HYPERHOMOCYSTEINEMIA AS THE PATHOGENETIC FACTOR IN OBSTETRICAL COMPLICATIONS

The study of the influence of various levels of the hyperhomocysteinemia with mutation in methylenetetrahydrofolate reductase (МТНFR) on the system of the hemostasis was carried out. 84 patients were examined with various obstetrical pathology in the anamnesis. The genetic form of the hyperhomocysteinemia with various degrees of severity has been revealed in 21 (25%) patients. At the stage of planning of pregnancy and in the I-st trimester the thrombophilia manifestations were revealed: increasing the activity thrombocytes, the quantity of markers of thrombophilia D-dimer, ТАТ, F1+2. Thrombophilia augmented with terms of preeclampsia and the degree of severity of the hyperhomocysteinemia. The offered pathogenetic algorithm of treatment of thrombophilia state of patients using the low-molecular weight heparin (clexane), a folic acid, vitamin В6, В12 antioxidants has given the significant positive effect. It is necessary to carry out the studies of the hemostasis on latent thrombophilia and to carry out, if necessary, the antitromboembolitic therapy to establish the ethiopathogenetics of obstetrical complications. It will enable to exclude the further perinatal losses.