PECULIARITIES OF PREGNANCY AND DELIVERY IN WOMEN WITH HISTORY OF INFERTILITY
Authors: Shlemkevich A.M. , Sharhorodska Yе.B. , Shkolnyk О.S. , Hnateіko O.Z. 
Published: April 2022

Institute of Hereditary Pathology of the National Academy of Medical Sciences of Ukraine, Lviv. Ukraine. Objective: to analyze data on somatic, reproductive, gynaecological history, pregnancy course and outcomes in women with a history of infertility residing in the Lviv region. Material and methods. The data and results of medical genetic counselling of 170 women aged 18-42 with a history of infertility (main group) were analyzed. The comparison was carried out with similar parameters of 80 healthy women aged 18-42 years in the control group. The data of somatic, reproductive, gynecological anamnesis, the pregnancy course and outcomes were studied. Statistical processing of the findings obtained was carried out by the Statistica 7.0 software package using the standard Excel 2013 statistical analysis package. Differences were considered statistically significant at p <0.05. Results. The analysis of the data of the results of medical genetic counselling of 170 women with a history of infertility for 2019-2021 was carried out. The patients with a history of infertility were significantly more likely to be over 36 years of age compared to the same indicators in the control group. They had a complicated somatic anamnesis, 80.0% versus 20.0% in the control group, with a significant predominance of cardiovascular pathology (21.8% and 11.2%), and they also more often had reproductive history complications, 51 (30.0%) versus 11 (13.7%), mainly due to spontaneous miscarriages and missed pregnancies: 46 (27.0%) and 11 (13.7%), respectively. The gynaecological history in all these patients was complicated by infertility, and only infertility was in 113 (66.5%); infertility in combination with ovarian apoplexy was found in 17 (10.0%) and with ectopic pregnancy in 15 (8.8%) that was significantly higher in relation to respective data in the control group of women: 2 (2.6%) and 1 (1.3%), respectively. In women with a history of infertility, a high incidence of pregnancy complications was noted: 146 (85.9%) versus 39 (48.75%) in the control group: they more often gave birth for the first time: 110 (64.7%), and 35 (43.7%) in the control group. Analysis of the data obtained showed the presence of a large number of maternal risk factors for obstetric complications in this group of women. Conclusion. The study has demonstrated the risk factors for the occurrence of obstetric pathology in women with a history of infertility include presumably older age (over 36 years) (13.5%), a complicated reproductive history (30.0%) mainly due to spontaneous miscarriages and missed pregnancies (27.0%); complicated somatic history (80.0%) with a significant predominance of the pathology of the cardiovascular system (21.8%). A gynaecological history aggravated by infertility was found in all 170 (100.0%) women of the main group, and a significant increase in the combination of infertility with ovarian apoplexy was detected in 17 (10.0%) and with ectopic pregnancy in 15 (8.8%) women compared with the control group: 2 (2.6%) and 1 (1.3%), respectively. The complicated course of pregnancy was found in 85.9% of women with a history of infertility and in 48.75% of women in the control group; they more often gave birth for the first time: 110 (64.7%) versus 35 (43.7%) patients in the control group (p<0.05). Women with a history of infertility are at risk for obstetric complications.