EXTRAGENITAL DISEASES AND THE SOCIAL STATUS OF WOMEN WITH SPONTANEOUS ABORTION

Objective. To study the specific features of a sociomedical portrait and reproductive health status in women with spontaneous abortions (SA), as well as their pattern in the light of the theory of pathomorphism. Material and methods. Case reports (form 003/y) were clinically and statistically analyzed in 1213 patients with SA up to 22 weeks gestation. Group 1 comprised 342 female inpatients of the gynecology units of Chelyabinsk City Clinical Hospital Six in 1996—1998; Group 2 included 871 patients treated in 2006—2008. The biomedical and social factors, obstetric and gynecological histories, genital and somatic diseases, genital tract microbial flora, and pattern of SA were analyzed in the light of the pathomorphism theory. Results. In the present state of the art, there is SA pathomorphism that is reflected by changes in the sociomedical portrait and reproductive health status in patients with miscarriage and by the specific features of the pattern, periods, and mechanism of pregnancy interruption. There was a significant decrease in the proportion of early and late reproductive age patients engaged in industrial production and students and an increase in the number of housewives, women who had started sexual life by age 18 years, and those who had chronic inflammatory diseases of the genitals, their mycoplasma or herpes infections, and ovarian tumoroids. The patients use contraception significantly more frequently and have repeated surgical abortions made less often. The pattern of SA shows a significant rise in the proportion of non-developing pregnancy or miscarriages at 5—8 weeks and a fall in the rate of late miscarriages. There is a trend towards higher rates of spontaneous termination of the first pregnancy and lower rate of recurrent miscarriage; there are a significantly lower proportion of patients with three miscarriages or more and those with SA after overcoming their primary infertility. Infectious and inflammatory genesis prevails in the mechanism of spontaneous pregnancy termination. Conclusion. In gestosis, anemia is referred to as that in chronic diseases and must not be treated with iron preparations.

spontaneous abortion, pathomorphism, reproductive health, sociomedical