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CNAA / Theses / 2018 / July /

Role of methionine metabolism disorders in women with recurrent spontaneous abortion:diagnostic and correction


Author: Visternicean Elena
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2018
Scientific adviser: Veaceslav Moşin
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 3 July, 2018
Approved by NCAA on the 23 November, 2018

Abstract

Adobe PDF document – 0.32 Mb / in romanian

Thesis

CZU 618.39-021.3-008.9+577.112.386

Adobe PDF document 7.37 Mb / in romanian
0 pages

Keywords

recurrent pregnancy loss, homocysteine, polymorphism, MTHFR C677T, MTHFRA1298C, MTR A2756G, MTRR A66G, thrombophilia

Summary

The research area: Obstetrics and gynecology.

Study aim: diagnosis of methionine metabolism disorders in women with idiopathic recurrent pregnancy loss for optimizing therapeutic management.

Study objectives: (1) evaluation of medico-social particularities of women with recurrent pregnancy loss; (2) assessment of serum homocysteine levels, vitamin B12, folic acid and the frequency of the MTHFR C677T, MTHFR A1298C, MTR A2756G and MTRR A66G polymorphisms in women with recurrent pregnancy loss; (3) identification of relations between serum homocysteine levels, vitamin B12, folic acid and MTHFR C677T, MTHFR A1298C, MTR A2756G and MTRR A66G polymorphisms and their implications in women with recurrent pregnancy loss; (4) evaluation of therapeutic efficacy, monitoring of hemostasis parameters and homocysteine in pregnant women with methionine metabolic disorders; (5) developing recommendations for clinical management of these patients.

The novelty and the scientific originality. The study provides information on prevalence and incidence, as well as correlations between biochemical parameters (homocysteine, vitamin B12, folic acid) and MTHFR C677T, MTHFR A1298C, MTR A2756G and MTRR A66G polymorphisms with recurrent pregnancy loss. These findings provide valuable information with practical implications for health care providers, that can be linked to recurrent pregnancy loss in order to identify the etiology and to establish a proper therapeutic strategy.

The scientific solved problem evidence the role of genetic and biochemical factors in the pathogenesis of recurrent pregnancy loss. This will help to optimize and identify the risk of obstetric complications in patients with genetic mutations of enzymes involved in homocysteine and methionine metabolismand will determine therapeutic approaches during the next pregnancy.

The theoretical significance of the study is that the research results provide insights into the role of knowlodge of biochemical parameters (homocysteine, vitamin B12 and folic acid) and MTHFR C677T, MTHFR A1298C, MTR A2756G and MTRR A66G genetic polymorphisms in the pathophysiology of recurrent pregnancy loss.

The applicable value of the study isto evaluate the metabolic disturbances of methionine and homocysteine metabolism, the determination of which is necessary for the risk stratification and individualized approach to prophylaxis and therapy in patients with recurrent pregnancy loss. Based on the research, the efficacy of thromboprophylaxis and correction of hyperhomocysteinemia was argued by the evolution of pregnancy and exceeding 22 weeks gestation.

Implementation of scientific results. The sudy results were implemented in clinical work of Medical center “Repromed”and Scientific Research Institute of Mother and Child Health Care, Chisinau, Republic of Moldova.