PROGNOSIS OF RECURRENT PREGNANCY LOSS
Aim. To develop a model for the prognosis of recurrent pregnancy loss (RPL) which is based on the determination of the polymorphism of genes 675 5G4/G plasminogen activator inhibitor – 1 (PAI-1) and fibrinogen β 455 G→A and to evaluate its effectiveness. Materials and methods. A prospective case-...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department
2025-05-01
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| Series: | Клінічна та профілактична медицина |
| Subjects: | |
| Online Access: | https://cp-medical.com/index.php/journal/article/view/593 |
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| Summary: | Aim. To develop a model for the prognosis of recurrent pregnancy loss (RPL) which is based on the determination of the polymorphism of genes 675 5G4/G plasminogen activator inhibitor – 1 (PAI-1) and fibrinogen β 455 G→A and to evaluate its effectiveness.
Materials and methods. A prospective case-control study included 109 women in the 1st trimester of pregnancy with RPL and 34 conditionally healthy pregnant women with an uncomplicated obstetric history and no risk factors for miscarriage. Genetic polymorphisms of coagulation and fibrinolysis factors 675 5G/4G PAI-1and fibrinogen β 455 G→A have been investigated using allele-specific polymerase chain reaction.
Results. Pathological polymorphisms genes of hemostasis system play an important role in the development of miscarriage, namely such pathological genotypes as 675 4G/4G PAI-1 – increases the risk by 7.5 times (95 % CI 1.7-33.79), -455AA fibrinogen β – by 10.87 times (95 % CI 1.42-83.27). The combination of allelic variants of the PAI-1 genes 5G/4G, 4G/4G and fibrinogen β -455 GA, -455 A in women with RPL (53.2%) were significantly more common than in the control group (20.5%), (p<0.05, OR = 4.17, 95% CI 1.71-10.14). Pathogenetically grounded methods for predicting RPL have been developed. It is based on the determination of gene polymorphisms PAI-1 (675 5G/4G), fibrinogen β (-455 G→A) which consider the cumulative contribution each of the markers, and make it possible to determine the probability of miscarriage. Prognostic model has a sensitivity 69.72% (95% CI 60.19-78.16%), specificity –76.47% (95% CI 58.83-89.25%).
Conclusions. The course of pregnancy against the background of pathological polymorphisms of genes of the hemostasis system significantly increases the risk of habitual miscarriage, which should be considered when planning pregnancy in such women. |
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| ISSN: | 2616-4868 |