EFFECTS OF HEPARIN AND CLEXANE COMBINED WITH CONTRYKAL ON STERILE INFLAMMATION DURING EARLY PREGNANCY IN THE ABSENCE OF GENITAL INFECTIONS

This study investigated the effects of heparin and low-molecular-weight heparin (Clexane) administered in combination with Contrykal on markers of sterile inflammation during early pregnancy in women without genital infections. The results demonstrated that the dynamics of HMGB1, IL-1α, and IL-33 varied considerably according to the type of preconception therapy. In Group 1 (standard treatment) and Group 2 (standard treatment plus antibiotics), these inflammatory markers increased as early as the sixth week of gestation and reached the highest absolute con­centrations, indicating that empirical antibiotic therapy provided no significant anti-inflammatory or immunomodu­latory benefit. In Groups 3 (Clexane) and 4 (Clexane plus Contrykal), activation of HMGB1 occurred predominantly by the twelfth week of pregnancy, suggesting that low-molecular-weight heparin, particularly when combined with Con­trykal, delayed the development of sterile inflammatory responses. In Groups 5 (unfractionated heparin) and 6 (un­fractionated heparin plus Contrykal), all three inflammatory markers increased significantly by the twelfth week; how­ever, their concentrations remained substantially lower than those observed in Groups 1 and 2. The greatest inhibitory effect on HMGB1, IL-1α, and IL-33 was observed in women receiving the combination of unfractionated heparin and Contrykal. Serum uric acid concentrations showed no significant gestational changes but demonstrated stable inter­group differences, with unfractionated heparin, particularly when combined with Contrykal, being associated with lower baseline uric acid levels.