Identification and characterization of risk factors for miscarriage in women of the first trimester of gestation
DOI:
https://doi.org/10.15574/HW.2025.1(176).5964Keywords:
miscarriage, first trimester of pregnancy, ultrasound, heat shock proteins, HSP60, GroElAbstract
Ultrasound examination plays a significant role in the diagnosis of threatened abortion. Changes in the structure of the myometrium, pathological ECHO inclusions, morphological changes in the appendages, shortening of the length of the cervix, opening of the internal os, deformation of the fetal egg, pathological localization of the chorion, the presence of retrochorial hematoma, impaired blood flow in the uterine arteries - the main ultrasound characteristics of the threat of abortion.
Aim - to optimize the prediction of miscarriage in women by identifying early risk factors.
Materials and methods. A prospective analysis of 94 pregnant women was conducted. The study included 59 pregnant women who, at the time of blood serum donation, were diagnosed with a threat of miscarriage and/or had a history of complicated pregnancy and childbirth. Anamnestic and biochemical data, ultrasound parameters were analyzed, and univariate and multivariate analysis of the risk of miscarriage was performed.
Results. Univariate analysis revealed a significant increase in the risk of miscarriage with the age of the woman, in the presence of retrochorial hematoma, chorion presentation or pathological attachment, the presence of uterine and adnexal formations and a significant decrease in the risk of miscarriage of vaginitis with an increase in the cervical length index. In univariate analysis, HSP60 and GroEl indicators do not play a role, although GroEL is on the verge of significance. In multivariate analysis, a significant increase in the risk of miscarriage with the presence of retrochorial hematoma, uterine and adnexal formations and a significant decrease in the risk of miscarriage with an increase in the cervical length index and the total number of births. The indicators of multivariate and univariate analysis differ significantly.
Conclusions. The study confirms that ultrasound examination plays an important role in the diagnosis of miscarriage. The presence of retrochorial hematoma, chorion presentation or pathological attachment, the presence of uterine and/or adnexa formations, and shortening of the length of the cervix are risk factors for miscarriage. The risks of miscarriage are associated with the age of the woman and the total number of births. Determination of heat shock protein levels can be taken into account in the complex and indirectly indicate the presence of a risk of miscarriage or a complicated course of pregnancy.
The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committee. Informed consent for the study was obtained.
The authors declare no conflict of interest.
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