CAUSES AND DIAGNOSTIC OF MISCARRIAGE IN EARLY PREGNANCY IN WOMEN WITH CYTOMEGALOVIRUS INFECTION

Abstract

The aim of the study was to analyze the relationship between early miscarriage and specific immune response parameters in CMV-seropositive pregnant women. Retrospective analysis included 150 women in the first trimester of pregnancy, 100 of them were CMV-seropositive (main group) and 50 were CMV-seronegative (control group). At the first stage of the study, all pregnant women from the main group were divided into two subgroups: with exacerbation of cytomegalovirus (CMV) infection and with the latent course of the disease. At the second stage, all women of the main group were divided into subgroups, depending on the outcome of pregnancy: an incipient abortion with pregnancy termination at the gestational age out of 12 weeks and with prolonged pregnancy. The assessment of CMV infection activity markers in biological material (blood, cervical canal lining, buccal epithelium scraping, villous chorion) was performed by seroimmunological methods and PCR analysis. The direct dependence of the frequency of miscarriage and the nature of clinical manifestations on a specific immune response was established in the course of a study of CMV-seropositive women in the first trimester of pregnancy. Markers of highly active infection were detected in CMV-seropositive women, whose pregnancy ended in spontaneous abortion for up to 12 weeks of pregnancy. At a lower level of activity of specific immune response parameters, the threatened abortion with prolongation of pregnancy was diagnosed in 60% of cases; with the latent course of the disease, the risk of pregnancy complications was minimal (in 18%) and statistically did not differ from the control group (in 15%). The obtained data made it possible to develop an algorithm for assigning CMV-seropositive women to risk groups for developing a threatened miscarriage in early pregnancy.