Pregestational preparation of patients with fetal loss (FL) in the anamnesis is an important and responsible stage, requiring from the doctor not only competent examination of the patient, but also a personalized approach to the correction of the detected disorders. The issues of determining the indications for antioxidant therapy, selection of drugs, and evaluation of antioxidant therapy efficacy remain relevant and controversial at present.
OBJECTIVE
To assess the state of prooxidant-antioxidant system in endometrial tissues for the purpose of differentiated approach to antioxidant therapy in women with anamnesis of FL at the stage of pregestational preparation.
MATERIAL AND METHODS
The main group included 21 patients with a history of FL who applied for pregestational preparation; the control group consisted of 25 practically healthy women without reproductive losses. In biopsy specimens of endometrial tissue obtained by Pipel biopsy on the 16th-18th day of the menstrual cycle, the concentration of malonic dialdehyde (MDA) was determined by its reaction with thiobarbituric acid (TBA) in biological substrates according to the method of I.D. Stalnaya and T.G. Garishvili (1977). G. Garishvili (1977), in spontaneous, enzymatic and non-enzymatic reactions of lipid peroxidation (LPO) and superoxide dismutase (SOD) activity by quantitative method by direct enzyme-linked immunosorbent assay (ELISA) using microplate photometer.
RESULTS
It was found that in women with early fetal loss in the anamnesis the indicators of the balance of pro-oxidant-antioxidant system in the studied tissues are shifted towards the strengthening of peroxidation processes (p<0.05). In the main group the level of MDA in spontaneous reaction of POL (sp. POL) was 5.72 nmol/h (p<0.05), at enzymatic (nicotinamide, adenine, dinucleotide — NADH-dependent reaction) POL (NZP) — 4.61 nmol/h (p<0.05), at non-enzymatic (ascorbate-dependent) reaction POL (AZP) — 13.56 nmol/h (p<0.05), the level of SOD activity — 121.5 ng/ml (p<0.05).
CONCLUSION
Taking into account that oxidative stress may play a role in the development of early pregnancy complications, the administration of antioxidant therapy can be recommended to patients with a history of FL in observations where the causes of loss have not been established in order to improve reproductive outcomes. Studies of the role of antioxidants in pregnancy and its complications allow us to expand our understanding of the potential use of antioxidant therapy both for the treatment and prevention of gestational losses at the pregravidational stage.
