Pathogenetic mechanisms of placental insufficiency and preeclampsia
Objective. Identify common pathogenetic mechanisms of preeclampsia and placental insufficiency to justify the possibility of a common approach to prevention.Lipatov I.S., Tezikov Yu.V., Lineva O.I., Tyutyunnik V.L., Kan N.E., Martynova N.V., Ovchinnikova M.A., Dobroditskaya A.D.
Material and methods. In the course of pregnancy were examined 140 women at high risk of decompensation of placental insufficiency. Taking into account the outcome of the pregnancy two comparison groups were formed: I group comprised 68 women with PN; II - 72 women with a combination of Mo and PE. pregnant Group II results of the survey further analyzed taking into account the period of implementation of PE (early manifestation of PE to 34 weeks, late PE – after 34 weeks.). III The control group consisted of 30 healthy women with physiological gestation. In the blood of women by enzyme immunoassay, immunofluorescence, biochemical tests determined the content of endothelial dysfunction, hemostatic markers of apoptosis and inflammatory response, decidualization stromal cells, placental angiogenesis and power, modulation of the immune response, the general reactive capacity of magnesium concentration and endogenous carbon dioxide.
Results. The study showed a high incidence of severe combination of Mo and PE with one-pointedness of changes both in the PN development and realization of PE at that favors the formation of pathogenic communication disorders embryo (feto) placental complex and development of PE. When the characteristic changes in the placenta early as embrioplatsentarnoy dysfunction later realized early PE, late PE for changes is formed in the later stages of the functioning of the FPC. Laboratory predictors recorded for 4-6 weeks before clinical manifestation of PE and PN, which justifies a predictive and preventive approach to the differentiated management of pregnant women at high risk.
Conclusion. Allocation of common pathogenetic mechanisms of formation of the PN and PE allows you to stratify pregnant women in the choice of a single prevention method.
Keywords
placental insufficiency
preeclampsia
pathogenesis
prevention
Supplementary Materials
- Тable 1. Laboratory test results of pregnant women with placental insufficiency (Мe [LQ-HQ])
- Тable 2. Laboratory test results of pregnant women with preeclampsia and placental insufficiency (Мe [LQ-HQ])
- Figure. Laboratory parameters reflecting the mechanisms of severe forms of placental insufficiency development and combined development of preeclampsia and placental insufficiency
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Received 21.12.2016
Accepted 23.12.2016
About the Authors
Lipatov Igor S., Doctor of Medical Sciences, Professor at the Department of Obstetrics and Gynecology № 1, Samara State Medical University, Ministry of Health of Russia. 443099, Russia, Samara, Chapaevskaya str. 89. Tel.: +78469582418. E-mail: i.lipatoff2012@yandex.ru. ORCID ID: orcid.org/0000-0001-7277-7431Tezikov Yuriy V., Head of the Department of Obstetrics and Gynecology № 1, Samara State Medical University, Ministry of Health of Russia.
443099, Russia, Samara, Chapaevskaya str. 89. Tel.: +78469582418. E-mail: yra.75@inbox.ru. ORCID ID: orcid.org/0000-0002-8946-501Х
Lineva Olga I., Professor at the Department of Obstetrics and Gynecology IPO, Samara State Medical University, Ministry of Health of Russia.
443099, Russia, Samara, Chapaevskaya str. 89. Tel.: +78463342278
Tyutyunnik Victor L., M.D., PhD; the head of the obstetric physiological department, Research Center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79039695041. E-mail: tioutiounnik@mail.ru. Number Researcher ID B-2364-2015.
ORCID ID 0000-0002-5830-5099
Kan Natalia E., M.D., PhD; the head of the obstetric department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia.
117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +79262208655. E-mail: kan-med@mail.ru. Number Researcher ID B-2370-2015. ORCID ID 0000-0001-5087-5946
Martynova Nadezhda V., Postgraduate student at the Department of Obstetrics and Gynecology № 1, Samara State Medical University, Ministry of Health of Russia.
443099, Russia, Samara, Chapaevskaya str. 89. Tel.: +78469582418
Ovchinnikova Marina A., Postgraduate student of the Department of Pediatrics faculty, Samara State Medical University, Ministry of Health of Russia.
443099, Russia, Samara, Chapaevskaya str. 89. Tel.: +78469582418. E-mail: marinasharypova@yandex.ru
Dobroditskaya Alina D., Postgraduate student of the Department of Obstetrics and Gynecology № 1, Samara State Medical University, Ministry of Health of Russia.
443099, Russia, Samara, Chapaevskaya str. 89. Tel.: +78469582418
For citations: Lipatov I.S., Tezikov Y.V., Lineva O.I., Tyutyunnik V.L., Kan N.E.,
Martynova N.V., Ovchinnikova M.A., Dobroditskaya A.D. Pathogenetic mechanisms
of placental insufficiency and preeclampsia development.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (9): 64-71. (in Russian)
http://dx.doi.org/10.18565/aig.2017.9.64-71
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