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To determine the new criteria for predicting the outcome of pregnancy in women with habitual abortion based on features of differentiation of naive T cells and memory cells in a population of T-helper (CD4+) and cytotoxic T lymphocytes (CD8+). The study involved 61 women with threatened and habitual abortion in the first trimester of gestation. Depending on the outcome of pregnancy was allocated to 3 groups: I went to 39 women whose pregnancy ended in timely delivery; in II - 10 women whose pregnancies ended in premature birth; in III - 11 patients in whom there was a spontaneous miscarriage. Using three-color flow cytometry as peripheral venous blood in populations of CD8+ and CD4+ determined by the content Tn, Tcm, Tem and Temra cells. Statistical analysis was carried out in the program «MicrosoftOffice 2010», «Statistica for Windows 6.0» and MedCalc». When conducting a retrospective assessment, it was found that in the group of patients whose pregnancy ended in preterm delivery, the percentage of CD4 + Tem memory cells was significantly higher and CD4 + Tn lower than in the subgroup with timely delivery (p = 0.013 and p = 0.025, respectively ) In patients with early spontaneous miscarriage, the level of CD8 + Tn significantly decreased against the background of the growth of CD8 + Tem memory cells compared with the same parameters in patients with timely delivery (p = 0.040 and p = 0.014, respectively). Prediction of spontaneous abortion is possible up to CD4+ Tn equal to 34.2% or less (sensitivity - 100.0%, specificity - 56.4%, accuracy - 63.8%), premature birth - if the CD4+ Tn equal to 35, 2% or less (sensitivity - 66.7%, specificity - 74.4% accuracy - 72.9%). Thus, the new criteria will allow additional time to identify risk and assign adequate treatment aimed at prolonging the desired pregnancy.

A lot of research nowadays is dedicated to the problem of habitual pregnancy loss, and this attention is dictated by the continued high frequency of this condition. The pathogenesis of habitual pregnancy loss is very complicated and includes many factors, at present especially close attention is paid to immune aspects. It is considered, that cytokine imbalance might play a key role in the pathogenesis of habitual pregnancy loss. Examination of 38 pregnant women was carried out at 5-12 weeks of gestation. The main group consisted of 17 women with habitual miscarriage and the threat of interruption at the time of the examination, the control group consisted of 21 women with uncomplicated pregnancy and a favorable obstetric history. As the material for investigation peripheral blood was used. Serum level of a complex of cytokines IL-1β, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, IL-22, IL-23, IL-27, IFNγ, TNFα, GM-CSF was assessed on the Luminex 200 multiplex fluorescence analyzer (Luminex Corporation, USA). The significant differences in the serum level of IL-1β, IL-22, IL-23 and IL-27 were observed between the groups, in the main group their level was higher comparing to that of healthy pregnant women. When evaluating the cytokines serum level, fairly high values of IL-27 (in 25%of cases) (p<0,05), TNFα - (in 18% of cases) (p>0,05) were found in the main group, while in the control group they were not registered. Significant differences in the serum level of IL-2, IL-4, IL-9, IL-12p70, IL-18 and IFNγ were not noted in the compared groups (p>0,05). The simultaneous increase in the serum level of pro- and anti-inflammatory cytokines observed in our study can be explained by both an increase in the immune response and triggering of fetoprotection mechanisms. Inadequate cytokine regulation may be a prerequisite for the development of conditions for the development of a threat of termination of a real pregnancy in women with habitual miscarriage.

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