DISABILITY OF PREGNANCY IN PATIENTS WITH “NON-CRITERIA” FACTORS PREDISPOSING TO THE DEVELOPMENT OF THROMBOPHILIA: A MODERN VIEW ON THE PROBLEM

Many practitioners in our country diagnose thrombophilia when detecting thrombogenic mutations, as well as antiphospholipid antibodies. At the same time, there is a rejection of thrombophilia in the genesis of obstetric complications, and its overdiagnosis in healthy women. The incidence of polymorphisms and mutations included in the classification of thrombophilia (the so-called “criterion” forms) among patients with obstetric complications is low. The frequency of hypercoagulable states in patients with obstetric complications is much higher, and their use of pathogenetic therapy leads to a positive outcome. In such patients, combinations of “non-criteria” forms of thrombophilia, a combination of polymorphisms in the genes of one coagulation unit, a combination of hereditary and acquired thrombophilia are detected. The study, which included 350 patients, including early pre-embryonic losses (failures of assisted reproductive technologies, biochemical pregnancy) - 59, spontaneous abortions - 223, antenatal death of the fetus - 68, demonstrated the importance of thrombophilia in the genesis of obstetric complications. The clinical implementation of thrombophilic defects has been shown to be possible both with point “criterion” mutations of thrombophilia and their combination, and with a combination of defects of the hemostasis system, including “non-criteria”, polymorphisms and mutations of genes in one link of the hemostasis system, with combinations of mutations and/or polymorphisms with acquired thrombophilia and/or risk factors.