Factors, markers, diagnostic methods, and prediction of pregnancy loss

Cover Page

Cite item

Full Text

Abstract

Aim. To evaluate the risk factors associated with pregnancy loss in the studied cohort; to establish the clinical relevance of leukocyte-derived proteolytic enzymes as biomarkers of pregnancy loss; to develop a diagnostic and prognostic approach for early detection of pregnancy loss.

Materials and methods. The study included 152 participants aged 18 to 40 years: 35 conditionally healthy pregnant women and 117 patients diagnosed with threatened miscarriage at 5–6 weeks of gestation. These patients, based on the activity levels and quantity of leukocyte-derived proteolytic enzymes and/or pregnancy outcomes, were divided into three groups: 35 patients with a missed miscarriage, 35 patients with a complete spontaneous abortion, and 35 patients with an incomplete spontaneous abortion. The diagnosis of threatened miscarriage was established based on clinical presentation (complaints of lower abdominal cramping and/or vaginal bleeding), as well as ultrasound findings (presence of a gestational sac in the uterine cavity). The diagnosis of complete spontaneous abortion in the main group was based on the absence of a gestational sac in the uterine cavity as confirmed by ultrasound and/or the identification of chorionic tissue on histological examination. The diagnosis of incomplete spontaneous abortion was based on the presence of retained products of conception in the uterine cavity and confirmation of chorionic tissue in histological analysis. The diagnosis of a missed miscarriage was based on deformation of the gestational sac and/or absence of embryonic cardiac activity on ultrasound. To assess cathepsin activity, biochemical assay kits were used, and the resulting data were analyzed using spectrofluorimetric methods.

Results. The new method for early diagnosis of pregnancy loss possesses high sensitivity and specificity. Conclusion. The study confirmed that cathepsins are markers of miscarriage, and a method for early diagnosis and prediction of this pregnancy pathology before its clinical manifestations and pregnancy outcome was developed.

About the authors

P. A. Koshulko

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

Author for correspondence.
Email: nikolconnik@gmail.com
ORCID iD: 0000-0003-2806-4017

Pavel Aleksandrovich Koshulko

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

A. M. Kirsanova-Martynova

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0008-0847-3546

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

V. A. Buchnev

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0004-1029-6922

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

E. V. Ignatova

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0009-8408-3328

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

S. S. Kupriyanov

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0004-0162-3530

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

E. S. Melnikov

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0007-2274-5598

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

P. A. Solodov

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0009-2471-8707

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

A. M. Dorogova

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0003-2441-0987

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

G. D. Bagirova

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0000-1607-2920

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

A. V. Zubkov

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0007-5635-3453

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

A. D. Kolyvanova

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0003-5604-3528

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

E. A. Zubareva

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0000-8292-8299

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

A. D. Senatskaya

Vladimir Branch of the Volga Region Research Medical University, Ministry of Health of Russia

ORCID iD: 0009-0003-8155-5963

1 Oktyabrskiy Prospekt, Vladimir 600000

Russian Federation

References

  1. Koshulko P.A., Koshulko D.A., Shevchenko A.A. et al. Markers of incomplete miscarriage (incomplete spontaneous abortion). Reproduktivnoe zdorovye. Vostochnaya Evropa = Reproductive Health. Eastern Europe 2023;13(5):482–8. (In Russ.). doi: 10.34883/PI.2023.13.5.007
  2. Koshulko P.A., Koshulko D.A., Pyrikova K.S. et al. Biochemical markers of complete miscarriage (complete spontaneous abortion). Reproduktivnoe zdorovye. Vostochnaya Evropa = Reproductive Health. Eastern Europe 2023;13(5):489–95. (In Russ.). doi: 10.34883/PI.2023.13.5.008
  3. Timoshkova Yu.L., Andrianov M.A., Makeev K.A. et al. Infertility structure in female military personnel: a descriptive study. Morskaya meditsina = Naval Medicine 2024;10(1):105–11. (In Russ.). doi: 10.22328/2413-5747-2024-10-1-105-111
  4. Evdokimov V.I., Sivashchenko P.P. Key health indicators of female military personnel in the Russian Navy from 2003 to 2016. Morskaya meditsina = Naval Medicine 2019;5(1):45–56. (In Russ.). doi: 10.22328/2413-5747-2019-5-1-45-56
  5. Schmidt A.A., Kharkevich O.N., Kalyuzhnaya L.I. Current state of the problem of female fertility in oncological diseases and diminished ovarian reserve. Morskaya meditsina = Naval Medicine 2019;5(2): 18–33. (In Russ.). doi: 10.22328/2413-5747-2019-5-2-18-33
  6. Bradford M.M. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein dye binding. Anal Biochem 1976;7(72):248–54. doi: 10.1016/0003-2697(76)90527-3

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c)



СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 36991 от  21.07.2009.