ПРЕЖДЕВРЕМЕННЫЕ РОДЫ У ВИЧ-ИНФИЦИРОВАННЫХ ЖЕНЩИН: ВКЛАД СИСТЕМНОЙ ВОСПАЛИТЕЛЬНОЙ РЕАКЦИИ В ФОРМИРОВАНИЕ ПАТОЛОГИИ БЕРЕМЕННОСТИ
2020
The study aims to study the contribution of the systemic inflammatory response to the development of premature labor in pregnant women with HIV living in the territory of Ugra. Material and methods. A retrospective analysis of the course of gestation and its outcomes in 106 HIV-negative and positive pregnant women is made. These patients contacted Women’s Health Organizations in the city of Surgut in 2016–2018. Control group I consisted of 20 case histories of pregnant women without HIV. The main group II included medical histories of 81 HIV-positive pregnant patients, including 65 women with childbirth after 37 weeks of gestation (subgroup IIA), and 16 women with childbirth before 37 weeks of gestation (subgroup IIB). During the analysis, five cases with inevitable miscarriage and missed abortion up to 22 weeks are identified and excluded. The control group (group I) consisted of 20 cases of pregnant women without HIV. Clinical and anamnestic data, analysis of the course of pregnancy and its outcomes, laboratory blood parameters, including the T cells, leukocytes, white blood cell differential, leukocytes intoxication index, and viral load are compared. The results are processed using the Statistica-10 software system. The critical level of statistical significance is taken at p <0.05. Results. In the group II in women with premature labor and HIV affected by prolonged viremia, a cytopathic effect of the virus on CD4 + cells and a change in the white blood cells towards agranulocytes (lymphocytes) were noted. Long-term immune activation with an increasing loss of the T cells could contribute to the formation of additional bacterial infection of the placenta and its structures, activation of the systemic inflammatory response, release of inflammatory mediators, and prostaglandins, and triggering of premature labor.
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