scholarly journals The Role of Inflammation in the Pathogenesis of Preeclampsia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Michał Michalczyk ◽  
Aleksander Celewicz ◽  
Marta Celewicz ◽  
Paula Woźniakowska-Gondek ◽  
Rafał Rzepka
Keyword(s):  
Arterial Hypertension ◽  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Underlying Mechanism ◽  
Perinatal Morbidity ◽  
Intrauterine Growth ◽  
Antiangiogenic Factors ◽  
Significant Factors

Preeclampsia (PE) affects 5-8% of pregnant women, and it is the major cause of perinatal morbidity and mortality. It is defined as arterial hypertension in women after 20 weeks of gestation which cooccurs with proteinuria (300 mg/d) or as arterial hypertension which is accompanied by one of the following: renal failure, liver dysfunction, hematological or neurological abnormalities, intrauterine growth restriction, or uteroplacental insufficiency. Currently, pathophysiology of preeclampsia poses a considerable challenge for perinatology. Preeclampsia is characterized by excessive and progressive activation of the immune system along with an increase in proinflammatory cytokines and antiangiogenic factors in fetoplacental unit as well as in vascular endothelium in pregnant women. A single, major underlying mechanism of preeclampsia is yet to be identified. This paper discusses the current understanding of the mechanisms which underlie the development of the condition. Some significant factors responsible for PE development include oxidative stress, abnormal concentration and activity in mononuclear phagocytic system, altered levels of angiogenic and antiangiogenic factors, and impaired inflammatory response triggered by inflammasomes. Detailed understanding of pathophysiology of inflammatory process in PE can largely contribute to new, targeted anti-inflammatory therapies that may improve perinatal outcomes in PE patients.

scholarly journals Maternal and perinatal outcomes of hyperthyroidsm in pregnancy at Dr. Cipto Mangunkusumo Hospital, Jakarta, period of January 2015 - December 2016

2021 ◽  
Vol 29 (1) ◽  
pp. 36
Author(s):  
Fita Maulina ◽  
M Adya F F Dilmy ◽  
Ali Sungkar
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Intrauterine Growth Restriction ◽  
Fetal Death ◽  
Perinatal Outcomes ◽  
Growth Restriction ◽  
Intrauterine Fetal Death ◽  
Adequate Treatment ◽  
Intrauterine Growth ◽  
In Pregnancy

Objectives: To report maternal and perinatal outcomes of hyperthyroidsm in pregnancy.Case Report: There were 3622 cases of delivering pregnant women during the period of the study. From this number, the prevalence of pregnant women with hyperthyroid was 0.2 %. We reported 9 cases of hyperthyroid in pregnancy. The number of pregnancy complication and outcome on pregnant women with hyperthyroidism were preterm labor (44%) and preeclampsia (22%), both were found in group of mother who did taking antihyperthyroid therapy. In those who did not take antihyperthyroid therapy 11% had spontaneous abortion and 11% had preterm delivery. Fetal complications were intrauterine growth restriction (11%) and intrauterine fetal death (23%), both of these complication were on the group who did not take antihyperthyroid. On the contrary, 44% babies were born with normal birthweight in group who took antihyperthyroid.Conclusion: There were differences noted between the group that took adequate treatment and the group that did not take antihyperthyroid. The incidence of intrauterine growth restriction and intrauterine fetal death were high in group that did not took antihyperthyroid therapy but the incidence of preterm delivery as the maternal complication was high in group that did take the antihyperthyroid therapy.  

Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction

2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen
Keyword(s):  
Pregnant Women ◽  
Shear Wave ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Shear Wave Elastography ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
The Mean ◽  
Adverse Perinatal Outcomes ◽  
Doppler Indices

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.

scholarly journals Hyperhomocysteinemia, C-677T polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene, and chronic arterial hypertension in pregnant women

2012 ◽  
Vol 11 (1) ◽  
pp. 41-44
Author(s):  
V. S. Chulkov ◽  
N. K. Vereina ◽  
S. P. Sinitsyn
Keyword(s):  
Arterial Hypertension ◽  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Methylenetetrahydrofolate Reductase ◽  
Mthfr Gene ◽  
Intrauterine Growth ◽  
Immunoenzymatic Method ◽  
Group I ◽  
Polymerase Chain ◽  
Complicated Pregnancy

Aim. To investigate the prevalence of C-677T polymorphism of methylenetetrahydrofolate reductase (MTHFR) gene and hyperhomocysteinemia (HHC) in pregnant women with chronic arterial hypertension (CAH). Material and methods. This prospective cohort study included two groups: Group I – pregnant women with CAH (n=80), and Group II – pregnant women without AH (n=40). In all participants, homocysteine (HC) levels were assessed using immunoenzymatic method, at 9-12 weeks, 22-24 weeks, and 30-32 weeks. Genotyping of the C-677T polymorphism of MTHFR gene was performed using polymerase chain reaction. Results. In pregnant women with CAH, HC levels were higher than in women without AH, throughout the pregnancy. Group I also demonstrated higher prevalence of T allele and T/C genotype. In pregnant women with HHC, relative risk (RR) of pre-eclampsia was 3,5 (95% CI 2,0-5,6), of chronic placental insufficiency - 1,2 (95% CI 0,9-1,6), and of intrauterine growth restriction syndrome - 6,4 (95% CI 3,1-13,3). Conclusion. HCC, as well as its combination with C-677T polymorphism of MTHRF gene, could be regarded as a biomarker of complicated pregnancy in women with CAH.

Influence of Arterial Hypertension on the Pregnancy in Women with RH-Negative Blood

2015 ◽  
Vol 22 (3) ◽  
pp. 56-62
Author(s):  
Тамазаева ◽  
Kh. Tamazaeva ◽  
Омаров ◽  
N.S. Omarov
Keyword(s):  
Arterial Hypertension ◽  
Pregnant Women ◽  
High Titer ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Threatened Premature Birth ◽  
Definition Of ◽  
D Antigen ◽  
Work Up

The purpose of the study was to assess the role of arterial hypertension (AH) in the development of immunization in women with Rh-negative blood to optimize perinatal outcomes. Subject and methods. A prospective comparatively study was conducted in 3 groups of pregnant women with Rh-negative blood. The 1-st group (n=148) was with hypertensive disease (HD), the 2-nd group (n=144) - with gestational arterial hypertension (GAH); the 3-rd group (n=110) - without somatic pathology. The immune-hematological studies included a definition of the partial D antigen using gel method. Results. It was definited that the pregnancy of these patients accompanied by the high frequency of early gestational toxicosis, threatened premature birth, preeclampsia, placental insufficiency as well as expressed changes immu-nological properties of blood, which are pathogenetic basis of fetal and neonatal rhesus hemolytic disease. Antibodies (AB) in the blood serum of patients with hypertension were detected in the first half of pregnancy (up to 20 weeks) in 1.2-1.4 times more often than in healthy women, high titer of AB rate in patients with HD was significantly higher compared to other groups. Disadvantageous combination of immunoglobulins subclasses Gl and G3 was found in the group of pregnant women with HD (11.4%) and GAH (10,8%), significantly less frequently (6,45%) in the control group. Conclusion. To improve maternal, fetal and neonatal gestation outcomes the authors justified the necessity of prenatal work-up and delivery of these women.

ROLE OF GESTATIONAL ENDOTHELIALOPATHY IN DEVELOPMENT OF INTRAUTERINE GROWTH RESTRICTION IN PREGNANT WOMEN WITH PLACENTAL DYSFUNCTION

2020 ◽  
pp. 33-37
Author(s):  
Iryna Borysivna Borzenko
Keyword(s):  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Comprehensive Evaluation ◽  
Growth Restriction ◽  
Predictive Diagnosis ◽  
Intrauterine Growth ◽  
Placental Dysfunction ◽  
Early Predictors ◽  
Endothelial Growth Factor

To determine the role of gestational endotheliopathy in development of intrauterine growth restriction in pregnant women with placental dysfunction and introduction of the methods for its predictive diagnosis, a retrospective analysis of 200 histories of pregnant women was performed and 70 women with gestational endotheliopathy, intrauterine growth restriction syndrome were examined. The study used ultrasonic, Doppler, biochemical, enzyme−linked immunosorbent, morphological and statistical methods. As a result of the carried out study, the changes in endothelium−dependent vasodilation of vessels, vascular−endothelial growth factor, thrombospondin, thrombomodulin, vascular and platelet−endothelial molecules of cell adhesion were determined, that indicated a crucial role of gestational endothelium in pathogenesis and can be used as early predictors of intrauterine growth restriction. Thus, the presented study, based on a comprehensive evaluation of the endothelial component in genesis of early placental dysfunction, showed that the presence of gestational endotheliopathy is an independent prognostic factor associated with adverse effects of pregnancy. In pregnant women with placental dysfunction there were revealed the disorders of vasoregulatory, atrombogenic functions, intercellular integration, changes in the parameters of uterine−placental−fetal hemodynamics, histomorphometric disorders, enabling to better understand the pathogenesis of various forms of placental dysfunction, to propose the ways to forecast the complications at early stages and to develop the optimal tactics of monitoring this category of patients. Key words: gestational endothelialopathy, placental dysfunction, intrauterine growth restriction.

scholarly journals Determining diagnostic markers of intrautering growth retardation in early pregnancy

2021 ◽  
Vol 1 ◽  
pp. 61-65
Author(s):  
Yu.P.  Vdovichenko ◽  
V.O.  Golyanovskyi
Keyword(s):  
Pregnant Women ◽  
Mean Platelet Volume ◽  
Intrauterine Growth Restriction ◽  
First Trimester ◽  
Growth Restriction ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Platelet Volume ◽  
Intrauterine Growth ◽  
First Trimester Of Pregnancy

Intrauterine growth restriction is the cause of significant increases in perinatal mortality, morbidity and problems in the development of newborns and infants. The leading place of this pathology is not accidental, because according to various authors, the frequency of perinatal loss associated with it is from 19 to 287‰ and more, the level of perinatal morbidity - from 58.7 to 88.0%.The objective: To determine certain serum and ultrasound markers during the first trimester of pregnancy and to improve the perinatal morbidity and mortality rate in women with intrauterine growth restriction. Materials and methods. A prospective study of pregnant women in the gestation period of 11 weeks 0 days – 13 weeks 6 days, which was to determine the level of plasma protein A associated with pregnancy (PAPP-A), mean platelet volume (MPV), and ultrasound placenta examination. Pregnant women were divided into 2 groups: the main group (n1-52) and the control group (n2-50). The study group consisted of women with a low PAPP-A level and changes in the mean platelet volume towards their increase. It is this group of women that is more sensitive, in our opinion, for the development of placental disorders and the occurrence of fetal growth retardation.Results. In this study, PAPP-А levels in 39 pregnant women were <0.5 MoM, and WTO levels in 36 cases were> 10 fl, which, according to the literature, can be used as markers of early prediction of ZRP.Ultrasound type of disorders of the first stage of trophoblast invasion is described as intra- and / or periplacental pathological areas, which can be considered the causes of placental insufficiency, which results in a risk of ZRP. According to the study, high specificity and sensitivity of Doppler parameters with the determination of indices (PI and IR) in the uterine arteries were established. Conclusions. The results of the study showed that performing a screening based on a detailed history and determining PAPP-A, MPV, and ultrasound examination at first trimester of pregnancy in women with the risk of IUGR allows for prophylactic treatment and monitoring of pregnancy and thus reduces neonatal morbidity and mortality.

Pathological features of the sequence in pregnant women with delayed fetal growth

2019 ◽  
pp. 50-54
Author(s):  
V.O. Golyanovskiy ◽  
◽  
Ye.O. Didyk ◽  
Keyword(s):  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Normal Development ◽  
Intrauterine Infection ◽  
Normal Pregnancy ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Infection And Inflammation

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.

The Role of the Anti-Angiogenic Factor Endostatin in Intrauterine Growth Restriction

2005 ◽  
Vol 12 (3) ◽  
pp. 195-197 ◽  
Author(s):  
Ariadne Malamitsi-Puchner ◽  
Theodora Boutsikou ◽  
Emmanuel Economou ◽  
Evangelos Makrakis ◽  
Zoe Iliodromiti ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Angiogenic Factor ◽  
Intrauterine Growth
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