PREDICTORS OF PRE-ECLAMPSIA IN PREGNANT WOMEN WITH HYPERTENSIVE SYNDROME

Abstract

Background. Pre-eclampsia is a frequent and serious complication of pregnancy associated with arterial hypertension (HTN). The underlying mechanisms remain unclear. At present time, reliable early predictors are lacking, as well as the precise criteria to assess the safety and effectiveness of its treatment and prevention are absent. the aim of the study was to identify additional predictors of pre-eclampsia of pregnant women with high blood pressure (BP). design and methods. The study included 223 pregnant women. Among them 63 (28.3 %) pregnant women had HTN: in 31 (49.2 %) pregnant women chronic HTN was diagnosed, and 32 (50.8 %) had gestational HTN. Women with secondary and non-classified HTN were not included. Depending on the presence of BP elevation, pregnant women with pre-eclampsia were retrospectively divided into two groups. The first group included 50 pregnant patients with HTN without signs of pre-eclampsia, and the second group was formed by 13 hypertensive women who reported pre-eclampsia symptoms during pregnancy. results. Dynamics of office BP throughout pregnancy did not differ between groups. The higher risk of pre-eclampsia at 30 weeks correlated with more pronounced morning BP surge, higher average pulse BP, SBP time index in the morning, BP variability at night, and high frequency of DBP “non-dipping” profile. Left ventricular diastolic dysfunction and reduced glomerular filtration rate (CKD-EPI) in the third trimester of pregnancy associated with HTN correlated with increased frequency of pre-eclampsia. In the first and third trimesters of pregnancy, cystatin C level was higher (p = 0.01; p = 0.005, respectively), and the levels of matrix metalloproteinase (MMP) –2 (p 0.001; p < 0.001) and MMP-9 (p < 0.001; p = 0.002) were lower in women with pre-eclampsia. conclusions. Increased concentrations of cystatin C and reduction of MMP-2 and –9 in the early stages of pregnancy in women with HTN can be considered as early predictors of risk of pre-eclampsia.