Development Of Placental Dysfunction Research Articles

137. The influence of acute respiratory infection in pregnant women on the development of preeclampsia

Introduction In recent years, there has been an increase of the incidence of acute respiratory infections (ARI) in pregnant women, reaching 35.6%. There is conflicting evidence that ARI during gestation may increase the risk of placental dysfunction, preeclampsia and perinatal infections. eclampsia. Research material The course of pregnancy was analyzed in 232 women who had undergone ARI in different terms of pregnancy. According to the classification ICD-10, pregnant women were divided into two groups: ARI of the upper respiratory tract (URT) (n = 124) and acute respiratory infections of the lower respiratory tract (NDP) (n = 108). Results The study of the course of pregnancy in women who underwent ARI in the first trimester showed the development of placental dysfunction (ED) in 36.4% of women with ORI NDP and 30.6% of women with ARI VDP. Whereas, in women who underwent ARI in the II trimester PD development was observed in 1.9 and 2.5 times less than in women with ARI in the I trimester. The above results showed that the development of PD in women with ARI in 1 and 2 trimester was not dependent on the localization of the infectious process. Pre-eclampsia depended on the period in which he moved, ARI, i.e. from early development of PD . Thus, the most often severe preeclampsia was observed in the group with ARI in the first trimester. In the III trimester of women who have undergone ARI, pregnancy was complicated by the development of preeclampsia (10.8%). The interval between the ARI and the manifestation of symptoms of pre-eclampsia made up 9.46 ± 1.13 weeks. Conclusions the most typical gestational complications after ARI are: PD (22.4%), preeclampsia (10.8%). An increase in the frequency of PD in the early stages more than 2 times significantly increased the likelihood of PE in 1.8 times.

PERINATAL RISK FACTORS FOR HYPOXIC-ISCHEMIC ENCEPHALOPATHY IN PRETERM INFANTS

The article presents the results of an assessment of risk factors for the development of hypoxic-ischemic encephalopathy in premature newborns. We examined 75 pregnant women who gave 92 premature newborns, patients with hypoxic-ischemic encephalopathy (main group). The comparison group included 75 pregnant women, who gave birth to 82 preterm infants, did not have GIE symptoms. In pregnant women of the main group who gave birth to children with GIE, more accurate were such extragenital pathology as hypertension (9.3%), chronic pyelonephritis (18.6%), thyroid disease (12 0%), tuberculosis and HIV infection, trichomoniasis, chlamydia. Among the complications of pregnancy in both groups was a high percentage of the threat of termination of pregnancy in all trimesters. Placental dysfunction and fetal growth retardation were in every fifth pregnant woman in both groups. Complications of labor, such as preterm premature rupture of amniotic membranes (PPROM) was in 32% of women, placenta previa with bleeding (8%) and abruption of placenta (14 6%) were significantly more frequent in the main group. The urgent cesarean section was performed in 41.4% of cases in the main group, 2.5 times greater than in the comparison group. Pregnant of the main group significantly more often gave birth to children with extremely low body weight (up to 30 weeks of pregnancy), 2 times more likely to give birth to children at 32 weeks of gestation. Among the 92 children of the main group, the Apgar scores of 3 points were -5-5.4%, 4-5 points - 18-19.5%, 6 points-28-30.4%, 7 and higher - 41-44, 5%. One of four children had severe fetal distress at birth. In the comparison group, the Apgar scores of 4-5 points were only 9.7%, 6 points - 14.6%, the other 75.7% had a satisfactory condition at birth. Artificial ventilation was performed in 58-63.1% of the newborns in the main group and only 10% in the comparison groupThus, perinatal risk factors for hypoxic-ischemic encephalopathy in premature newborns are the factories that lead to the development of placental dysfunction, fetal growth retardation, antenatal fetal distress and premature birth. The most important factor in the development of GIE is gestation (up to 32 weeks gestation), placenta previa with bleeding and premature placental abruption in the given time.

Clinical-statistical analysis of pregnancy and labour in women with nodular goiter

The incidence of nodular goiter in pregnant women occupies one of the leading places and constitutes from 30 to 40%, which, in its turn, produces unfavourable effect on the health of mother and fetus. Objective: to study the course of pregnancy, labour and condition of newborns born to women with nodular goiter. Material and methods. Clinical-statistical analysis of the course of pregnancy, labour and condition of newborns born to 60 women with nodular goiter (the main group) was carried out. The control group included 20 healthy pregnant women. Results. The analysis of the course of pregnancy demonstrated that its complicated development was found in 48 (80%) women of the main group and 1 (5%) – in the control one. In the control group in 100% of cases the outcome of pregnancy was labour, and in the main group – in 54 (90%) women. In patients of the main group, complications in labor were significantly more frequent (p <0,05). The data of the cardiotocography, the biophysical profile of the fetus and doplerometry testified to the deterioration of the intrauterine fetus in the main group. It was found that the lower an average level of free thyroxin in mother’s organism is, the lower is the score of the fetal condition (р<0,05). Assessment of the results of ultrasound and histological examinations of placentas enables to consider thyroid pathology as a risk factor promoting the development of placental dysfunction. Conclusions. Pregnancy in women with nodular goiter is often complicated with a tendency to miscarriage against the ground of hormonal imbalance. Nodular goiter available is a risk factor promoting the development of placental dysfunction. Fetal condition is in direct dependence on the level of thyroid hormones in mother.

The Role of Pro- and Antioxidant Systems in the Development of Placental Dysfunction in Human Pregnancy

The pro-and antioxidant systems of the human placenta have been studied in its central and peripheral areas in the state of dysfunction. It has been shown that the intensity of free-radical oxidation (FRO) is 24% higher (p < 0.05) in mitochondria isolated from peripheral placental areas in the case of preterm termination of pregnancy than in placental mitochondria of women with normal pregnancy ending in delivery on due dates. The values of total antioxidant activity in mitochondria isolated from the central and peripheral areas of placentae of women with preterm labor exceeded 1.5-and 1.8-fold the respective values for the placental mitochondria of women with the normal duration of pregnancy. The rate of glutathione peroxidase activity in placental mitochondria of women with preterm labor was lower than in patients with normal duration of pregnancy terminated on due dates. Higher values of intensity of both the FRO processes and the active components of thiobarbituric acid (TBA) were recorded (higher by 42% and 62%, respectively) in the postmitochondrial fraction in the peripheral area of placentae of women with spontaneous termination of pregnancy, compared with the placentae of women with uncomplicated duration of pregnancy with labor on due date. No differences have been observed in the intensity of oxidative modification of placental proteins in both the periphery and the center in the placentae of women from the studied groups. The rate of glutathione peroxidase activity in the placenta of women with spontaneous termination of pregnancy was more than twice as high as the activity of this enzyme during the first trimester of normal pregnancy and remained high during the second and third trimesters. The activity of the enzyme did not depend on its localization (center or periphery) in placentae of women participating in the study. The values of glutathione transferase activity in the placentae increased in the course of normal pregnancy but remained at the level of the first trimester in the central and peripheral areas in the case of a miscarriage at different gestational terms. Our findings allow us to suggest that oxidative stress developing in placenta from its center to periphery plays a key role in the pathogenesis of placental dysfunction, mainly, due to the glutathione-dependent component of the placental antioxidant defense.

The developmental origins of placental function.

The placenta is the link between mother and fetus and its function is central to a successful pregnancy. The predominant theorywithin the literature is that the development of placental dysfunction is a result of abnormal trophoblast invasion early in pregnancy. Knowledge of the development of the early placenta and the establishment of the fetomaternal circulation assists in understanding the origins of placental dysfunction which manifest later in pregnancy. Perinatally, chronic placental dysfunction may result in a growth-restricted fetus, maternal problems such as gestational hypertension, pre-eclampsia, eclampsia and pregnancy complications such as placental abruption, preterm labour and delivery. In addition, the growth-restricted fetus and the mother are at an increased risk of a myriad of disorders later in life. The role of ultrasound in the assessment of first trimester pregnancy is evolving with the potential for value in the prediction of placental function in later pregnancy. This review will address two aims, first to describe the development of the placenta from fertilisation to 12weeks' gestation, correlating this with first trimester ultrasound findings. Second, to describe the link between placental development and function later in pregnancy. Understanding the link between early placental development and later placental function is essential in directing the focus of new research addressing the role of ultrasound in the first trimester in the prediction of adverse obstetric outcomes.

АЛЕЛЬНИЙ ПОЛІМОРФІЗМ ГЕНІВ GSTS У МАТЕРІВ ІЗ ПЛАЦЕНТАРНОЮ ДИСФУНКЦІЄЮ ТА ЇХ НОВОНАРОДЖЕНИХ: АКУШЕРСЬКІ ТА ПЕРИНАТАЛЬНІ НАСЛІДКИ

Роль плаценти зумовлена реалізацією ряду функціональних механізмів забезпечення росту і внутрішньоутробного розвитку плода. Глутатіон-S-трансферази беруть активну участь у знешкодженні продуктів пероксидного окиснення ліпідів та пероксидів ДНК, відновлюючи органічні гідроперекиси в спирти та сприяючи ізомеризації деяких стероїдів та простагландинів. При наявності певних поліморфних варіантів GSTT1, GSTM1, GSTP1 генів сімейства глутатіон-S-трансфераз проходить виснаження глутатіонзалежного АОЗ та пригнічення детоксикаційної функції плаценти.Мета дослідження – визначити алельний поліморфізм генів глутатіон-S-трансфераз GSTT1 та GSTM1 у жінок із плацентарною дисфункцією, в здорових новонароджених та новонароджених із затримкою внутрішньоутробного розвитку на основе проведеного молекулярно-генетичного дослідження пуповинної крові.Матеріли і методи. У дослідження було залучено 105 жінок: основну групу склали 33 жінки з плацетарною дисфункцією (ПД) без затримки внутрішньоутробного розвитку (ЗВУР) у дітей, яких вони народили (перша група), та 17 жінок із ПД та ЗВУР (друга група). Контрольну групу склали 55 жінок (третя група), які народили здорових доношених дітей.Результати досліджень та їх обговорення. Встановлено, що ризик розвитку ПД та ПД зі ЗВУР за домінантної моделі успадкування (313AG + 313GG порівняно з 313AA) достовірно зростав. Перспективними прогностичними моделями міжгенної взаємодії для оцінки розвитку ПД передбачається аналіз варіантів генів GSTM1, GSTP1, а ПД зі ЗВУР – GSTT1, GSTM1, GSTP1. У результаті аналізу проб сироватки пуповинної крові та отриманих даних встановлено, що частота поліморфного варіанта GSTМ1“+” у всіх новонароджених області склала 42,69 %, а GSTМ1 “–” – 57,30 %. Частота поліморфного варіанта GSTT1“+” у всіх новонароджених області становила 79,77 %, а GSTT1 “–” – 20,22 %.Висновки. Результати досліджень розподілу різних алельних варіантів генів GSTM1 і GSTT1 показали їх відмінності у різних групах новонароджених. Виявлено вірогідну різницю між частотами делеційного варіанта гена GSTM1 у здорових новонароджених та новонароджених із ЗВУР. Сукупний аналіз комбінованого впливу декількох чинників виявив, що перебіг вагітності у жінок із ПД, гестозом та генотипом GSTМ1deletion асоціюється із значним зростанням ризику ЗВУР у плодів.

DistURBANCE OF PEROXIDATION PROCESS AS A RISK FACTOR OF PERINATAL COMPLICATIONs

Determination of intensity of peroxidation process as index of the cellular membranes destruction and strength of antioxidant protection, as evidence of cellular adaptation may be used for assessment of the degree of compensatory adaptable derangement mechanisms, prediction of unfavorable consequences for mother and fetus in women, whose pregnancy was complicated by the development of placental dysfunction (PD). The analysis of the data obtained showed that the content of lipid hydroperoxides and malonic aldehyde is significantly increased in pregnant women with compensated PD. At the same time, the level of the restored glutathione didn’t increase indicating manifestation of antioxidant insufficiency of the organism. Decrease of glutathione content and glutathione-perozidase activity was marked in women with decompensated PD at the end of pregnancy in response to significant activation of lipid peroxidation. It is evidence of emaciation of the compensatory-adaptable mechanisms. The disturbances mentioned above result in disorders of the adaptation processes of the organism of mother and fetus.

ОЦІНКА ФУНКЦІЇ ЕНДОТЕЛІЮ СУДИННОЇ СТІНКИ У ВАГІТНИХ З HBV-ІНФЕКЦІЄЮ.

&lt;p&gt; Діагностика функціонування ендотелію судинної стінки у вагітних з HBV-інфекцією з метою профілактики розвитку плацентарної дисфункції є&lt;br /&gt;важливим етапом в обстеженні таких пацієнток. Доведена ефективність доповненої препаратами «Глутаргін» та «Артишоку екстракт» терапії у вагітних з вірусним гепатитом В для нормалізації показників ендотеліальної системи.&lt;br /&gt;&lt;br /&gt;&lt;/p&gt;

Morphologic and immune-histochemic peculiarities of placenta in its dysfunction in anemia of pregnancy.

Placental dysfunction occurs in 17-35% of pregnant women. Iron deficiency anemia complicating pregnancy and childbirth affects fetal development. In its turn, pregnancy contributes to the rapid progress of iron deficiency anemia. The aim of the study was to evaluate the morphological and immunohistochemical features of the placenta in its dysfunction in women with anemia during pregnancy. The study was performed on clinical bases of the Department of Obstetrics and Gynecology №1 of ONMedU (Odessa) and pathologic department of SI IPOG NAMSU (Kiev). The complex dynamic examination of pregnant women with subsequent examination of the placenta was performed. Patients were divided into 3 groups. 1 st group consisted of pregnant women with physiological pregnancy and childbirth (n=10), 2 nd group included women suffering from anemia during pregnancy (n=10); 3 rd group consisted of women with pregnancy accompanied with placental dysfunction and anemia (n=10). Organometric, macroscopic, general histological, micrometer, histochemical and immunohistochemical methods were used. It is shown that reduction of incidence of regeneration - proliferative marker Ki -67 in the nuclei of villous syncytial structure is more pronounced in the development of placental dysfunction against a background of anemia during pregnancy.