PERINATOLOGIYA I PEDIATRIYA.2015.4(64):19-24; doi 10.15574/PP.2015.64.19 
 

Parameters of central hemodynamics in pregnant women with type 1 diabetes and preeclampsia: relationship with polymorphic variants of genes 
 

Grybanov A. V.

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

Municipal Perinatal Centre, Mykolaiv, Ukraine 
 

Objective. To compare output values of the central hemodynamics depending on the further development of appropriate forms of pre-eclampsia or its absence in the group of pregnant women with presiding diabetes type 1; On the base of obtained data to evaluate the predictive value of the relevant parameters in the prediction of preeclampsia development in the present population of patients; to establish the relationship between the relevant polymorphic variants of genes and changes in the central hemodynamics indices in the population of this women. 
 

Patients and methods. Overall 60 female patients with type 1 diabetes were investigated: pregnancy complicated with early (n=15) and late-onset (n=15) preeclampsia was reported in 30 subjects (the main study group); no complications were detected among the rest 30 patients (control group). Besides standard clinical investigation, parameters of central hemodynamics were estimated; also each patient underwent molecular genetic testing with detection of the

following polymorphic variants of genes: А1166С-AT2R1; C108T-PON1; Thr83Ala- and T138C-MGP; 4b/4a- and G894T-eNOS; as well as I/D-ACE. 
 

Results. It was established, that parameters of central hemodynamics registered in early pregnancy cannot be used as reliable prognostic markers to predict the risk of preeclampsia development in type 1 diabetic pregnant women. However, elevated values of cardiac index registered in the first trimester of pregnancy in combination with other markers and predictors may serve as an additional confirmation of high risk for early-onset preeclampsia development. DD genotype of the ACE gene insertion-deletion (I/D) polymorphism is associated with minimal values of stroke volume and stroke index, and 83Ala/Ala genotype of MGP gene Thr83Ala polymorphism — with minimal values of circulating blood volume (and, as a result, with more pronounced hypovolemia). 
 

Conclusions. Thus, the above-mentioned polymorphic variants of genes are involved in formation of pathogenic favorable profile of central hemodynamics, which, in its turn, may predispose to preeclampsia development. 
 

Key words: pregnancy, type 1 diabetes mellitus, early- and late-onset preeclampsia, central hemodynamics, gene polymorphism. 
 

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