Акушерство и Гинекология Санкт-Петербурга. 2018; : 26-30
Ранние предикторы преэклампсии
Аннотация
Цель исследования. Определить ранние эффективные клинико-анамнестические и биохимические маркеры поздней преэклампсии. Материалы и методы. Комплексное обследование проходили 640 беременных. На основании ретроспективного клинического анализа были сформированы две группы: пациентки с поздней преэклампсией и беременные без преэклампсии. Результаты. Показано, что в случае ИМТ>30,5 кг/м2 и MAP>98 мм. рт. ст. в 11–13 недель гестации и при наличии в анамнезе хронической артериальной гипертензии и хронического пиелонефрита, а также преэклампсии в предыдущих беременностях, пациентку необходимо выделить в группу высокого риска развития поздней преэклампсии. При определении значения ретинолсвязывающего протеина 4 более 87,90 мкг/мл и дизинтегрина и металлопротеиназы 12 более 2,33 нг/мл необходимо своевременно (не позднее 34 недель) определить оптимальное место и срок родоразрешения. Заключение. Для подтверждения полученных данных необходимо большее количество исследований.
Список литературы
1. Хлестова Г.В., Карапетян А.О., Шакая М.Н., Романов А.Ю., Баев О.Р. Материнские и перинатальные исходы при ранней и поздней преэклампсии. Акушерство и гинекология. 2017; 6: 41–47. https://dx.doi.org/10.18565/aig.2017.6.41-7.
2. Акушерство: национальное руководство. Под ред. Г.М. Савельевой, Г.Т. Сухих, В.Н. Серова, В.Е. Радзинского. 2-е изд., перераб. и доп. М.: Издательство ГЭОТАР-Медиа; 2015.
3. O’Gorman N., Wright D., Syngelaki A., Akolekar R., Wright А., Poon L. et al. Competing risks model in screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks of gestation. Am J Obstet Gynecol. 2016; 214 (1): 1–12. doi: 10.1016/j.ajog.2015.08.034.
4. Лемешевская Т.В., Прибушеня О.В. Прогнозирование преэклампсии при проведении расширенного комбинированного пренатального скрининга первого триместра беременности. https://dx.doi.org/10.18565/aig.2017.12.52-59.
5. Henderson J., Thompson J., Burda B., Cantor A. Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2017; 317 (16): 1668–1683. doi: 10.1001/jama.2016.18315.
6. Tayyar A., Krithinakis K., Wright A., Wright D., Nicolaides K. Mean arterial pressure at 12, 22, 32 and 36 weeks’ gestation in screening for pre-eclampsia. Ultrasound in Obstetrics and Gynecoljgy. 2016; 47: 573–579. doi: 10.1002/uog.15815.
7. Ali S., Khalil R. Genetic, immune and vasoactive factors in the vascular dysfunction associated with hypertension in pregnancy. Expert Opin Ther Targets. 2015; 19: 1495–1515. doi: 10.1517/14728222.2015.1067684.
8. Timofeeva A., Gusar V., Kan N., Prozorovskaya K., Karapetyan A., Bayev O. et al. Identification of potential early biomarkers of preeclampsia. Placenta. 2018; 61: 61–71. doi: 10.1016/j.placenta.2017.11.011.
9. Iacobelli S., Bonsante F., Robillard P. Comparison of risk factors and perinatal outcomes in early onset and late onset preeclampsia: A cohort based study in Reunion Island. J. Reprod. Immunol. 2017; 123: 12–16. doi: 10.1016/j.jri.2017.08.005.
10. Wang C., Wang X., Yang H. Effect of maternal age on pregnancy outcomes in Beijing. Zhonghua Fu Chan Ke Za Zhi. 2017; 52 (8): 514–520. doi: 10.3760/cma.j.issn.0529-567X.2017.08.003.
11. Ananth C., Keyes K., Wapner R. Preeclampsia rates in the United States, 1980–2010: age-period-cohort analysis. BMJ. 2013; 347: f6564. doi: 10.1136/bmj.f6564.
12. Bartsch E., Medcalf K.E., Ray J.G. Clinical risk factors for preeclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 2016; (353): 753. doi: 10.1136/bmj.i1753.
13. Panaitescu A., Syngelaki A., Prodan N., Akolekar R., Nicolaides K. Chronic hypertension and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. 2017; 50 (2): 228–235. doi: 10.1002/uog.17554.
14. Gallo D., Wright D., Akolekar R., Poon L., Nicolaides K. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 19–24 weeks’ gestation. Am J Obstet Gynecol. 2016; 214 (5): 1–17. doi: 10.1016/j.ajog.2015.11.016.
15. Metcalfe A., Langlois S., Macfarlane J., Vallance H., Joseph K. Prediction of obstetrical risk using maternal serum markers and clinical risk factors. Prenat Diagn. 2013; 34 (2): 172–179. doi: 10.1002/pd.4281.
16. Salomon C., Yee S., Mitchell M., Rice G. The possible role of extravillous trophoblast-derived exosomes on the uterine spiral arterial remodeling under both normal and pathological conditions Biomed. Res. Int. 2014; 2014: 693157. doi: 10.1155/2014/693157.
17. Masoura S., Kalogiannidis I., Makedou K., Theodoridis T., Koiou K., Gerou S. et al. Biomarkers of endothelial dysfunction in preeclampsia and neonatal morbidity: a case-control study. Eur J Obstet Gynecol Reprod Biol. 2014; 175: 119–123. doi: 10.1016/j.ejogrb.2014.01.012.
18. Nanda S., Nikoletakis G., Markova D., Poon L.C, Nicolaides K. Maternal serum retinolbinding protein-4 at 11–13 weeks’ gestation in normal and pathological pregnancies. Metabolism. 2013; 626: 814–819. doi: 10.1016/j.metabol.2012.12.011.
19. Sung K., Roh A., Eoh K., Kim E. Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study. Obstet. Gynecol. Sci. 2017; 60 (2): 154–162. doi: 10.5468/ogs.2017.60.2.154.
20. Arlıer S. Endothelial cell leptin receptors, leptin and interleukin-8 in the pathogenesis of preeclampsia: An in-vitro study. Turk J Obstet Gynecol. 2017; 14 (4): 220–227. doi: 10.4274/tjod.78545.
21. Nicolaides K.H. First-trimester screening for pre-eclampsia: time to act. Ultra-sound Obstet Gynecol. 2017; 50 (5): 663–664. doi: 10.1002/uog.18900.
22. Redman C., Staff A. Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity. Am J Obstet Gynecol. 2015; 213 (9) (suppl4): 1–11. doi: 10.1016/j.ajog.2015.08.003.
23. Tan M., Koutoulas L., Wright D., Nicolaides K., Poon L. Protocol for the prospective validation study: Screening programme for pre-eclampsia (SPREE). Ultrasound in Obstetrics and Gynecoljgy. 2017; 50 (2): 175–179.
24. Chen J., Khalil R. Matrix Metalloproteinases in Normal Pregnancy and Preeclampsia. Prog Mol Biol Transl Sci. 2017; 148: 87–165. doi: 10.1016/bs.pmbts.2017.04.001.
Obstetrics and Gynaecology of Saint-Petersburg. 2018; : 26-30
Early predictors of preeclampsia
Abstract
The aim of study. To evaluate early effective clinical and biochemical markers late preeclampsia. Material and methods. 640 pregnant women were included in this study. On the basis of retrospective analysis two groups were completed: patients with late preeclampsia and without it. Results. If BMI>30,5kg/m2 and MAP>98 mm at the 11–13 weeks of gestation, previous preeclampsia, chronic arterial pressure, chronic pyelonephritis were in anamnesis, the patient could be included in group with high risk of late preeclampsia. If retinolbinding protein 4 is more than 87,90 mkg/ml and desintegrin and metalloproteinase 12 more than 2,33 ng/ml, it is necessary to determine place and time of delivery. Conclusion. To prove our results more investigation is necessary.
References
1. Khlestova G.V., Karapetyan A.O., Shakaya M.N., Romanov A.Yu., Baev O.R. Materinskie i perinatal'nye iskhody pri rannei i pozdnei preeklampsii. Akusherstvo i ginekologiya. 2017; 6: 41–47. https://dx.doi.org/10.18565/aig.2017.6.41-7.
2. Akusherstvo: natsional'noe rukovodstvo. Pod red. G.M. Savel'evoi, G.T. Sukhikh, V.N. Serova, V.E. Radzinskogo. 2-e izd., pererab. i dop. M.: Izdatel'stvo GEOTAR-Media; 2015.
3. O’Gorman N., Wright D., Syngelaki A., Akolekar R., Wright A., Poon L. et al. Competing risks model in screening for pre-eclampsia by maternal factors and biomarkers at 11–13 weeks of gestation. Am J Obstet Gynecol. 2016; 214 (1): 1–12. doi: 10.1016/j.ajog.2015.08.034.
4. Lemeshevskaya T.V., Pribushenya O.V. Prognozirovanie preeklampsii pri provedenii rasshirennogo kombinirovannogo prenatal'nogo skrininga pervogo trimestra beremennosti. https://dx.doi.org/10.18565/aig.2017.12.52-59.
5. Henderson J., Thompson J., Burda B., Cantor A. Preeclampsia screening: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2017; 317 (16): 1668–1683. doi: 10.1001/jama.2016.18315.
6. Tayyar A., Krithinakis K., Wright A., Wright D., Nicolaides K. Mean arterial pressure at 12, 22, 32 and 36 weeks’ gestation in screening for pre-eclampsia. Ultrasound in Obstetrics and Gynecoljgy. 2016; 47: 573–579. doi: 10.1002/uog.15815.
7. Ali S., Khalil R. Genetic, immune and vasoactive factors in the vascular dysfunction associated with hypertension in pregnancy. Expert Opin Ther Targets. 2015; 19: 1495–1515. doi: 10.1517/14728222.2015.1067684.
8. Timofeeva A., Gusar V., Kan N., Prozorovskaya K., Karapetyan A., Bayev O. et al. Identification of potential early biomarkers of preeclampsia. Placenta. 2018; 61: 61–71. doi: 10.1016/j.placenta.2017.11.011.
9. Iacobelli S., Bonsante F., Robillard P. Comparison of risk factors and perinatal outcomes in early onset and late onset preeclampsia: A cohort based study in Reunion Island. J. Reprod. Immunol. 2017; 123: 12–16. doi: 10.1016/j.jri.2017.08.005.
10. Wang C., Wang X., Yang H. Effect of maternal age on pregnancy outcomes in Beijing. Zhonghua Fu Chan Ke Za Zhi. 2017; 52 (8): 514–520. doi: 10.3760/cma.j.issn.0529-567X.2017.08.003.
11. Ananth C., Keyes K., Wapner R. Preeclampsia rates in the United States, 1980–2010: age-period-cohort analysis. BMJ. 2013; 347: f6564. doi: 10.1136/bmj.f6564.
12. Bartsch E., Medcalf K.E., Ray J.G. Clinical risk factors for preeclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ. 2016; (353): 753. doi: 10.1136/bmj.i1753.
13. Panaitescu A., Syngelaki A., Prodan N., Akolekar R., Nicolaides K. Chronic hypertension and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. 2017; 50 (2): 228–235. doi: 10.1002/uog.17554.
14. Gallo D., Wright D., Akolekar R., Poon L., Nicolaides K. Competing risks model in screening for preeclampsia by maternal factors and biomarkers at 19–24 weeks’ gestation. Am J Obstet Gynecol. 2016; 214 (5): 1–17. doi: 10.1016/j.ajog.2015.11.016.
15. Metcalfe A., Langlois S., Macfarlane J., Vallance H., Joseph K. Prediction of obstetrical risk using maternal serum markers and clinical risk factors. Prenat Diagn. 2013; 34 (2): 172–179. doi: 10.1002/pd.4281.
16. Salomon C., Yee S., Mitchell M., Rice G. The possible role of extravillous trophoblast-derived exosomes on the uterine spiral arterial remodeling under both normal and pathological conditions Biomed. Res. Int. 2014; 2014: 693157. doi: 10.1155/2014/693157.
17. Masoura S., Kalogiannidis I., Makedou K., Theodoridis T., Koiou K., Gerou S. et al. Biomarkers of endothelial dysfunction in preeclampsia and neonatal morbidity: a case-control study. Eur J Obstet Gynecol Reprod Biol. 2014; 175: 119–123. doi: 10.1016/j.ejogrb.2014.01.012.
18. Nanda S., Nikoletakis G., Markova D., Poon L.C, Nicolaides K. Maternal serum retinolbinding protein-4 at 11–13 weeks’ gestation in normal and pathological pregnancies. Metabolism. 2013; 626: 814–819. doi: 10.1016/j.metabol.2012.12.011.
19. Sung K., Roh A., Eoh K., Kim E. Maternal serum placental growth factor and pregnancy-associated plasma protein A measured in the first trimester as parameters of subsequent pre-eclampsia and small-for-gestational-age infants: A prospective observational study. Obstet. Gynecol. Sci. 2017; 60 (2): 154–162. doi: 10.5468/ogs.2017.60.2.154.
20. Arlıer S. Endothelial cell leptin receptors, leptin and interleukin-8 in the pathogenesis of preeclampsia: An in-vitro study. Turk J Obstet Gynecol. 2017; 14 (4): 220–227. doi: 10.4274/tjod.78545.
21. Nicolaides K.H. First-trimester screening for pre-eclampsia: time to act. Ultra-sound Obstet Gynecol. 2017; 50 (5): 663–664. doi: 10.1002/uog.18900.
22. Redman C., Staff A. Preeclampsia, biomarkers, syncytiotrophoblast stress, and placental capacity. Am J Obstet Gynecol. 2015; 213 (9) (suppl4): 1–11. doi: 10.1016/j.ajog.2015.08.003.
23. Tan M., Koutoulas L., Wright D., Nicolaides K., Poon L. Protocol for the prospective validation study: Screening programme for pre-eclampsia (SPREE). Ultrasound in Obstetrics and Gynecoljgy. 2017; 50 (2): 175–179.
24. Chen J., Khalil R. Matrix Metalloproteinases in Normal Pregnancy and Preeclampsia. Prog Mol Biol Transl Sci. 2017; 148: 87–165. doi: 10.1016/bs.pmbts.2017.04.001.
