Pre-eclampsia. Selection of obstetric tactics

Abstract

Relevance. At the present time, despite the large number of studies, the root causes of pre-eclampsia remain unknown. In recent years, attention is paid to the study of the role of vascular growth factors in the pathogenesis of various obstetric pathologies, including pre-eclampsia. The aim of our study was to examine the features of the angiogenic imbalance in determining the severity of pre-eclampsia, and further tactics of conducting pregnant women. Matherials and Methods. 135 pregnant women were examined: I group - 50 pregnant women with preeclampsia moderate; II group - 36 pregnant women with preeclampsia-severe; Group III - 49 pregnant women with physiological pregnancy. All patients special methods of investigation have been carried out - the definition of levels of pro-angiogenic (PlGF) and anti-angiogenic (sFlt-1, sEng) factors in the serum in 28-34 weeks gestation. In our study we found significant differences in the content of vascular growth factors in patients in the three comparison groups. Results. With an increase in the severity of pre-eclampsia decrease pro-angiogenic placental vascular factors to a greater extent than other vascular factors points to the aggravation of the pathological process and can be used as an additional criterion of pre-eclampsia severity. The level of vascular growth factors and their relationship with a certain probability, reflects the extent of endothelial dysfunction that predicts the best time of prolongation of pregnancy in patients with pre-eclampsia. Conclusion. Use of vascular growth factor in the diagnosis and determining the severity pre-eclampsia, along with traditional clinical and laboratory research will optimize the obstetric tactics in these patients.