ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2022, 7(1): 91–97
https://doi.org/10.26693/jmbs07.01.091
Clinical Medicine

Clinical and Anamnestic Characteristics and Medical Accompanying of Pregnant Women with a Burdened Obstetric History and Thrombophilia

Zalyubovska O. I., Hryshchenko V. V.
Abstract

The purpose of the study was to determine the clinical and anamnestic features (age characteristics of women and anamnestic features of previous pregnancies) of pregnant women with burdened obstetric history and thrombophilia with the establishment of the main pharmacological mechanisms of therapeutic support. Materials and methods. The study was performed at the Department of Clinical Laboratory Diagnostics of Kharkiv National Medical University and at the Kharkiv Clinical Laboratory Center in the period from 2017 to 2021. We examined 137 pregnant women: the main group (101 women – pregnant women with a burdened obstetric history and thrombophilia aged 29.0 to 37.0 years) and the control group (36 women – pregnant women with a burdened obstetric history without thrombophilia aged 26.0 to 30.0 years). In general, the predominance of one (35.8 %) and two (46.7 %) pregnancies in the history of women with a burdened obstetric history compared to three (17.5 %) was noted. Results and discussion. An increase (U = 706.0; p <0.001) in the chances of developing negative consequences of pregnancy in thrombophilia with increasing age due to negative idiopathic thromboembolic effects due to thrombophilia was noted. A higher mean age of pregnant women with a burdened obstetric history in the presence of thrombophilia (33.0 [29.0; 37.0] years) was determined compared with the control (28.0 [26.0; 30.0] years). The maximum negative manifestations of idiopathic thromboembolic effects due to thrombophilia in the first pregnancy were found. The predominance of cases of fetal death in the first pregnancy of women with two (94.1 %) and three (78.3 %) pregnancies was determined. In general, the need for antiplatelet therapy in thrombophilia was stated. Its use (χ2 = 46,950; p <0.001) was determined in 85.1 % of cases, the majority (65.3 %) of one drug (probably (χ2 = 164.54; p <0.001) more often (52.5 %) acetylsalicylic acid compared with dipyridamole (5.9 %)). It was found that anti aggregate therapy, which included two drugs (combination: acetylsalicylic acid, dipyridamole or klexan) was most often used in the first (40.7%) pregnancy in contrast to the second (11.8%) and third (13.0 %). Conclusion. The study found that antiplatelet therapy with only one drug (acetylsalicylic acid, dipyridamole or klexan) was more commonly used in the second (74.5%) and third (73.9%) pregnancies than in the first one (40.7%). It was naturally determined that the absence of any medication was noted most often by pregnant women in the first (18.5%) pregnancy in contrast to the second (13.7%) and third (13.0%)

Keywords: anamnestic features, pregnant women, burdened obstetric history, thrombophilia

Full text: PDF (Ukr) 302K

References
  1. Kupferminc MJ. Thrombophilia and pregnancy. Reprod Biol Endocrinol. 2003;1:111. PMID: 14617365. PMCID: PMC305329. https://doi.org/10.1186/1477-7827-1-111
  2. Akinshina S, Makatsariya A, Bitsadze V, Khizroeva J, Khamani N. Thromboprophylaxis in pregnant women with thrombophilia and a history of thrombosis. J Perinat Med. 2018;46(8):893-899. PMID: 29949514. https://doi.org/10.1515/jpm-2017-0329
  3. Croles FN, Nasserinejad K, Duvekot JJ, Kruip MJ, Meijer K, Leebeek FW. Pregnancy, thrombophilia, and the risk of a first venous thrombosis: systematic review and bayesian meta-analysis. BMJ. 2017;359:j4452. PMID: 29074563. PMCID: PMC5657463. https://doi.org/10.1136/bmj.j4452
  4. Dugalic S, Petronijevic M, Stefanovic A, Stefanovic K, Petronijevic SV, Stanisavljevic D, et al. Comparison of 2 approaches in management of pregnant women with inherited trombophilias: Prospective analytical cohort study. Medicine (Baltimore). 2019;98(34):e16883. PMID: 31441864. PMCID: PMC6716684. https://doi.org/10.1097/MD.0000000000016883
  5. Linnikov V, Linnikov S. Trombofiliya yak klyuchova lanka patohenezu uskladnenʹ v akusherstvi ta hinekolohiyi [Thrombophilia as a key link in the pathogenesis of complications in obstetrics and gynecology]. Nauka i osvita. 2019;3:31-36. https://doi.org/10.24195/2414-4665-2019-3-5
  6. Trasca LF, Patrascu N, Bruja R, Munteanu O, Cirstoiu M, Vinereanu D. Therapeutic Implications of Inherited Thrombophilia in Pregnancy. Am J Ther. 2019;26(3):e364-e374. PMID: 30985485. https://doi.org/10.1097/MJT.0000000000000985
  7. Dłuski D, Mierzyński R, Poniedziałek-Czajkowska E, Leszczyńska-Gorzelak B. Adverse pregnancy outcomes and inherited thrombophilia. J Perinat Med. 2018;46(4):411-417. PMID: 28792912. https://doi.org/10.1515/jpm-2017-0059
  8. Baptista FS, Bortolotto MRFL, Bianchini FRM, Krebs VLJ, Zugaib M, Francisco RPV. Can thrombophilia worsen maternal and perinatal outcomes in cases of severe preeclampsia? Pregnancy Hypertens. 2018;11:81-86. PMID: 29523280. https://doi.org/10.1016/j.preghy.2017.12.012
  9. Bao SH, Chigirin N, Hoch V, Ahmed H, Frempong ST, Zhang M, et al. Uterine Radial Artery Resistance Index Predicts Reproductive Outcome in Women with Recurrent Pregnancy Losses and Thrombophilia. Biomed Res Int. 2019;2019:8787010. PMID: 31534965. PMCID: PMC6724444. https://doi.org/10.1155/2019/8787010
  10. Dugalić S, Petronijevic M, Stefanovic A, Jeremic K, Petronijevic SV, Soldatovic I, et al. The association between IUGR and maternal inherited thrombophilias: A case-control study. Medicine (Baltimore). 2018;97(41):e12799. PMID: 30313110. PMCID: PMC6203511. https://doi.org/10.1097/MD.0000000000012799
  11. Dargaud Y, Rugeri L, Fleury C, Battie C, Gaucherand P, Huissoud C, et al. Personalized thromboprophylaxis using a risk score for the management of pregnancies with high risk of thrombosis: a prospective clinical study. J Thromb Haemost. 2017;15(5):897-906. PMID: 28231636. https://doi.org/10.1111/jth.13660
  12. Ormesher L, Simcox LE, Tower C, Greer IA. 'To test or not to test', the arguments for and against thrombophilia testing in obstetrics. Obstet Med. 2017;10(2):61-66. PMID: 28680464. PMCID: PMC5480652. https://doi.org/10.1177/1753495X17695696
  13. Cavalcante MB, Sarno M, Cavalcante CTMB, Araujo Júnior E, Barini R. Coagulation Biomarkers in Women with Recurrent Miscarriage and Polycystic Ovarian Syndrome: Systematic Review and Meta-Analysis. Geburtshilfe Frauenheilkd. 2019;79(7):697-704. PMID: 31303657. PMCID: PMC6620176. https://doi.org/10.1055/a-0884-3212
  14. Borsi SH, Shoushtari MH, MalAmir MD, Angali KA, Mavalizadeh MS. Comparison of the D-dimer concentration in pregnant women with or without pulmonary thromboembolism. J Family Med Prim Care. 2020;9(8):4343-4347. PMID: 33110857. PMCID: PMC7586610. https://doi.org/10.4103/jfmpc.jfmpc_1070_19