Современное состояние проблемы привычной потери беременности: дискуссионные вопросы причин и факторов риска, тактика периконцепционного ведения
Современное состояние проблемы привычной потери беременности: дискуссионные вопросы причин и факторов риска, тактика периконцепционного ведения
Скворцова М.Ю., Прилуцкая С.Г. Современное состояние проблемы привычной потери беременности: дискуссионные вопросы причин и факторов риска, тактика периконцепционного ведения. Гинекология. 2017; 19 (2): 59–65.
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Skvortsova M.Yu., Prilutskaia S.G. Current state of the problem of habitual loss of pregnancy: discussion questions of causes and risk factors, tactics of periconceptive management. Gynecology. 2017; 19 (2): 59–65.
Современное состояние проблемы привычной потери беременности: дискуссионные вопросы причин и факторов риска, тактика периконцепционного ведения
Скворцова М.Ю., Прилуцкая С.Г. Современное состояние проблемы привычной потери беременности: дискуссионные вопросы причин и факторов риска, тактика периконцепционного ведения. Гинекология. 2017; 19 (2): 59–65.
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Skvortsova M.Yu., Prilutskaia S.G. Current state of the problem of habitual loss of pregnancy: discussion questions of causes and risk factors, tactics of periconceptive management. Gynecology. 2017; 19 (2): 59–65.
В литературном обзоре представлены современные взгляды на проблему привычной потери беременности. Обсуждаются вопросы терминологии, причины и факторы риска, стратегические направления прегравидарного обследования и периконцепционного ведения пациенток с данной патологией. Причины привычной потери беременности крайне разнообразны и, как правило, взаимосвязаны. Это генетические причины (хромосомные аномалии эмбриона или одного/обоих родителей), эндокринные расстройства (конечной точкой приложения которых являются нарушения функционального и структурного состояния эндометрия), иммунологические факторы (которые реализуются на уровне локального нарушения выработки различных цитокинов, в норме обеспечивающих процессы имплантации и плацентации) и гемостазиологические нарушения (наиболее изученным из которых является антифосфолипидный синдром). Показана важная роль догестационного выявления и корригирования факторов риска потери беременности у супружеской пары.
The literary review presents modern views on the problem of habitual loss of pregnancy. Questions of terminology, causes and risk factors, strategic directions of pre-survey examination and per-conceptual management of patients with this pathology are discussed. The causes of habitual loss of pregnancy are extremely diverse and, as a rule, are interrelated. These are genetic causes (chromosomal abnormalities of the embryo or one or both parents), endocrine disorders (the endpoint of which is a violation of the functional and structural state of the endometrium), immunological factors (realized at the level of local disruption of the production of various cytokines, normally providing implantation and placentation processes) and hemotaziologic disorders (the most studied of which is AFS). An important role of pre-gestational detection and correction of risk factors for pregnancy loss in a married couple is shown.
Key words: spontaneous abortion, habitual loss of pregnancy, pregravid preparation.
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3. WHO Library Cataloguing in Publication. Good clinical diagnostic practice: a guide for clinicians in developing countries to the clinical diagnosis of disease and to making proper use of clinical diagnostic services. By Jane Carter et al. WHO Regional Publications, Eastern Mediterranean Series, 27).
4. Management of pregnancy, childbirth and the postpartum period in the presence of female genital mutilation Department of Gender, Women and Health Department of Reproductive Health and Research Family and Community Health World Health Organization 2001 from: htpp://www.who.intentitygenderother_healthmanageofpregnan.pdf
5. Practice Committee of American Society for Reproductive Medicine. Definitions of infertility and recurrent pregnancy loss: a committee opinion. Fertil Steril 2013; 99 (1): 63. PMID: 23095139.
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Авторы
М.Ю.Скворцова*, С.Г.Прилуцкая
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
*margodus@mail.ru
________________________________________________
M.Yu.Skvortsova*, S.G.Prilutskaia
Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
*margodus@mail.ru