International Journal of Medical Sciences And Clinical Research
28
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VOLUME
Vol.05 Issue01 2025
PAGE NO.
28-31
10.37547/ijmscr/Volume05Issue01-03
Immunological factors and miscarriage
Zakirova Nodira Islamovna
Doctor of Medical Sciences, Professor, Department of Obstetrics and Gynecology No. 1, Samarkand State Medical University,
Uzbekistan
Yuldasheva Farangiz Ismatilloevna
Freelance applicant, assistant of the Department of Pathophysiology, Samarkand State Medical University, Samarkand, Uzbekistan
Received:
24 October 2024;
Accepted:
26 December 2024;
Published:
16 January 2025
Abstract:
This study aims to study the clinical condition of pregnant women with disturbed vaginal
microbiocenosis, that is, complicated by bacterial vaginosis, during 2020-2024. 150 pregnant women who applied
to the Gynecology Department of the multidisciplinary clinic of the Samarkand State Medical University, family
polyclinic No. 3 and the Samarkand Regional branch of the Republican Specialized Center for Maternal and Child
Health Scientific and Applied Medicine took part in the study. The control group consisted of 50 women who had
an uncomplicated pregnancy. The results of the research serve for the in-depth study of problems related to
bacterial vaginosis and its complications in pregnant women and the development of preventive measures.
Keywords:
Immune system, Inflammation, Autoimmune diseases, Cytokines, T cells, NK cells, Antibodies,
Endometriosis, Infection, Thrombophilia, Genetic factors, Immune response, Placental insufficiency,
Immunodeficiency, Chorioamnionitis, Microbiome.
Introduction:
Jahon Sogʼliqni Saqlash Tashkiloti (JSST)
m
aʼlumotlariga koʼra, har yili 1 milliondan ortiq
homilador qin mirobitsenozining buzilishi yoki bakterial
vaginoz bilan asoratlanadi, bundaga sabab homiladorlik
davrida gormonal fonning oʼzgarishi tufayli boʼlishi ham
mumkin. Dunyo miqyosda 14-49 yoshdagi ayollar
orasida BV (bakterial vaginoz) ning umumiy tarqalishi
29,2% dan ortiqni tashkil etadi. Oq tanli ayollarda BV
tarqalishi 23%, meksikaliklarda esa 32% ni, Аfro
-
amerikalik ayollar orasida BV tarqalishi taxminan 51%
ni tashkil etdi, bu esa juda yuqori
koʼrsatkichdir [1,6,7].
Mamlakatimizda olib borilgan tadqiqotlar natijasida,
Th1 ning faollashishi yalligʼlanish oldi sitokinlarning
-
oʼsimta nekrozi omili alfa (FNO
-
α) va interleykinlar IL
-
1β, IL
-2, IL-6, IL-8, IL-12, ishlab chiqarilishiga olib keladi
va
ularni
ragʼbatlantiradilar,
sitotoksik
T
-
limfotsitlarning koʼpayishi, yalligʼlanish va immun
reaktsiyalarida
ishtirok
etadigan
makrofaglarni
faollashtiradi. Th2 faollashishi natijasida yalligʼlanishga
qarshi sitokinlar ishlab chiqarilishi ragʼbatlantirila
di,
trofoblast hujayralariga taʼsir qiladi (Аxmadjonova
G.M., Negmatshaeva X.N.,2023). homiladorlikni koʼtara
olmaslikning rivojlanishini aniqlashda biokimyoviy
xususiyatlarini tavsiflovchi (АFА, β2 –
glikoprotein,
volchankali antikoagulyant), regionar gemodinamika
parametrlarining oshishi orqali namoyon boʼladigan
klinik
belgilar va
gemostaz tizimi
(D-dimer)
buzilishlarining asosiy xavf omillari aniqlangan va
akusherlik asoratlarini klinikagacha tashxislash va
bashoratlash usullari ishlab chiqilgan(Solieva N.K.,
2022; Sultonova N.А.,2022);
Respublikamizda olib borilayotgan ustuvor siyosatlar
natijasi oʼlaroq yosh olimlarning tadqiqotlarida
reproduktiv yoshdagi ayollar salomatligiga eʼtibor
qaratilib, ularga davlatimiz tomonidan koʼrsatilayotgan
yuksak eʼtibo
r masalasi tibbiy va ijtimoiy jihatdan tahlil
etilgan. Maʼlumotlarga koʼra, Samarqand viloyati
hududida qin mikrobiotsenozi buzilgan homilador
ayollarda homilaning oʼz
-
oʼzidan tushishining uchrashi,
hamda uning samarali va iqtisodiy qulay tashxislash
usull
ari oʼrganilmaganligi aniqlangan va ushbu
yoʼnalishda tadqiqotlarni amalga oshirish dolzarb,
ilmiy-amaliy ahamiyatga ega hisoblanadi.
Goal of work
to study the status of vaginal micro
biocenosis, the course of pregnancy and its
consequences in healthy women with a history of
International Journal of Medical Sciences And Clinical Research
29
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
miscarriage;
METHODS
During the years 2020-2024, pregnant women with
disturbed vaginal microbiocenosis, i.e., complicated by
bacterial vaginosis, with a history of miscarriage, at the
Gynecology Department of the multi-network clinic of
the Samarkand State Medical University, family
polyclinic No. 3 and the Republican Specialized
Maternal and Child Health Scientific and Applied
Medical Center Pregnant women who applied to the
Samarkand regional branch were involved in the study
and 150 pregnant women were examined. The control
group was made up of 50 pregnant women whose
pregnancy was uncomplicated.
All pregnant women under observation underwent a
complete clinical examination in the conditions of the
above-mentioned treatment facilities. Based on
subjective feelings, anamnesis, clinical and additional
examination methods, a diagnosis of bacterial vaginosis
was made.
The study of general blood analysis indicators
(erythrocytes, platelets, leukocytes, hemoglobin,
hematocrit index) was carried out using a
hematological analyzer Mindray BC-5300 (Shenzhen
Mindray Bio-Medical Electronics Co., Ltd. China.) in
accordance with the requirements of clinical and
hematological examination. 150 patients included in
the study were subjected to complex quantitative real-
time PTsR using Femoflor-16 reagents. The Femoflor-
16 reagent kit is designed for the detection of DNA of
opportunistic microorganisms, lactobacilli and human
genomic DNA (biological materials were used for
testing).
Statistical processing functions were included in the
data obtained as a result of the research, statistical
processing was performed on a Pentium-IV personal
computer using the Microsoft Office Excel-2012
software package. Variational parametric and non-
parametric statistical methods were used to calculate
the arithmetic mean (M), standard deviation (s),
standard error of the average (m), relative sizes
(frequency, %) of the studied indicator, the statistical
value of the obtained measurements was the normality
of the distribution according to the kurtosis criterion,
and error probability by examining the equality of
principal variances (F
–
Fisher's test) (R) was
determined by Student's (t) test. A confidence level of
R<0.05 was accepted as statistically significant changes.
RESULTS
Since the onset of sexual life is important in pregnant
women with impaired Qin biocenosis, we decided to
study this indicator in women as well. Analyzing the
gynecological anamnesis of the women involved in the
study, we were convinced that women with a history of
miscarriage, mainly medical abortions, spontaneous
abortions,
menstrual
cycle
disorders
from
gynecological diseases, chronic endometritis, and
inflammatory diseases of the cervix and vagina suffered
significantly more.
We examined 150 pregnant women in the general
pregnant
women
with
disturbed
vaginal
microbiocenosis included in our study and in the
control group, they also examined microscopically the
smear from the vagina and identified "primary cells" to
determine whether there is dysbiosis.
The appearance of "primary cells" in the violation of the
vaginal microflora can be associated with dystrophic
changes in the vaginal mucosa and, in addition, a
decrease in glycogen in the vaginal mucosa,
desquamation of the epithelial layer, and increased
adhesion of gram-negative microorganisms to these
cells.
>10 leukocytes were found in 26.7% of pregnant
women of group 1, and in 6% of control group.
Leukocytes in the amount of 8-10 were equal to 39.2%
in women with disturbed vaginal biocenosis, and 4% in
the control group, respectively.
6-7 in the 1st group involved in the study and the
control group; 0-5 leukocytes were found in 19.6% and
16%, 14.2 and 70%.
In our opinion, leukocytes in the vaginal smear should
be evaluated not by their quantity, but by their
functional activity, which requires further research. An
increase in the number of leukocytes in the vaginal
smear increases the transudation of leukocytes due to
dystrophic changes in the vaginal mucosa, which leads
to leukorrhea. Among the pregnant women involved in
our study, gonococci and trichomonas causative agents
were not detected.
Significant changes in the composition of the vaginal
biocenosis were found in pregnant women involved in
our study with a risk of miscarriage or inability to bear
a fetus.
Significant changes in the composition of the vaginal
microflora were found in pregnant women involved in
our study, group 1, i.e., with a history of disturbed
vaginal microbiocenosis, in comparison to the control
group. The total bacterial mass in pregnant women in
group 1 was 1.34% higher than Lg10 in the control
group (6.4±0.25 vs. 8.6±0.13, respectively) R<0.05. The
reason why the total mass of bacteria is more than the
control group is represented by the presence of
inflammatory processes in the genitals of women.
Lactobacittus spp listed in the table. when we
International Journal of Medical Sciences And Clinical Research
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International Journal of Medical Sciences And Clinical Research (ISSN: 2771-2265)
interpreted the content of Lg10, it was 6.2±0.25 in
pregnant women of the control group, and 5.2±0.2 in
group 1 (R<0.05). Enterobacteriaceae from aerobic
microorganisms was equal to 3.0±0.16 in the control
group, while it was 3.7±0.1 in group 1 (R<0.01). Among
anaerobic microorganisms, Gardnerella vaginalis was
detected in the ratio of 4.7±0.11 in the control group,
and 8.6±0.21, respectively, and it was statistically
reliable (R<0.001) It can be noted that Gardnerella
vaginalis was 1.82 percent higher than the control
group,
Eubacterium
spp.
and
1.60
higher,
Peptostreptococcus spp. we can see that the
microorganism was 2.36% higher.
Among the groups, the occurrence of dysbiosis was
78.5% among the women of the 1st group, which was
significantly higher than that of the women of the
control group, and the frequency of occurrence in the
control group was 10%. The incidence of anaerobic
microorganisms was 7.14 and 4%, respectively, among
the groups. Aerobic microorganisms were recorded in
3.57% of women of group 1. Anaerobic microorganisms
were also not recorded in women of the control group.
It was found in 35.7% of women of the 1st group of our
study.
CONCLUSION
Thus, concluding our researches, monitoring the
indicators of vaginal microbiocenosis allows us to
evaluate the type of microorganisms, identify possible
complications associated with vaginal microbiocenosis,
monitor the effectiveness of treatment without waiting
for the exacerbation of clinical manifestations, and
assess their level in time.
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