Эндотоксикоз и плацентарная дисфункция при остром пиелонефрите у беременных

Abstract

Objective. To assess the impact of endotoxicosis in pregnant women with acute pyelonephritis (AP) on the function of the utero-placental-fetal complex and gestational outcomes. Patients and methods. This study included 37 pregnant women with AP (Group 1) and 35 women with uncomplicated pregnancy (Group 2). Patients have undergone Doppler ultrasonography. In addition to that, we measured leukocyte intoxication index, total endotoxin, pregnancy-specific beta-1-glycoprotein (PSBG-1), and placental alpha microglobulin-1 (PAMG-1) in serum using enzyme-linked immunosorbent assay (ELISA). Results. AP during pregnancy led to placental dysfunction with desynchronization of pregnancy protein synthesis, endotoxicosis, and changes in hemodynamics in the uterine arteries, which, in case of standard treatment, increased the frequency of placental premature aging (43.2%), amniotic fluid disorders (32.4%), fetal growth retardation (27.8%), gestational hypertension (40.5%), preeclampsia (37.8%), preterm birth (27.8%), and caesarean section (32.4%). We found a correlation between the uterine artery resistance index and the level of endotoxicosis markers, as well as PSBG-1 and PAMG-1 levels. Conclusion. Our findings suggest the need for further studies in this area in order to develop a complex of therapeutic measures to increase the number of successful pregnancy outcomes after AP. Key words: pregnancy, acute pyelonephritis, placental dysfunction, endotoxicosis