Severe forms of preeclampsia as a manifestation of thrombotic microangiopathy
Objective. To present and analyze an update on a relationship of thrombotic microangiopathy to severe vascular complications during pregnancy.Makatsaria A.D., Bitsadze V.O., Akinshina S.V.
Material and methods. The literary sources on the topic during the last 10 years, which had been found in the Pubmed and Medline databases, were analyzed.
Results. Thrombotic microangiopathy is one of the most severe thrombotic events that are characterized by microvascular lesions in various organs and accompanied by thrombocytopenia and hemolytic anemia. The term thrombotic microangiopathy encompasses several nosological entities characterized by different mechanisms of microthrombosis. At present, thrombotic microangiopathy includes thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, heparin-induced thrombocytopenia, and HELLP syndrome. Pregnancy is one of the most important triggers of thrombotic microangiopathy. This fact opens up broad prospects for studying the pathogenesis of thrombotic microangiopathy in the context of physiological changes in hemostasis during pregnancy.
Conclusion. The discovery of molecular mechanisms of thrombotic microangiopathy allows a fresh look at the pathogenesis of thrombotic events associated with pregnancy and at that of the so-called placental obstetric complications, including the severe forms of preeclampsia.
Keywords
preeclampsia
HELLP syndrome
thrombosis
thrombotic microangiopathy
antiphospholipid syndrome
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Received 06.12.2016
Accepted 23.12.2017
About the Authors
Makatsaria Alexander Davidovich, MD, professor, corresponding member of RAMS, the head of Department of Obstetrics and Gynecology of the Faculty of Medicine and Prevention, I.M. Sechenov First Moscow State Medical University. 109004, Russia, Moscow, Zemlyanoi Val, 62, bld. 1. Tel.: +79037280897. E-mail: gemostasis@mail.ruBitsadze Victoria Omarovna, MD, professor of the Department of Obstetrics and Gynecology of the Faculty of Medicine and Prevention,
I.M. Sechenov First Moscow State Medical University. 109004, Russia, Moscow, Zemlyanoi Val, 62, bld. 1. Tel.: +79262313829. E-mail: gemostasis@mail.ru
Akinshina Svetlana Vladimirovna, Ph.D., scientific employee of the Department of Obstetrics and Gynecology of the Medical-Prophylactic Faculty,
I.M. Sechenov First Moscow State Medical University. 109004, Russia, Moscow, Zemlyanoi Val, 62, bld. 1. Tel.: +79032388048. E-mail: gemostasis@mail.ru
For citations: Makatsaria A.D., Bitsadze V.O., Akinshina S.V. Severe forms of preeclampsia as a manifestation of thrombotic microangiopathy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (4): 21-6. (in Russian)
http://dx.doi.org/10.18565/aig.2017.4.21-6
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