RESUMO
The scanning electron microscopy of the endometrial surface epithelium during the 'implantation window' was performed in 119 patients with uterine factor of infertility or recurrent miscarriage due to endometrial hypoplasia. Ultramorphological picture of the surface endometrial epithelium was characterized by aplasia and hypoplasia of pinopodes (67.39%), dense cell - cell contacts (69.53%), heteromorphy of secretory cells (15.22%) in combination with atypia of microenvironment cells (50%) in patients with infertility. The asynchronous development of pinopodes (46.67%) and the absence of intercellular contacts separation during the 'implantation window' (84.44%) was observed in patients with recurrent miscarriage. The revealed disturbance determines the mechanisms of the blastocyst adhesion violation and trophoblast invasion in the different stages of implantation in patients with uterine factor of infertility and recurrent miscarriage.
Assuntos
Aborto Habitual/patologia , Implantação do Embrião/fisiologia , Perda do Embrião/patologia , Endométrio/patologia , Endométrio/ultraestrutura , Aborto Habitual/diagnóstico , Adolescente , Adulto , Atrofia/diagnóstico , Biomarcadores/análise , Estudos de Casos e Controles , Perda do Embrião/diagnóstico , Feminino , Humanos , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Útero/patologia , Útero/ultraestrutura , Adulto JovemRESUMO
AIM: The aim of this research was to have a thorough study of predictors of critical states during pregnancy after assisted reproductive technologies. MATERIALS AND METHODS: A retrospective study of 303 patients with "near-miss," out of which 37 are pregnancy cases after ART (the main group) and 265 are spontaneous pregnancy cases (the control group). RESULTS: Pregnancy after ART constituted 12.3% of all critical states. In the main group (10.8%), severe ovarian hyperstimulation prevailed over all possible reasons for critical states within the period of up to 22 weeks of gestation, whereas bleeding predominated in the control group (57.1%). When pregnancy terms exceeded 22 weeks, the leading reason for "near-miss" in the main group was preeclampsia (59.5%) with underlying thrombophilia (29.7%) and gestation pancreatic diabetes (32.4%); bleeding was the main factor in the control group (36.6%). CONCLUSION: Women after assisted reproductive technologies constitute a high-risk group for critical obstetric states not only in the nearest time period but also long after ART.
