Formational features of the vascular component of the chorion in miscarriage in the first trimester of gestation

Abstract

In women with miscarriage in early pregnancy by ultrasound was studied the volume of the ovum, the volume of the cavity of the amnion and their relationship. Using special three-dimensional VOCAL program performed the calculation of the volume of the chorion, the evaluation of his vascular system based on the definition of the vascularization index (VI) and flow index (FI). The aim of the study: to study the stages of growth and vascularization of the chorion with the threat of miscarriage in the first trimester of gestation. Materials and methods. There were examined 50 pregnant women with threat of miscarriage at early terms of gestation: 30 - burdened obstetric history (BOH), receiving the drug micronized progesterone 50 mg 3-4 times per day (the main group) and 20 pregnant women, the history of which was not encumbered, who were on symptomatic therapy (control group). Results. Analysis of the frequency of occurrence of extragenital pathology in the study groups showed that in women with recurrent pregnancy loss and BOH somatic diseases were almost 2 times more often than in the control group (respectively 60% and 30%). The frequency of infectious complications in the first trimester of pregnancy in women with threatened abortion and BOH compared to the control group of patients, significantly more frequently noted violations of vaginal microbiocenosis, in the form of gardnerellosis (20% and 10%), Candida vaginitis (30% and 5.5%) and urogenital infections – chlamydia, ureaplasmosis, mycoplasmosis (15% and 0%). All pregnant women was carried out sanitation of the source of infection in the first trimester of gestation – local therapy, systemic treatment after completion of the processes of placentation. Conclusion. The study found that use of micronized progesterone in miscarriage in the first trimester of gestation contributes to the growth of the volume of the chorion, the intensity of the flow in the parenchyma and a complete restructuring of the spiral arteries resulting in inadequate formation of the placental-uterine blood flow, which certainly improves the prediction of the further course of pregnancy. Key words: miscarriage, the I trimester of gestation, the vessels of the chorion.