MACROAND MICRORHEOLOGICAL PROPERTIES OF BLOOD IN PREGNANT WOMEN WITH PLACENTAL INSUFFICIENCY AFTER IN VITRO FERTILIZATION
Objective. To evaluate the macro- and microrheological properties of blood in pregnant women with placental insuff iciency (PI) after in vitro fertilization (IVF) and embryo transfer (ET). Subjects and methods. Clinical laboratory tests were carried out in 47 patients who were divided into 3 groups. A study group comprised 14 pregnant women after IVF and ET. A comparison group included 18 patients with chronic PI, in whom pregnancy occurred spontaneously. A control group consisted of 15 women with physiological pregnancy. Blood rheological parameters were estimated by macrorheological (asymptomatic blood viscosity, plasma viscosity, packed cell volume, and plasma total fibrinogen concentration) and microrheologic (spontaneous red blood cell aggregation and disaggregation) parameters. Results. After IVF, the pregnant women with PI were found to have blood macro- and microrheological changes; among other things, there were impairments in red blood cell aggregation and disaggregation processes and deformation. In PI, hyperaggregation and impaired blood rheology after IVF were ascertained to be mainly associated with the increased rate of formation of linear aggregates of red blood cells, their enhanced rigidity and lowered deformation. Conclusion. After IVF, the mechanism of hyperaggregation in PI is associated with considerable blood rheological changes which consist in the decreased disaggregation rate of large aggregates, the higher rigidity index of red blood cells, and their reduced deformation capacity. This requires timely diagnosis, correction of blood rheological parameters, and development of treatment regimens to improve the gas transport function of red blood cells in the microcirculatory bed of the fetoplacental unit, which positively affects perinatal outcomes.