Correction of chronic tonsillitis as a component of pre-pregnancy preparation for primary miscarriage

Aim. To substantiate the effectiveness of conservative treatment of CT at the pre-pregnancy stage in order to reduce reproductive losses.

Materials and Methods. The study involved 86 women aged 21−35 years (on average 29.4±4.6 years) with a history of habitual miscarriage and chronic tonsillitis. The main group (n = 45) consisted of patients who were treated for chronic tonsillitis at the pre-gravidar stage. The comparison group (n = 41) consisted of patients who did not receive treatment for chronic tonsillitis at the pre-gravidar stage. The parameters of hemostasiogram and uterine blood flow in dynamics in patients of the main group were analyzed.

Results. Against the background of chronic tonsillitis and habitual miscarriage, all parts of hemostasis are disrupted and uterine blood flow worsens. When studying the effect of circulating RFMC, it was found that their presence increases the risk of abnormal fibrinogen concentrations (OR = 1.95; 95 % CI 0.46– 8.21) and PTI (OR = 1.35; 95 % CI 0.31–5.88), increases the frequency of abnormal INR values (OR = 1.55; 95 % CI 0.42–5.65). At the same time, circulating RFMC does not affect the risk of violation of the duration of ACTV. The presence of RFMC does not significantly affect the dynamics of hemostasiogram indicators before and after treatment of chronic tonsillitis, whereas patients with negative RFMC experience significant changes in hemostasiogram indicators before and after treatment of chronic tonsillitis.

After treatment of chronic tonsillitis, no patient showed a decrease in endometrial thickness. The blood flow rate in the PMA and LMA returned to normal, whereas before treatment, blood flow in the PMA was reduced in 1 (2.2 %), in the LMA was reduced in 7 (15.6 %) patients and increased in 2 (4.4 %) women. The resistance index in PMA and LMA returned to normal in all patients. The index of resistance of the arcuate arteries after treatment − increased values remained unchanged in 2 (4.4 %) patients.

Conclusion. The results obtained in our study prove the negative effect of chronic tonsillitis on the hemostasis system and, as a result, deterioration of uterine blood flow and substantiate the effectiveness of conservative treatment of chronic tonsillitis at the pre-gravidar stage in order to reduce reproductive failures.

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