

9. Carr BR. Endometrium and implantation. Semin Reprod Med. 2014;32(5):331-332. https://doi.org/10.1055/s-0034-1381230

10. Tan SY, Hang F, Purvarshi G, Li MQ, Meng DH, Huang LL. Decreased endometrial vascularity and receptivity in unexplained recurrent miscarriage patients during midluteal and early pregnancy phases. Taiwan J Obstet Gynecol. 2015;54(5):522-526. https://doi.org/10.1016/j. tjog.2014.10.008

11. Lash GE, Innes BA, Drury JA, Robson SC, Quenby S, Bulmer JN. Localization of angiogenic growth factors and their receptors in the human endometrium throughout the menstrual cycle and in recurrent miscarriage. Hum Reprod. 2012;27(1):183-195. https://doi.org/10.1093/humrep/der376

12. Chen X, Jiang L, Wang CC, Huang J, Li TC. Hypoxia inducible factor and microvessels in peri-implantation endometrium of women with recurrent miscarriage. Fertil Steril. 2016;105(6):1496-1502.e4. https://doi.org/10.1016/j.fertnstert.2016.02.032

13. Rabadanova A.K., Shalina R.I., Gugushvili N.A. Uterine hemodynamics and ovarian reserve quality in the prediction of in vitro fertilization outcomes. Bulletin of Russian State Medical University. 2018;(2):49- 56. https://doi.org/10.24075/vrgmu.2018.015

14. Check JH. Premature ovarian insufficiency - fertility challenge. Minerva Ginecol. 2014;66(2):133-153.

15. Shah D, Nagarajan N. Luteal insufficiency in first trimester. Indian J Endocrinol Metab. 2013;17(1):44-49. https://doi.org/10.4103/2230-8210.107834

16. Pregravidarnaja podgotovka : klinicheskij protokol. Мoscow: StatusPraesens, 2016. (In Russ.).

17. Saravelos SH, Li TC. Intra- and inter-observer variability of uterine measurements with three-dimensional ultrasound and implications for clinical practice. Reprod Biomed Online. 2015;31(4):557-564. https://doi.org/10.1016/j.rbmo.2015.06.024

18. Titchenko YuP, Zarochentseva NV, Arshakian AK, Men'shikova NS. Use of ultrasound techniques in the evaluation of the endometrium in patients with chronic endometritis and miscarriage. Russian bulletin of obstetrician-gynecologist. 2014;(1):55-58 (In Russ.).

19. Ozerskaya IA, Shcheglova EA, Sirotinkina EV. et al. Physiological hemodynamic changes of the uterus in women of reproductive, perimenopausal and post menopausal periods. SonoАce Ultrasound. 2010;21:40-56. (In Russ.).


Review

For citations:


Lebedeva E.I., Yavorskaya S.D., Momot A.P., Fadeeva N.I. Ultrasound markers informative of efficient non-pharmacological correction of hypofibrinolysis at preconception period in patients with recurrent pregnancy loss. Fundamental and Clinical Medicine. 2021;6(2):31-40. (In Russ.) https://doi.org/10.23946/2500-0764-2021-6-2-31-40

Views: 500


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2500-0764 (Print)
ISSN 2542-0941 (Online)