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

Abstract

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.