It has been determined, based on a comprehensive clinical, laboratory, instrumental and statistical analysis of 109 women with pregnancy loss and 34 conditionally healthy pregnant women with a non-complicated obstetrical anamnesis, that the main risk factors for pregnancy loss are: age over 35 years (OR 5.43; 95% CI) 1.02-60.9), history of premature birth (5.22; 1.66-41.10), overweight (7.88; 1.02-60.91), hypertensive disorders (8.74; 1.13-67.36), varicose disease of the vein of lower extremities (9,74; 1,27-74,83). It is established that the hereditary factors of pregnancy loss are: hypertension of the proband`s mother (5.81; (2.15-12.52), father (23.2; 3.06-175.9), lipid metabolism disorders (6.32; 2.61-15.34), carbohydrate metabolism disorders (9.09; 2.62-31.51), cardiovascular catastrophes (heart attacks, strokes in the age under 50 (21.5; 2.83- 103.08). Women with a history of pregnancy loss are at risk for obstetric complications, namely: preeclampsia (OR = 21.9; 95% CI 1.3-369.5), fetal growth retardation (14.19; 1.85- 109.08), oligohydramnios (5.75; 1.05-31.44). It is proved that changes in lipid metabolism are more often observed, in the form of an increase in the atherogenic coefficient of 1.09 times in the first trimester, in 1.13 times in the second trimester (p<0.05) and an increase homocysteine levels in 1.65 times in pregnant women with pregnancy loss due to hereditary thrombophilia. Pathological polymorphisms of hemostasis and endothelial dysfunction genes play an important role in the development of miscarriage, namely the following pathological genotypes: 1691 GA factor V Leiden - increases the risk by 5.3 times (95% CI 1.5-18.5), 20210 GA prothrombin - 26.47 times (1.6-445.7), 675 4G / 4G PAI-1 - 7.5 times (1.7-33.79), -455AA fibrinogen β - 9.7 times (1.3-74.16), 677 CT MTHFR - 2.6 times (1.0-6.2), 677TT MTHFR - 21.7 times (1.3-368.6). It has been found that multigenic forms of thrombophilia predominate in most patients with pregnancy loss - 76.1% (p <0.001, OR = 12.31, 95% CI 4.8-31.55). It has been determined that the simultaneous existence of two pathological polymorphisms increases the risk of pregnancy loss by 3.88 times (OR 3.38; 95% CI 1.26-9.97), and three more than 2.5 times (OR 2, 66; 95% CI 1.02-7.19). Substantiated pathogenetic methods for predicting pregnancy loss, based on the determination of gene polymorphisms PAI-1 (675 5G / 4G), fibrinogen β (-455 G → A), MTHFR (677 C → T), which take into account the total contribution of each of the markers, make it possible to determine the probability of pregnancy loss and have a sensitivity of 68.81% (95% CI 59.22-77.34%) and 69.72 (95% CI 60.19-78.16%), specificity - 86.4 % (95% CI 76.22-98.14%) and 76.47% (95% CI 58.83-89.25%).
