Spontaneous termination of pregnancy as a risk factor for intrauterine infection during subsequent gestation

Abstract

DOI: 10.52705/2788-6190-2026-03-5
УДК616.33-022.7-036.1-06-037:007

The objective: to evaluate the clinical and pathogenetic characteristics of spontaneous termination of pregnancy in the genesis of intrauterine infection during subsequent gestation.
Materials and methods. To study the clinical and pathogenetic characteristics of spontaneous miscarriages, 114 women in early pregnancy (6–10 weeks) were examined. As a control group, 57 healthy women who presented for an induced abortion at the same gestational age were examined. Control group patients were comparable to the main group in age and had no somatic or gynecological diseases. Clinical, laboratory, echographic, and microbiological methods were included in the complex of additional research methods.
Results. According to echographic data, it was found that in the main group, non-developing pregnancy was observed in 57.89 ± 6.54 % of cases, anembryony – in 14.04 ± 4.60 %, and inevitable abortion – in 28.07 ± 5.95 % of cases. According to echographic data, in patients of the control group who subsequently underwent induced abortion, a progressive pregnancy corresponding to the gestational age was observed. According to histological data, signs of inflammation in the endometrium and trophoblast were detected in patients with spontaneous pregnancy loss in 59.65 ± 6.50 % of cases, whereas in the control group – only in 19.30 ± 5.23 % (p < 0.01). Dystrophic changes in the decidual tissue of women with miscarriage were observed 10 times more frequently than in the control group. Additionally, vascular thrombosis, foci of necrosis in the decidual tissue, and hyalinosis of the decidual tissue vessels were observed in the main group. For patients with early progressive pregnancy, the absence of pathological changes in the endometrium and chorion was characteristic in most cases.
Conclusions. For patients with miscarriage, the presence of allergic diseases was characteristic, which can be viewed as a tendency toward developing an excessive immune response to antigens. In more than half of the cases, histological examination revealed signs of deciduitis and choriodeciduitis. This confirms that the inflammatory genesis of pregnancy loss in the early stages of pregnancy is leading. Bacteriological examination revealed no significant differences between the two groups. It can be assumed that the main mechanism of inflammatory process development in pregnancy loss is not so much the quantity of the pathogen, but rather an excessive immune response to its antigens. Therefore, the next task of the study was to evaluate the role of the innate (nonspecific) immune system in the induction of the inflammatory response.