HEALTH OF WOMAN. 2019.1(137):78–81; doi 10.15574/HW.2019.137.78

Govseev D. O.
Shupyk National Medical Academy of Postgraduate Education, Kiev
Clinical Maternity Building № 5, Kyiv

The objective: to develop technique of forecasting of preeclampsia at women with endothelial dysfunction.

Materials and methods. We conducted complex examination of 90 pregnant women who were divided into three groups. The control (1) group was made by 30 patients without endothelial dysfunction with the uncomplicated course of pregnancy and labors. The 2nd group – pregnant women with the early endothelial dysfunction (n=30) which pregnancy proceeded without clinical symptoms of preeclampsia at which mild disturbances in hemodynamic system a mother-placenta-fetus were taped. The 3rd group (main) – pregnant women with early endothelial dysfunction (n=30), with clinical implications of preeclampsia, pregnancy proceeded with disturbances in maternal and fetus hemodynamic, ended with the birth of children with hypoxia signs. To all pregnant women on terms (6–8, 18–21, 28–31, 35–37, 38–41 weeks) conducted obstetric and clinical-laboratory research, ehografical, dopplerometrical research, an echocardiography and research of endothelial function.

Results. At pregnant women with preeclampsia against initial endothelial dysfunction were traced more expressed disturbances of reaction of vascular wall on compression in comparison with control group. From early durations of gestation disturbances of function of an endothelium mild and moderate severity were shown. Harbingers of development of preeclampsia are inadequate reaction of vascular wall to carrying out assay about an endothelium dependent vazodilatation in dynamics of pregnancy at which there is an augmentation of diameter of humeral artery less, than for 15% and insignificant augmentation of peak systolic rate of blood flow. Change of function of an endothelium in group with the developed preeclampsia on the term of the second wave of an invasion of trophoblast was less than 4%. In groups with uncomplicated pregnancy change of function of an endothelium in the first half of pregnancy was more than 4%. At the complicated course of pregnancy during the second and third trimester the gain of diameter of humeral artery progressively decreased, and before labors pathological reaction of an endothelium was observed, and at patients of control group activization of endothelial function throughout pregnancy became perceptible.

Conclusion. On the basis of the obtained data the way of forecasting of development of preeclampsia was developed.

Key words: preeclampsia, endothelial dysfunction, forecasting.

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