ХРОНИЧЕСКИЕ ЗАБОЛЕВАНИЯ ГЕПАТОПАНКРЕАТОБИЛИАРНОЙ СИСТЕМЫ В ГЕНЕЗЕ ПРИВЫЧНОГО НЕВЫНАШИВАНИЯ БЕРЕМЕННОСТИ

Introduction: To date, among the somatic and gynecological diseases in women of childbearing age, habitual miscarriage (PNP) is considered as a multifactorial problem. The aetiology of PNP remains completely unknown, and the role of general somatic pathology in the development of PND is poorly understood. Chronic liver diseases, leading to a disruption of its detoxification function and metabolic disorders, are one of the causes of PNP in the first trimester of pregnancy. Study Aims. To study the state of the hepatopancreatobiliary system in patients with PNP Methods. The study involved 74 women, aged 20-44 years (mean age = 32.5 ± 1.13). Group I (n = 53) included women with PNP (main group), group II (n = 21) - women with normal pregnancy in the history (control group). All women underwent a clinical examination, a biochemical blood test, ultrasound of the abdominal cavity, echo cholystography. Results. In the 1 group, a significant increase in cytolysis and cholestasis, fasting glucose, insulin and HOMA-IR index, atherogenic lipoprotein fractions, atherogenicity index. According to the data of ultrasound in the main group, the change in liver size, hepatic structure by the type of steatosis, enlargement of the gallbladder and thickening of its walls, sediment in the gall bladder was detected more often. Evaluation of the motor-evacuation function of the gallbladder indicated a predominance in the main group of hypomotor dysfunction of the gallbladder. Conclusions. In patients with PNP, changes in hepatic, lipid and carbohydrate metabolism, hepatomegaly with signs of steatosis of the liver, changes in the state and content of the gallbladder with a violation of its function predominate, which confirms the opinion of the influence of the pathology of the hepatobiliary system on the development of PNP, both in isolation and in metabolic syndrome