Роль генетических факторов в развитии гнойно-септических осложнений в акушерстве

Abstract

The purpose to study the role of polymorphisms of endothelial nitric oxide synthase (eNOS3 G894T), transforming growth factor beta TGF-β (CA rs1800470) and plasminogen activator inhibitor (SERPINE-1 5G (-675)4G) in full-term pregnant women in the development of purulent-septic complications after cesarean section in the lower uterine segment. Material and methods. The authors analyzed obstetric complications after cesarean section in the lower uterine segment. Prospectively, 81 maternity patients after single-fetus delivery by caesarean section in the lower uterine segment were monitored and treated for emergency indications in order to diagnose purulent-septic complications and perform genetic analysis. The Statistica 10.0 and Eviews 12.0 software packages were used for statistical processing of the obtained results. Results. A direct correlation was established between the presence of a homozygous mutation of the transforming growth factor-β1 gene (TGF-β (CA rs1800470)), as well as the presence of a homozygous mutation of the endothelial nitric oxide synthase eNOS3 (G894T) gene, with significant risk factors for purulent-septic complications after cesarean section in full-term pregnancy: obesity 3-grade II (rs = 0.467, p < 0.001; rs = 0.461, p = 0.005) and pathological overall weight gain during pregnancy (rs = 0.660, p < 0.001; rs = 0.385, p = 0.024). Conclusion. The genetic study data allow concluding that homozygous polymorphisms of the studied genes of transforming growth factor-β1 (TGF-β (CA rs1800470)) and endothelial nitric oxide synthase eNOS3 (G894T) are associated both with the presence of purulent-septic diseases in the postpartum period after cesarean section in the lower uterine segment, and with metabolic disorders such as obesity of the 3rd degree and pathological overall weight gain during pregnancy. It is the combination of these factors that significantly increases the risks of obstetric purulent-septic complications in women with this genotype.