An urgent medical and social problem is the restoration of reproductive function of womenwho suffer from infertility, which became possible due to auxiliary reproductive technologies. Women with induced pregnancy make thegroup of a high-risk on miscarriage, due to interrelated processes –immunological disorders and endothelial dysfunction that occur in the body of pregnant women after the use of extracorporal fertilization programs, and can lead to the chorion detachment and the formation of subchorionic hematomas.
The purpose of the study is to determine the role of endothelial dysfunction as one of the leading factors that determine the development of a local non-progressive chorion detachment in infertile patients included in the program of auxiliary reproductive technologies.
Materials and methods. We have examined 130 pregnant women, who were divided into groups: the control group included 30 women, whose pregnancy occurred in the natural cycle and with uncomplicated gestational course; the main group – 50 patients with induced pregnancy and risk factors of the occurrence of chorion detachment, who wereperformed the proposed pre-gravidapreparation; the comparative group – 50 pregnant women who received a standard scheme of pregnancy management before and after in-vitro fertilization. A general clinical examination, ultrasound examination, homocysteine level determination, endothelin-1 and nitrogen oxide metabolites were performed.
Results. In women included into the program of auxiliary reproductive technologies with local chorion detachment were recorded changes of vascular endothelial function with a possible increase in endothelin-1 production and a decrease of the nitric oxidesynthesis. During the induced pregnancy with the presence of subchorionic hematoma, an increase of the level of endothelium-damaging factor of homocysteine was noted.
Conclusions.This study identifies the parameters that reflect the main links of endothelial dysfunction and can be used as markers of local chorion detachment.
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