The purpose of the study was TO analyze the fetoplacental complex hormone levels and changes in their dynamics in pregnant women with miscarriage and the impact of these features on the subsequent course of pregnancy. Hormone levels were determined at different stages of gestation in 50 healthy women with a physiological course of pregnancy (control group) and 50 pregnant women with a history of miscarriage (main group). The women of the main group had a significantly slower rate of increase in hormones and a lag in quantitative indicators than the control group. The estradiol level indicators were 4.1 times (76.0%) and 2.89 times (65.5%) lower in women with miscarriage in the embryonic and late fetal period, respectively, compared to healthy women. Indicators of the level of placental lactogen and chorionic gonadotropin in the embryonic period in women with miscarriage were lower by 39.1% and 50.9%, respectively, compared to healthy women. In the late fetal period, the level of these hormones was lower by 72.9% and 35.4%, respectively. In the embryonic and late fetal periods, progesterone levels were lower by 67.4% and 68.4%, respectively, compared to the control group. The data obtained are evidence of a pronounced hormonal abnormality of the placenta, and hence a marker of fetoplacental dysfunction, which on the background of miscarriage develops at the early stages and continues to progress with the course of pregnancy.

The aim: The aim of the study was to assess the peculiarities of the formation and development of the fetoplacental system, to study the structures of the embryo, gestational sac, chorion in pregnant women with miscarriage. Materials and methods: A comprehensive ultrasound examination of 50 pregnant women was carried out in the period from 5 to 16 weeks of pregnancy, of which 25 - with a history of miscarriage (main group), and 25 - with an unremarkable medical history (control group). Results: We have identified the following echographic markers of adverse course and outcome of pregnancy in women with miscarriage in embryonic and early fetal periods:- lag of CRL of an embryo by 2 weeks and more at ultrasound examination in terms up to 9 weeks of gestation;- corporal or basal (near the stem of the embryo body) location of chorionic detachment with the formation of retrochorial hematoma with a volume of more than 25 ml;- pronounced progressive decrease in the volume of the gestational sac and amniotic cavity;- pronounced polyhydramnios with the presence of a coarse echopositive suspension in the amnioticcavity. The likelihood of spontaneous miscarriage and the formation of placental dysfunction is higher with the simultaneous detection of 2 or more echographic markers. Conclusions: Ultrasound examination is necessary to assess the echographic parameters of the formation and development of the embryo and extraembryonic structures in the first trimester with a history of miscarriage in order to the subsequent choice of rational tactics of pregnancy management.

Іntroduction. Currently, endometrial polyps (EMP)are the most common pathology of the uterine mucosa,detected in miscarriage and infertility. However, thequestion of the relationship between the mechanisms thatregulate proliferation processes and the morphofunctionaland microbiological features of the endometrium, whichare often confirmed by changes in immunohistochemicalparameters and may be important in treatment, remainsopen.The aim is to optimize the results of treatment inpatients with EMP and infertility by using antioxidantsin combination with immunomodulatory therapy andnonsteroidal anti-inflammatory drugs.Materials and methods. We examined 30 healthywomen who hadn’t had any gynecological diseases,abortions or intrauterine interventions in history and hadnot used intrauterine contraception (the control group), and60 women with EMP and infertility (the main group) byusing clinical, microbiological, bacteriological, ultrasound,hysteroscopic pathohistological and laboratory methods,statistical analysis.Results. In order to assess the effectiveness of theproposed treatment, the main group was divided into twosubgroups: the first one included 30 patients who have beenreceiving the proposed treatment and prevention algorithmand the second one with 30 patients receiving traditionaltreatment.After targeted polypectomy with the basal layer of theendometrium at the site of EMP had been provided, thepatients of the first subgroup were prescribed to take 100mg of doxycycline orally twice a day for 2 weeks and 100mg of vitamin E per day for 4 weeks in combination withimmunomodulatory therapy - cycloferon 12.5% 2.0 mlintramuscularly №10 every other day and anti-inflammatorytherapy with the appointment of rectal suppositoriescontaining non-steroidal anti-inflammatory components - 1suppository per night for 10 days.The patients of the second subgroup were prescribedtraditional antibiotic prophylaxis after hysteroscopy: 100mg of doxycycline orally twice a day for 5 days. Also, thepatients of the main group have been receiving 10 mg ofduphaston twice a day from the 11th to the 25th day of MC.The species composition of the vaginal microflora inwomen with EMP is represented mainly by anaerobic flora.Every second patient with EMP (46%; р І-ІІІ = 0,007) in theabsence of clinical symptoms, and along with a moderateor reduced number of lactobacilli, was diagnosed withopportunistic bacteria, uremicoplasma or Candida fungus.Pregnancies occurred in 9 (47%) of the 19 patients in thefirst natural menstrual cycle after polypectomy and proposedtreatment. Six (31%) women became pregnant during thefirst three menstrual cycles. The remaining patients havebeen observed during six months and were recommendedin vitro fertilization due to long-term infertility. Women ofthe main group who did not plan to get pregnant had norecurrence of EMP for two years. 19 (63.3%) patients ofthe second subgroup faced the recurrence of EMP duringtwo years of follow-up. 11 (30.5%) pregnant womengave physiological childbirth; the labor of 3 patients wascomplicated by hypotonic bleeding in the early postpartumperiod; 3 (11.1%) women are currently pregnant. In patientsof the second subgroup, pregnancy occurred in 5 (16.6%)cases only.Conclusions. The use of the developed method of EMPand infertility treatment allows to restore reproductivefunction in more than half of women. Thus, theimplementation of the method of EMP treatment indicatesits positive effect. In addition, it helps to achieve lastingremission and solves the medical and social problems ofwomen's health and motherhood.

Introduction. The article represents the results of the study of the placental hormone level during the early stages of gestation (5-20 weeks). The aim of the study. To analyze the level of hormones of the fetoplacental complex in pregnant women with miscarriage, along with the dynamics of changes in these indicators. To evaluate the features of the hormonal status of women during law-risk pregnancy and  miscarriage in history and the impact of these features on the functional state of the fetoplacental complex and the subsequent course of pregnancy. Material and methods. We examined 30 somatically healthy women with a physiological course of pregnancy (the control group) and 30 pregnant women with a miscarriage in history (the main group). Research results. It was found that the content of estradiol, chorionic gonadotropin and placental lactogen in the blood plasma of pregnant women of the main group was significantly lower during the entire gestational period compared to the control group. Estradiol levels in pregnant women with miscarriage were 4.2 times lower than in healthy pregnant women. Placental lactogen levels in the main group of pregnant women were 6.1 times lower, and chorionic gonadotropin - 3.7 times lower compared with the control group. There was also a significant backlog in the growth of hormone levels as the pregnancy progressed. In its turn it indicates the development of placental dysfunction in women with a miscarriage in history in the early stages of gestation. Conclusions. As a result of the described changes there is a violation of the first wave of cytotrophoblast invasion and, as a consequence, incomplete gestational remodeling of segments of spiral arteries. The walls of blood vessels are not completely replaced by fibrinoid and the formed placental vessels do not provide a constant flow of arterial blood into the intervillous space. As a result, the uterine-placental area and the formed placenta are not ready to meet the needs of the developing fetus. In the future, this can lead to perinatal losses.

Advances in perinatology have revealed new problems related to the gestational process and antenatal protection of the fetus. Among them, the leading place belongs to chronic placental insufficiency (CPI). One of the main causes of CPI is miscarriage. The aim of the work is to consider the main aspects of the etiology and pathogenesis of the development of placental insufficiency in women with miscarriage. The article covers the issues of etiology, as well as the main pathogenetic ways in the development of placental dysfunction in women with miscarriage. Risk factors, mechanisms of development of placental insufficiency (PI), and also its forms depending on etiological factors are allocated. The peculiarities of the morphological structure of the placenta in women with this pathology in early and late gestation terms, their impact on the subsequent course of pregnancy, development and condition of the fetus are considered in detail. The relationship between structural changes in the placenta and clinical manifestations of PI is shown. The influence of rheology and hemodynamic disorders on the condition of the fetus is highlighted.Conclusions. There are a large number of etiological factors that lead to the development of placental insufficiency. However, for a variety of reasons, this pathology has key pathogenetic ways, which are common for different forms. Knowledge of the causes of placental dysfunction during miscarriage, features of pathogenesis and morphological changes that develop even in early terms of gestation has a great clinical importance, because it will contribute to the development of methods of early prevention and pathogenetically conditioned correction of this pathology.