Fetal growth retardation and hemorheological predictors of oxygen delivery in hypertensive vs normotensive pregnant women

2019 ◽  
Vol 71 (4) ◽  
pp. 387-396
Author(s):  
Jean-Frédéric Brun ◽  
Emmanuelle Varlet-Marie ◽  
Pierre Boulot ◽  
Bénédicte Marion ◽  
Céline Roques ◽  
...  
2022 ◽  
Vol 15 (6) ◽  
pp. 695-704
Author(s):  
E. A. Orudzhova

Aim: to study the role of antiphospholipid antibodies (AРA) and genetic thrombophilia as a potential cause of the development or a component in the pathogenesis of early and late fetal growth retardation (FGR).Materials and Methods. There was conducted a prospective randomized controlled trial with 118 women enrolled. The main group consisted of 83 patients, whose pregnancy was complicated by FGR degrees II and III, stratified into two groups: group 1 – 36 pregnant women with early FGR, group 2 – 47 pregnant women with late FGR. Women were subdivided into subgroups according to the FGR severity. The control group consisted of 35 pregnant women with a physiological course of pregnancy. АРА were determined according to the Sydney antiphospholipid syndrome criteria by enzyme immunoassay (ELISA): against cardiolipin, β2 -glycoprotein 1, annexin V, prothrombin, etc. (IgG/IgM isotypes); lupus anticoagulant – by the three-stage method with Russell's viper venom; antithrombin III and protein C levels – by chromogenic method; prothrombin gene polymorphisms G20210A and factor V Leiden – by polymerase chain reaction; homocysteine level – by ELISA.Results. AРA circulation (medium and high titers), genetic thrombophilic defects and/or hyperhomocysteinemia were detected in 40 (48.2 %) patients with FGR, which was significantly higher than that in the control group (p < 0.05): in group 1 (41.7 % of women) AРA (30.6 %) and AРA with genetic thrombophilia or hyperhomocysteinemia (11.1 %) were revealed; in group 2 (51.1 % of women) AРA (21.3 %), AРA with hyperhomocysteinemia (4.3 %), genetic thrombophilia (25.5 %), and due to hyperhomocysteinemia (2.1 %) were found. No differences in prevalence of thrombophilia rate in patients were observed related to FGR severity, but a correlation between the FGR severity and AРA titers was found.Conclusion. Testing for the presence of AРA, genetic thrombophilia and hyperhomocysteinemia should be recommended for patients with FGR (including those with FGR in medical history), especially in the case of its early onset. It is recommended to determine the full AРA spectrum.


GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 330-334
Author(s):  
Oleg V. Golovchenko ◽  
Irina V. Ponomarenko ◽  
Mikhail I. Churnosov

Aim. To assess the relationship of rs5918 ITGB3, rs1126643 ITGA2 and rs5985 F13A1 polymorphic loci with the risk for preeclampsia (PE) in pregnant women with fetal growth retardation (FGR). Materials and methods. The study included 272 pregnant women, of which 76 had a combination of PE and FGR and 196 had FGR. In the studied groups, genetic testing was carried out for three polymorphic loci of candidate genes for hereditary thrombophilia (rs5918 ITGB3, rs1126643 ITGA2, and rs5985 F13A1). Results. The rs5918 genetic variant in the ITGB3 gene is associated with the development of PE in pregnant women with FGR: C allele of rs5918 ITGB3 increases the risk for this complication of pregnancy by 1,8 times (OR 1.761.77, p0.036, pperm0.038). The rs5918 polymorphism determines an increase in the affinity of DNA motifs for seven transcription factors (BDP1, ELF1, IRF, NRSF, Pax-5, Sp1, and Zfx), is a missense mutation and causes the Leu59Pro amino acid substitution in the 3 subunit of integrin, is multidirectionally associated with the expression of five genes (EFCAB13, TBKBP1, NPEPPS, MRPL45P2, THCAT158) and alternative splicing of two genes (EFCAB13, MRPL45P2), is located in the region of functionally important DNA regions (promoters and enhancers) in cell cultures and organs which are pathogenetically important for the formation of PE and FGR. Conclusion. The rs5918 polymorphism in the ITGB3 gene increases the risk for PE in pregnant women with FGR.


2020 ◽  
pp. 50-53
Author(s):  
Kh. Alirzayeva ◽  

The objective: to determine the risk factors for the development of ESRD in pregnant women with preeclampsia and anemia. Materials and methods. 97 pregnant women with preeclampsia with iron-deficiency anemia were monitored. The first group included 46 pregnant women with diagnosed ZRD, the second group-51 pregnant women who gave birth to children with normal body weight. Criteria of FGR is to reduce body weight and length of newborn at birth (less than 10 percentile of assessment tables in comparison with due to gestational age), morphological maturity index (a lag of 2 weeks or more from the true gestational age), disproportionate body, the signs of malnutrition and trophic disorders of the skin and mucous membranes. Results. A step-by-step elimination of the factors that contributed the least to the development of ARI in a combination of preeclampsia and anemia was performed. The results of multivariate analysis showed that in General, the following factors had the strongest influence on the development of RR in preeclampsia and anemia: arterial hypertension (RR= 2.055 [95% CI 1.31-3.20]), overweight/obesity (RR=1.646 [95% CI 1.03-2.62]), anemia in the anamnesis (RR=2.591[95% CI 1.56-4.28]),complicated labor in the anamnesis (RR=1.886 [95% CI 1.29-2.74]), habitual miscarriage (RR=1.850 [95% CI 1.21-2.82]), a history of preeclampsia (RR= 1.922 [95% CI 1.31-2.80]), a history of RR (RR=3.502 [CI 2.37-5.16]). Conclusions. The most significant clinical and anamnestic risk factors for the development of RRT are: arterial hypertension, overweight/obesity, anemia in the anamnesis, pre-eclampsia in the anamnesis, complicated labor in the anamnesis, habitual miscarriage, RRT in the anamnesis. Keywords: pregnancy, preeclampsia, anemia, fetal growth retardation, risk factors.


2011 ◽  
Vol 17 (4) ◽  
pp. 379-383
Author(s):  
V. S. Chulkov ◽  
N. K. Vereina ◽  
S. P. Sinitsin

Objective. To investigate homocysteine ​​levels in pregnant women with chronic hypertension in different terms of pregnancy, and to evaluate the prognostic significance of hyperhomocysteinemia in the development of preeclampsia, placental insufficiency syndrome and fetal growth retardation. Design and methods. It is a cohort prospective study. Pregnant women were divided into 2 groups: group 1 was formed by women with chronic hypertension (n = 80), group 2 consisted of 40 women without hypertension. Results. Pregnant women with chronic hypertension had higher homocysteine ​​levels throughout the pregnancy compared to those without hypertension. Homocysteine ​​level was higher in pregnancy complicated by preeclampsia, placental insufficiency and fetal growth retardation syndrome. Conclusion. Homocysteine ​​levels above 5,8 mmol/l in the III trimester of pregnancy may be used as a prognostic risk factor for preeclampsia development.


1987 ◽  
Vol 45 (6) ◽  
pp. 845-850 ◽  
Author(s):  
P.Y. Scarabin ◽  
C. Bonithon-Kopp ◽  
L. Bara ◽  
M. Samama ◽  
P. Blot

2019 ◽  
Vol 100 (3) ◽  
pp. 426-433 ◽  
Author(s):  
S D Mayanskaya ◽  
A V Ganeeva ◽  
R I Gabidullina

Aim. To assess the short-term and long-term variability of blood pressure in women, starting from early pregnancy, to predict the development of complications of gestation, including preeclempsia. Methods. In 131 pregnant women, systolic blood pressure, diastolic blood pressure, as well as short-term (intra-visit) and long-term (inter-visit) blood pressure variability were assessed during the gestation period and 6 weeks after delivery. At the end of gestation period, depending on the identified complications, all study participants were divided into four groups: group 1 - control (healthy); group 2 - pregnant with preeclempsia; group 3 - with placental insufficiency; group 4 - with chronic arterial hypertension. In patients with placental insufficiency the indices of fetal growth retardation were also analyzed. Results. In group 4, starting from the second trimester, higher values of short-term blood pressure variability were demonstrated, which increased as pregnancy progressed. Long-term blood pressure variability increased in groups 2 and 4, starting from the second trimester. In pregnant women with fetal growth retardation in the first trimester, blood pressure variability was higher than in pregnant controls and in the second trimester it was higher than in the group with the subsequent development of preeclempsia. Thus, during pregnancy complicated by preeclempsia or placental insufficiency with fetal growth retardation, high long-term blood pressure variability was observed. At the same time, the highest values were observed in the third trimester. Conclusion. The assessment of long-term blood pressure variability from the early gestation seems to be an effective tool for detecting preclinical changes in the body of a pregnant woman, preceding the development of preeclempsia and fetal growth retardation, and in the presence of risk factors of preeclampsia allows narrowing the group of patients for target follow-up and prevention.


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