• Role of vascular regulation disturbances in the occurrence perinatal complications in high-risk pregnancies 

Role of vascular regulation disturbances in the occurrence perinatal complications in high-risk pregnancies 

 

PERINATOLOGIYA I PEDIATRIYA.2016.1(65):33-36;doi 10.15574/PP.2016.65.33 
 

Role of vascular regulation disturbances in the occurrence perinatal complications in high-risk pregnancies 
 

Kaminsky V. V., Kolomiychenko T. V., Boychuk O. G., Yarotskaya Yu. O., Korniyenko S. M.

P.L. Shupik National Medical Academy of Postgraduate Education, Kyiv, Ukraine

O.O. Bogomolets National Medical University, Kyiv, Ukraine

SI «Institute of pediatrics, obstetrics and gynecology NAMS of Ukraine», Kyiv 
 

Purpose — to establish the role of disorders of vascular regulation in the occurrence of perinatal complications in pregnant women at high risk. 
 

Patients and methods. The study included 50 pregnant women after ART with hepatobiliary disorders (study group) and 50 pregnant women after ART without such disorders (control group) and 50 somatically healthy women with non"induced pregnancy (control group) at 14–16 weeks of gestation. The content of L-arginine in the blood was determined by the photometric method, which was based on the L-naphthol with gipobromidnim reagent reaction. Homocysteine was determined by the enzymatic cycling reaction using a set Diasyis (Germany) using the analyzer «Respons 920» (Germany) in the manufacturer's procedure. For the quantitative determination of human placental growth factor (PLGF) in samples of blood plasma used immunochemical electro-chemistry fluorescent detection method (ECLIA). 
 

Results. To determine the role of vascular homeostasis disorders regulation in the event of pregnancy complications in liver disorders in the study group allocated 2 groups: 1st — 19 women with essential obstetric and perinatal disorders (abortions and missed abortion, preeclampsia, severe, decompensated fetal distress), 2nd — 31 women without such disorders. It was found that pregnancy after ART programs held for particularly severe complications in women with hepatobiliary pathology, who already at the beginning of pregnancy, the formation and development of the placenta takes place under conditions of endothelial dysfunction (reduction of L-arginine to 39.8±2.0 versus 45.8±1.6 mmol/l in women without significant violations of gestation, p<0.05), the negative impact of homocysteine (an increase to 7.4±0.44 versus 6.4±0.36 mmol/l, p<0.05), violations of angiogenesis (PlGF decrease in blood to 70.5±11.9 versus 103.7±9.8 pg/ml, p<0.05). Consequently, these factors may be early prognostic markers of severe obstetric and perinatal disorders during induced pregnancy in women with hepatobiliary disorders. 
 

Conclusions. In the context of homeostatic imbalance in this group of women violation of the endothelium and vascular regulation factors underlie the pathogenesis of reproductive, obstetric and perinatal complications, which is the theoretical precondition for the development of a pathogenetic substantiation of complex prevention and treatment of complications, aimed at correcting the violations. 
 

Key words: pregnancy, ART, liver, obstetric complications, endothelium. 
 

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