The palatine tonsils are secondary lymphoid organs where immune processes occur, affecting the development of both cellular and humoral responses. A large proportion of spontaneous reproductive pregnancy losses are associated with immunologic problems. One variant of such disorders is associated with the production of autoantibodies to phospholipids or phospholipid-binding proteins, chorionic gonadotropin, and increased activity of natural killer cells. The condition of the palatine tonsils in patients with immunologic causes of infertility is greatly underestimated in modern clinical practice. In addition, both domestic and foreign literature lack comparative studies on the course and outcomes of pregnancy in women with an aggravated reproductive history in case of treatment of chronic tonsillitis (CT) at the pregravidar stage.
OBJECTIVE
To evaluate the influence of chronic tonsillitis on the course and outcomes of pregnancy in women with a burdened reproductive history.
MATERIAL AND METHODS
The study involved 86 female patients with chronic tonsillitis aged 21—35 years with reproductive complications in anamnesis. The main group (n=45) consisted of patients who were treated with CT at the pregravidar stage, the comparison group (n=41) consisted of patients who did not receive treatment for CT at the pregravidar stage. Treatment of patients with CT consisted in tonsil lacunae sanation and exposure to continuous laser radiation. Statistical processing of the obtained results was performed in IBM SPSS 26.0 software environment.
RESULTS
According to the prevalence of different forms of CT the patients of both groups were comparable (p=0.78). In 25 (55.6%) patients of the main group and in 24 (58.5%) patients of the comparison group the simple form of CT was diagnosed, toxic-allergic form (TAF1) — in 20 (44.4%) and 17 (41.5%) patients respectively. In the study of microflora in the lacunae of tonsils both pathogenic and conditionally pathogenic prevailed. Epstein-Barr virus (EBV) was predominantly isolated in every second patient in both the main and comparison groups. Spontaneous early termination of pregnancy occurred in 2 (4.4%) patients in the main group and 8 (19.5%) in the comparison group (p=0.043). Threat of abortion was diagnosed in 5 (11.1%) pregnant women in the main group and in 12 (29.3%) in the comparison group (p=0.056). Premature detachment of normally located placenta was less frequent in the main group (n=3; 7.0%) compared to the comparison group (n=12; 36.4%), the differences were statistically significant (p=0.003). There were no significant differences in the incidence of early toxicosis, hydroamnion, preeclampsia, preterm labor and low birth weight for gestational age. Analysis of the dynamics of circulating autoantibodies content before and after treatment of patients with CT at the pregravidar stage showed that their concentration statistically significantly decreased in patients treated for CT at the pregravidar stage.
CONCLUSION
The results demonstrate a trend towards a decreased risk of a number of pregnancy complications after pregravidar treatment for CT. However, the relatively small sample size of the study requires caution in interpreting the results. Further studies are needed to confirm the findings and to evaluate the long-term effects of treatment of CT patients on pregnancy and labor outcomes.
