THE ROLE OF E-SELECTIVE IN THE DEVELOPMENT OF PREVENTION OF MISCARRIAGE

Abstract

Introduction. The article presents the results of enzyme-linked immunosorbent assay of E-selectinin blood serum of pregnant women with physiological pregnancy and miscarriage.Miscarriage, especially in the early stages, continues to be a topical both medical and socio-demographic problem. Reducing the healthy potential of the population leads to an increase in the percentage of women whose pregnancy goes through complications or is generally interrupted prematurely.According to many scientists, the success in solving the problem of the early perinatal loss lies in a deeper study of the etiopathogenesis of this problem. Therefore, the priority is to search for markers that will detect pre-clinical forms of the threat of abortion, which will allow prolongation of pregnancy and reduce perinatal losses.At the present stage, the theory of endothelial dysfunction and its role in the development and pathogenesis of obstetric complications is of great importance intending to clarify the anatomical and functional disorders of the reproductive system.Objective. To determine the role of E-selectin in the development of miscarriage.Materials and methods. In order to study E-selectin in women with miscarriage 153 pregnant women with the physiological course and miscarriage have been examined, who were registered in the Women's consultation №1, Chernivtsi, and were in inpatient treatment at the gynecological department of MHCF "City clinical maternity hospital №1". They have been divided into three groups, 30 women were with uncomplicated pregnancy for 6-12 weeks (Group I - Control), 60 women were with the threat of miscarriage (Group II), 34 women were with spontaneous abortion (Group III) and 29 women were with a blighted ovum (Group IV).The average age of the examined women was 18-45 years. Artificial abortions and reproductive loss occurred in the history of most patients. Gynecological and extragenital diseases in the acute and subacute stages were absent in patients of all groups. Pregnant women with antiphospholipid syndrome have not been included in the study.E-selectin has been determined by the method of immunoassay analysis using a test system manufactured by the company Diaclone (France). The human CD62E ELISA kit is designed to quantify the "in vitro" soluble adhesive molecule of endothelial leukocytes ELAM-1 (CD62E) in plasma, human serum, buffer solution, or cell culture. It defines both natural and recombinant CD62E.Results. The conducted research showed that in women at 6-12 weeks of uncomplicated pregnancy, the level of E-selectin was 69.04 ± 4.30 μg/l, and with the threat of abortion, it dropped to 52.43 ± 3.91 μg/l. In case of spontaneous abortion, this index was characterized by a tendency to further decrease – 43.06 ± 5.95 μg/l, and in the case of blighted ovum – up to 47.14 ± 6.04 μg/l. Analysis of the level of E-selectin within the II, III and IV groups of the studied women has not revealed a significant difference.Taking into account the important role of E-selectin in the processes of trophoblast invasion, the development of chorion, its vascular system, it can be assumed that the reduction of its level in the blood of pregnant women indicates the development of endothelial dysfunction in women with a pathology of pregnancy.Conclusions. Studies have shown that women with a risk of miscarriage, with spontaneous abortion and non-developing pregnancy, tend to decrease the concentration of E-selectin compared with the indicators in physiological pregnancy. Since the above reduction of this indicator is a reflection of endothelium work, it can be considered that one of the reasons for not pregnancy in the examined women was endothelial dysfunction.