HEALTH OF WOMAN. 2016.9(115):47–51

Endothelial dysfunction as a marker of placental insufficiency

Melnik Y. N., Zhuk S. I., Atamanchuk I. N.

Kyiv city center of reproductive and perinatal medicine

National medical Academy of postgraduate education P. L. Shupyk, Kyiv

Clinic of genetics and reproduction «Victoriya», Kyiv

The objective: studying of endothelial function and immunological status to identify and expand concepts of the regularities of the gestational process as in a
normal pregnancy, and in pathological.

Patients and methods. To achieve this goal in 2013-2015 was conducted a comprehensive survey of 334 pregnant women, which depending on the peculiarities of pregnancy and childbirth were divided into groups.

The control group (CG) comprised of 236 pregnant women with uncomplicated gestational period and birth without morphological signs of placental dysfunction in patients of the main group (MG) – 98 patients with complicated pregnancy, which was revealed violations of the fetal-placental relationship.

Depending on options of course of gestation period pregnant MG were divided into subgroups: subgroup 1 (SG1) is 31 pregnant with signs of pre-eclampsia of varying severity; subgroup 2 (SG2) – 33 pregnant women with clinical and morphological signs of placental dysfunction subgroup 3 (SG3) – 34 pregnant women with threatened miscarriage and premature birth.

Results. T was found that women with disorders of fetal-placental blood flow, there are changes in the vasomotor function of endothelium with a significant increase in the level of endothelin-1 and decreased synthesis of prostacyclin. It is proved that in the presence of placental dysfunction in pregnant women is a violation of proliferative endothelial function with an imbalance of growth factors – reduced level of vascular endothelial growth factor and placenta growth factor with increased concentrations of tumor necrosis factor. In placental insufficiency weremarked changes of aggregation, coagulation and fibrinolytic functions of the endothelium with increased levels of ADP-induced aggregation, prolongation of activated partial thromboplastin time and prothrombin index, increased fibrinogen content, an index of fibrinolytic activity and concentration of the molecular marker of thrombophilia – D-dimer. Pregnant women with placental dysfunction also have an imbalance of cytokine profile in the form of an increase in the concentration of proinflammatory interleukin-1b and lower anti-inflammatory interleukin-3.

Conclusion. So, in this study were stated a number of parameters that reflect the links of endothelial dysfunction and can be used as markers of placental insufficiency.

Key words: endothelial dysfunction, placental insufficiency, endothelin-1, prostacyclin, growth factor, interleukin.

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