scholarly journals Clinical and Pathogenetic Causes of Developing Complications in Multiple Pregnancy

2020 ◽  
Vol 27 (1) ◽  
pp. E202016
Author(s):  
Iryna Nikitina ◽  
Volodymyr Boiko ◽  
Tetiana Babar ◽  
Natalia Kalashnik ◽  
Nataliia Ikonopistseva ◽  
...  
Keyword(s):  
Growth Factor ◽  
Pregnant Women ◽  
Multiple Pregnancy ◽  
First Trimester ◽  
Placental Growth Factor ◽  
Enzyme Linked Immunosorbent Assay ◽  
Full Time ◽  
Singleton Pregnancy ◽  
Placental Dysfunction ◽  
First Trimester Of Pregnancy

To assess the role of the placental growth factor in the development of gestational complications during multiple pregnancy, there was conducted a study of this indicator in serum of 320 pregnant women with multiple pregnancy in the first trimester and 40 pregnant women with singleton pregnancy (the control group).          The objective of the research was to study the effect of placental growth factors on the gestational process in multiple pregnancy.          Materials and Methods. There was conducted a prospective study of pregnancy and childbirth in 320 females with multiple pregnancy (the main group) and 40 healthy women with singleton pregnancy. The level of serum placental growth factor was determined by enzyme-linked immunosorbent assay using monoclonal antibodies in the first trimester of pregnancy. The indicators of the hemostasis system (vascular, platelet and coagulation components) were evaluated according to generally accepted methods. Doppler ultrasound of the placental and fetal blood flow was performed in the uterine arteries, the umbilical artery and vein, the fetal middle cerebral artery.          Results. Women with multiple pregnancy were at high risk of developing gestational complications such as preterm deliveries (67.8%, p<0.01), placental dysfunction, pre-eclampsia (17.5%, p<0.05). The disorders of the vascular platelet and coagulation hemostasis in the first trimester of pregnancy were the main risk factors for early termination of pregnancy. Low level of serum placental growth factor in pregnant women with multiple pregnancy in case of preterm delivery, placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg/ml), in comparison with the corresponding indicators in singleton pregnancy (418.2 ± 10.4 pg/ml), was proven to be a prognostic marker for the development of gestational complications.          Conclusions. Timely correction of gestational complications in multiple pregnancy with micronized progesterone, low molecular weight heparins, angio-protective agents allowed us to prolong pregnancy with monochorionic placentation type for 3.2 weeks (up to 34.2 ± 2.4 weeks) and provide full-time delivery of dichorionic twin pregnancy.

scholarly journals BASIC CLINICAL AND PATHOGENETIC ASPECTS OF DEVELOPING THE COMPLICATIONS DURING MULTIPLE PREGNANCIES

2019 ◽  
Vol 72 (1) ◽  
pp. 52-55
Author(s):  
Volodymyr I. Boiko ◽  
Alla V. Boychuk ◽  
Irina M. Nikitina ◽  
Tetyana V. Babar ◽  
Alesya V. Boiko ◽  
...  
Keyword(s):  
Growth Factor ◽  
Pregnant Women ◽  
Solid Phase ◽  
First Trimester ◽  
Enzyme Analysis ◽  
Control Group ◽  
Multiple Pregnancies ◽  
Placental Dysfunction ◽  
First Trimester Of Pregnancy ◽  
A Prospective Study

Introduction: In order to evaluate the value of the Placenta Growth Factor (PlGF) in the developing the gestational complications during multiple pregnancies, a study of this indicator in serum of 320 pregnant women with multiple pregnancies in the first trimester, as well as 40 pregnant women with single pregnancy, constituted a control group. The aim: of the study is to investigate the effect of the placental growth factors on gestational process during multiple pregnancies. Materials and methods: A prospective study of maternity pregnancy in 320 females with multiple pregnancies was conducted, which comprised the main group of the subjects and 40 healthy women with unipolar pregnancy. The level of PlGF in serum was determined by solid phase enzyme analysis using monoclonal antibody sets in the first trimester of pregnancy. Indicators of the hemostasis system (vascular thrombocyte and coagulation link) were evaluated according to generally accepted methods. Dopplerometry of placental and fetal blood flow was performed in uterine arteries, arteries and umbilical cord veins, middle cerebral artery of the fetus. Results: Women with multiple pregnancies are at the risk of gestational complications - premature births in 67.8% (p <0.01), feto placental dysfunction, pre eclampsia - in 17.5% (p <0.05) cases. The revealed violations of the vascular thrombocyte and coagulation homeostasis in the first trimester of pregnancy are the main risk factors for early premature abortion. It has been shown that the low level of placental growth factor in serum of pregnant women with multiple pregnancies in the case of premature labor, feto placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg / ml) compared with the corresponding indicators for single-pregnancy (418.2 ± 10.4 pg / ml) is a prognostic marker for the development of gestational complications. Conclusions: Timely medical correction of gestational complications during multiple pregnancies with the use of micronized progesterone, low molecular weight heparins, angio protectants allowed prolonging the pregnancy with mono choric type of placentation by 3.2 weeks (up to 34.2 ± 2.4 weeks), and in the case of dichoric twins - to full-term pregnancy.

Early predictors of placental dysfunction

2016 ◽  
pp. 25-28
Author(s):  
J.M. Melnik ◽  
◽  
A.A. Shlyahtina ◽  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Pregnant Women ◽  
Umbilical Artery ◽  
Placental Growth Factor ◽  
Vascular Endothelial ◽  
Endothelin 1 ◽  
Placental Dysfunction ◽  
Early Predictors ◽  
Endothelial Growth Factor

The article presents the predictors of placental dysfunction on the early stage of pregnancy. The objective: the search for prognostic markers and criteria for the occurrence of placental insufficiency in the early stages of the gestational process to optimize the pregnancy and labor with improved perinatal outcomes. Patients and methods. To solve this goal in the period from 2013 to 2015 were conducted a comprehensive survey of 334 pregnant women, which depending on the peculiarities of pregnancy and childbirth were divided into groups. The control group consisted of 236 pregnant women with uncomplicated gestational period, no morphological signs of placental dysfunction. The study group included 98 patients with a complicated pregnancy who had revealed violations of the fetal-placental relations, which was confirmed by morphological examination of the placenta in the postpartum period. Results. It was found that pregnant women with placental insufficiency in the first trimester of pregnancy have higher levels of interleukin-1B (IL-1v) and interleukin-3 (IL-3) in comparison with physiological pregnancy, as well as there is a direct significant correlation between IL-1v and pulsative index (PI) in the spiral (r=0.84) and uterine artery (r=0.77), and the inverse correlation between the level of IL-3 and PI in the terminal branches of the umbilical artery (r=-0.69). Verified an inverse relationship between the concentration of endothelin-1, the level of vascular endothelial growth factor (r=-0.87) and placental growth factor (r=-0.73), and also a direct link between the content of endothelin-1 and PI in spiral arteries (r=0.89), uterine artery (r=0.83) and the terminal branches of the umbilical artery (r=0.79). Conclusion. Thus, it is proven that early predictors of placental dysfunction can be considered the concentration of endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin-1, interleukin-3, and the indices of pulsative index. Key words: placental dysfunction, predictors, endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin, pulsative index.

scholarly journals Interleukin-1 Receptor Antagonist Gene Polymorphism, Vaginal Interleukin-1 Receptor Antagonist Concentrations, and Vaginal Ureaplasma urealyticum Colonization in Pregnant Women

2003 ◽  
Vol 71 (1) ◽  
pp. 271-274 ◽  
Author(s):  
Parrin T. Barton ◽  
Stefan Gerber ◽  
Daniel W. Skupski ◽  
Steven S. Witkin
Keyword(s):  
Pregnant Women ◽  
Receptor Antagonist ◽  
Ureaplasma Urealyticum ◽  
Interleukin 1 ◽  
First Trimester ◽  
Enzyme Linked Immunosorbent Assay ◽  
Interleukin 1 Receptor Antagonist ◽  
First Trimester Of Pregnancy ◽  
The Relationship ◽  
Uneventful Pregnancy

ABSTRACT Ureaplasma urealyticum is the microorganism most frequently isolated from amniotic fluids of women in preterm labor. The relationship between vaginal colonization with U. urealyticum, vaginal interleukin-1 receptor antagonist (IL-1ra) levels, and the IL-1ra genotype in pregnant women was examined. Vaginal specimens, obtained with a cotton swab from 207 women in their first trimester of pregnancy, were tested for IL-1ra concentrations by enzyme-linked immunosorbent assay and for U. urealyticum and IL-1ra genotypes by PCR. U. urealyticum was detected in 85 (41.1%) women. The median IL-1ra level was 450 ng/ml in women positive for U. urealyticum, as opposed to 225 ng/ml in women negative for this microorganism (P < 0.0001). Sixty-two percent of the 16 women who were homozygous for allele 2 of the IL-1ra gene (IL-1RN*2) were colonized with U. urealyticum, as opposed to 47% of the 49 women who were IL-1RN*1/IL-1RN*2 heterozygotes and 34% of the 133 women who were IL-1RN*1 homozygotes (P < 0.05). Median IL-1ra levels were 750 ng/ml in IL-1RN*2 homozygotes, 300 ng/ml in IL-1RN*1/IL-1RN*2 heterozygotes, and 250 ng/ml in IL-1RN*1 homozygotes (P = 0.02). The vast majority of subjects had an uneventful pregnancy and delivered a healthy infant at term. The IL-1ra genotype or U. urealyticum colonization was unrelated to birth weight. Pregnant women who are colonized with U. urealyticum during the first trimester have elevated vaginal IL-1ra concentrations and a higher prevalence of the IL-1RN*2 homozygote genotype than do noncolonized women.

scholarly journals Study of the relationship between the parameters of complex prenatal screening of the first trimester of pregnancy with a risk of the most common aneuploidies

2020 ◽  
Vol 5 ◽  
pp. 33-36
Author(s):  
V. I. Oshovskyy
Keyword(s):  
Blood Pressure ◽  
Growth Factor ◽  
Pregnant Women ◽  
Prenatal Screening ◽  
First Trimester ◽  
Placental Growth Factor ◽  
Type I ◽  
Uterine Arteries ◽  
Increased Risk ◽  
The Relationship

Complex prenatal screening of the first trimester remains the most accessible and effective way of stratifying the risks of fetal chromosomal abnormalities in the general population, which has satisfactory sensitivity and specificity. Over the last decade, due to including additional parameters (average pulsation index of blood flow in the uterine arteries, average blood pressure, placental growth factor concentration, obstetric and somatic anamnesis data), it has also become a tool for determining obstetric risks. The objective: to study the effect of these additional parameters on the accuracy of predicting the most common aneuploidies was made. Materials and methods. The cohort included 2164 pregnant women at 11+0 – 13+6 weeks of gestation, who underwent extended complex screening of the first trimester, which aimed to determine the risk of trisomy on the 21st, 13th and 18th chromosomes in the fetus and calculation risk of perinatal complications, namely: premature birth, preeclampsia and fetal growth retardation. Results. It was found that the history of miscarriage at 13–22 weeks of pregnancy (P=0,0006), increased resistance in the uterine arteries (P=0,0307), decreased concentration of placental growth factor (P=<0,0001) and increased mean blood pressure (P=0,0125) correlate with a high risk of trisomy of chromosome 21. Type I diabetes mellitus in pregnant women (P=0,0477) correlates with an increased risk of trisomy on chromosome 18. The concentration of placental growth factor (P=<0,0001) correlates with an increased risk of trisomy on chromosome 13. Conclusions. The data obtained require detailed analysis in the context of the possibility of optimizing mathematical models for predicting aneuploidy, as well as studying the relationship between markers of trophoblast invasion and chromosomal pathology of the fetus to better understand the mechanisms of first trimester fetal loss and placental dysfunction in the second half of pregnancy.

scholarly journals A role of comprehensive cervix assessment in the first trimester of pregnancy for predicting preterm delivery

2020 ◽  
Vol 14 (2) ◽  
pp. 174-181
Author(s):  
V. G. Volkov ◽  
O. V. Chursina
Keyword(s):  
Pregnant Women ◽  
First Trimester ◽  
Diagnostic Value ◽  
Singleton Pregnancy ◽  
Group 4 ◽  
First Trimester Of Pregnancy ◽  
Group 3 ◽  
Group 2 ◽  
Delivery Term ◽  
Group 1

Aim: to improve efficacy of predicting preterm labor in the first trimester of pregnancy by combining diverse parameters of cervical ultrasound examination.Materials and methods. A prospective cohort study of 1517 women with uncomplicated pregnancy was performed. Inclusion criteria were: females underwent cervicometry at 11–14 weeks of gestation, singleton pregnancy, revealing no complaints at the onset of examination. All women were subdivided into four groups: Group 1 – 27 pregnant women with shortened cervix (less than 30 mm); Group 2 – 24 pregnant women without cervical gland area (СGA); Group 3 – 30 pregnant women with two risk factors (shortened cervix less than 30 mm and lacked СGA); Group 4 (control) consisted of 1436 pregnant women with cervix length exceeding 30 mm and presence of СGA.Results. Average delivery term in Group 1 was 35.7 weeks (95 % CI = 34.7–36.8), in Group 2 – 34.7 weeks (95 % CI = 33.59–35.0), in Group 3 – 33.23 weeks (95 % CI = 31.6–34.8), in Group 4 (control) – 38.11 weeks (95 % CI = 38.06–38.17). A significant moderate correlation (Rxy = 0.534) between shortened cervix, absence of СGA and delivery term was found (p < 0.001). A regression model consisting of cervical length and presence of СGA was simulated based upon 50.8 % factors underlying probability of preterm birth, revealing 42.6 % sensitivity, 99.1 % specificity, and 96.6 % overall diagnostic value. The area under the ROC curve was 0.902 ± 0.022 (95 % CI = 0.860–0.945). The data obtained reflect diverse biochemical changes such as collagen decomposition, altered glucosamine level and fluid amount within cervical tissues. Such processes result in shortened, softened and expanded (matured) cervix. Uncovering markers for preterm cervical maturation underlies a logical strategy to predict miscarriage.Conclusion. Untrasound cervical measurement in the first trimester of pregnancy allows for revealing valuable miscarriage predictors (shortened cervix and absence of GI). Risk assessment by combining diverse ultrasound cervix parameters would allow to improve overall predictive efficacy.

Pregnancy after influenza in the first trimester

2018 ◽  
pp. 14-18
Author(s):  
V.V. Kaminskyi ◽  
◽  
O.I. Zhdanovich ◽  
T.V. Kolomiychenko ◽  
A.D. Derkach ◽  
...  
Keyword(s):  
Pregnant Women ◽  
High Frequency ◽  
Clinical Manifestations ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
First Trimester ◽  
Placental Insufficiency ◽  
Perinatal Complications ◽  
Placental Dysfunction ◽  
First Trimester Of Pregnancy

The endpoint of the negative impact of adverse processes in the mother’s body with influenza is the formation of placental insufficiency, the basis of which is a violation of the uteroplacental blood flow. The objective: to study the features of the course of pregnancy, the state of the fetus and the newborn after the influenza in the first trimester of pregnancy. Materials and methods. 120 women who had the influenza in the first trimester of pregnancy were examined. In 68 (56.7%) pregnant women signs of feto-placental dysfunction were observed, 2 groups were distinguished: the main group - 68 patients with feto-placental dysfunction, the comparison group – 52 pregnant women without signs of feto-placental insufficiency. Results. 3 times more often than women without manifestations of placental insufficiency (42.6% versus 15.4%; p<0.05) a severe course of influenza was observed, it accompanied by a high frequency of clinical manifestations, including in almost all patients (95.6% versus 67.3%; p<0.05), body temperature rose to 38 °C and higher, and in 61.7% of women it stayed for 4–6 days (versus 11.5%; p<0.05). Among the complications of influenza: bronchitis (25.0% versus 9.3%; p<0.05), pneumonia (17.6% versus 5.7%; p<0.05), sinusitis (17.6% versus 7.7%; p<0.05). The threat of abortion was noted in 57.4% of cases, the threat of preterm birth was observed in 39.7% of women. Most often, placental dysfunction was associated with fetal distress (76.5% versus 13.5%; p<0.05) and growth retardation (54.4% versus 3.8%; p<0.05). 32.4% versus 13.5% of women had preeclampsia (p<0.05). The frequency of both polyhydramnios (17.6%) and low water (10.3%) is significantly higher. By cesarean section, 35.3% women were delivered (versus 15.4%, (p<0.05). Delivery was preterm in 17.6% of women versus 7.7% (p<0.05). Premature discharge of amniotic fluid (17.6%) and pathological blood loss during childbirth (16.2%), fetal distress during childbirth (48.5% versus 9.6%; p<0.05) were noted. Maternal placental dysfunction, fetal distress, prematurity (17.6%) and malnutrition (22.1%) led to a high incidence of birth asphyxia (46.5% versus 19.2%, p <0.05). Half (51.5%) of children had disadaptation syndromes, most often neurological disorders (32.4% versus 11.5%; p<0.05) and respiratory disorders (27.9% versus 7.7%; p<0.05). Conclusion. Influenza in early pregnancy with a severe course and a high frequency of complications is associated with a high frequency of feto-placental dysfunction and other obstetric and perinatal complications, which requires a more detailed study to determine risk factors and develop tactics for managing this category of pregnant women. Keywords: pregnancy, influenza, feto-placental dysfunction, obstetric and perinatal complications, newborn.

Urinary placental growth factor determined in the first trimester of pregnancy as a predictor of preeclampsia

2020 ◽  
Vol 21 ◽  
pp. 63-67
Author(s):  
Akylbek Tussupkaliyev ◽  
Andrey Gaiday ◽  
Saule Bermagambetova ◽  
Sholpan Arenova ◽  
Lyazzat Kaldigulova ◽  
...  
Keyword(s):  
Growth Factor ◽  
First Trimester ◽  
Placental Growth Factor ◽  
First Trimester Of Pregnancy

scholarly journals Impact of replacing or adding placental growth factor on Down syndrome screening: a prospective cohort study

2020 ◽  
Author(s):  
Wing To Angela Sin ◽  
Liona Poon ◽  
Piya Chaemsaithong ◽  
Yi Man Wah ◽  
Shuk Yi Annie Hui ◽  
...  
Keyword(s):  
Growth Factor ◽  
Test Performance ◽  
Trisomy 21 ◽  
Detection Rate ◽  
False Positive Rate ◽  
First Trimester ◽  
Placental Growth Factor ◽  
Singleton Pregnancy ◽  
Combined Test ◽  
Positive Rate

Objectives: To assess whether adding placental growth factor (PlGF) or replacing pregnancy-associated plasma protein-A (PAPP-A) improves the first trimester combined test performance for trisomy 21. Design: Prospective observation Cohort Setting: The Chinese University of Hong Kong, China Sample: 11,518 women having a singleton pregnancy screened for trisomy 21 between December 2016 and December 2019 using the first trimester combined test. Methods: PlGF was prospectively measured and estimated term risk for trisomy 21 was calculated by 1) replacing PAPP-A with PlGF and 2) adding PlGF to the combined test which includes nuchal translucency, PAPP-A and free β-human chorionic gonadotropin (hCG). Main Outcome Measure: Screening performance, area under curve (AUC), detection rate (DR), screen positive rate (SPR) and false positive rate (FPR) Results: 29 women had trisomy 21. The combined tests DR, FPR and SPR were 89.7%, 5.7% and 6% respectively. DR when replacing PAPP-A or adding PlGF to the combined test remained unchanged. Replacing PAPP-A by PlGF increased FPR and SPR to 6.2% and 6.4% respectively. Adding PlGF to the combined test gave FPR and SPR rates of 5.5% and 5.7% respectively. Adding or replacing PlGF did not give a significant increase in AUC (p>0.48) over that of the combined test. Conclusion: Adding PlGF to the combined test or replacing PAPP-A with PlGF in the combined test did not improve trisomy 21 detection rate. Replacing PAPP-A by PlGF increased SPR, whilst adding PlGF resulted in only a marginal reduction in SPR.

P-029. Role of Placental growth factor for prediction of preeclampsia in first trimester of pregnancy

2021 ◽  
Vol 25 ◽  
pp. e38
Author(s):  
Manju Lata Verma ◽  
Uma Singh ◽  
Vandana Solanki ◽  
Rekha Sachan ◽  
Pushp L Sankhwar
Keyword(s):  
Growth Factor ◽  
First Trimester ◽  
Placental Growth Factor ◽  
First Trimester Of Pregnancy

Hyperglycosylated chorionic gonadotropin – prognostic criteria development of complications of pregnancy

2017 ◽  
pp. 82-85
Author(s):  
N.V. Pehnyo ◽  
Keyword(s):  
Pregnant Women ◽  
Chorionic Gonadotropin ◽  
Human Chorionic Gonadotropin ◽  
Prognostic Significance ◽  
Neonatal Morbidity ◽  
First Trimester ◽  
Trophoblast Invasion ◽  
Placental Dysfunction ◽  
Hyperglycosylated Human Chorionic Gonadotropin ◽  
First Trimester Of Pregnancy

The objective: to assess the prognostic significance of the level of serum hyperglycosylated human chorionic gonadotropin (gHCG) reative to the development of pregnancy complications that lead to impaired fetal conditions. Materials and methods. 382 pregnant women were examined who were on the register, were hospitalized in case of complications of pregnancy and gave birth to KCMH №2 (Kiev). All pregnant women were evaluated serum gCGG in the period of 8-10 weeks gestation, evaluated the course and result of pregnancy. Results. Reduction in the level of gHCG is a marker of insufficient trophoblast invasion, which is likely to lead to the formation of placental dysfunction and the development of a variety of obstetric pathology complicating the course of pregnancy and a risk factor for antenatal loss and neonatal morbidity. The conclusion. Determination of the level of hyperglycosylated human chorionic gonadotropin in the first trimester of pregnancy will make it possible to identify pregnant women at risk for the formation of placental dysfunction and propose a set of monitoring activities aimed at early detection of violations of pregnancy and their timely removal. This helps prevent the formation of severe pathological conditions during pregnancy in both the mother and the fetus, which corresponds to the current trends in the development of medical care, namely: prediction, prevention and individual approach. Key words: hyperglycosylated chorionic gonadotrophin, complications of pregnancy, disturbed fetal condition.

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