CLINICO-LABORATORIAL BLOOD INDICES AS POSSIBLE PREDICTORS OF PREECLAMPSIA WITH EARLY AND LATE MANIFISTATION
Abstract
Aim. To reveal the characteristics of clinico-laboratorial indices in early (to 34 gestation weeks) and late preeclampsia onset. Material and methods. We performed the investigation (combination of prospective and case-control study) of 105 women with late preeclampsia (the onset after 34 weeks) and of 76 women with early one; we also studied pregnancy outcomes and dynamics of hematological and immune-biochemical blood indices. Results. We did not reveal any associations of late preeclampsia with “maternal contribution” (obesity, chronic arterial hypertension, or kidney disease). In case of early preeclampsia the pregnancy was often induced upon ART-programme, was multiple and accompanied by severe form of preeclampsia and placental disturbances, it was also conjugated with high perinatal morbidity and mortality. Anemia with relative iron deficiency and inadequate erythropoietin production developed in early preeclampsia. We also observed proinflammatory restructuring of differential blood cell count and lipid profile with increase of system inflammation markers (Kalf-Kalifa index, hs C-reactive protein), considerable reduction of initially relatively increased platelet levels, growth of liver function test indicators, decrease of total blood protein level accompanied by increase of nitrogen metabolism (creatinine, urea), and changes in electrolyte status (relative hypernatremia and hyperkalemia, hypocalcemia). Conclusion. Effective clinico-laboratorial predictors of early preeclampsia in the first trimester appeared to be erythropoietin (EPO) production less than 10.75 mmol/L (specificity 86.2%, sensibility 71.4%, accuracy 78.8%); OEPO/PEPO ratio (observed EPO value to predicted EPO value ratio) less than 0.770 (specificity 72.4%, sensibility 71.4%, accuracy 71.9%), which suggests possible erythropoietin participation in pathogenesis of early preeclampsia.References
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2. Zakharov Yu.M. [Cytoprotective Function of Erythropoietin]. Klinicheskaya nefrologiya [Clinical Nephrology], 2009, no. 1, pp. 16–21. (in Russ.)
3. Medvedev B.I., Syundyukova E.G., Sashenkov S.L. [The Value of Erythropoietin in the Pathogenesis of Pre-Eclampsia]. Voprosy ginekologii, akusherstva i perinatologii [Questions Gynaecology, Obstetrics and Perinatology], 2014, vol. 13, no. 4, pp. 35–41. (in Russ.)
4. Khodzhaeva Z.S., Shmakov R.G., Kogan E.A. [Clinical and Anamnestic Features, Placenta and Placental Bed at Early and Late Preeclampsia]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2015, no. 4, pp. 25–31 (in Russ.).
5. Medvedev B.I., Syundyukova E.G., Sashenkov S.L. [Erythropoietin Serum and Placental Expression in Pregnancies Complicated by Preeclampsia]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2015, no. 10, pp. 47–53. (in Russ.)
6. Osikov M.V., Akhmatov V.Yu., Telesheva L.F. [Pleiotropic Effects of Erythropoietin in Patients with Chronic Renal Failure]. Fundamental'nye issledovaniya [Basic Research], 2013, no. 7, pp. 218–224. (in Russ.)
7. Rumyantsev A.G., Morshchakova E.F., Pavlov A.D. Eritropoetin v diagnostike, profilaktike i lechenii anemiy [Erythropoietin in the Diagnosis, Prevention and Treatment of Anemia]. Moscow, Medicine Publ., 2003. 448 p.
8. Sukhikh G.T., Murashko L.E. Preeklampsiya: rukovodstvo [Preeclampsia. A Guide]. Moscow, GEOTAR Media Publ., 2010. 576 p.
9. Syundyukova E.G., Medvedev B.I., Sashenkov S.L. [The Outcomes of Pregnancy and Childbirth in Women with Preeclampsia and Anemia]. Akusherstvo i ginekologiya [Obstetrics and Gynecology], 2012, no. 2, pp. 24–29. (in Russ.)
10. Stepovaya E.A., Novitskiy V.V., Ryazantseva N.V. [Typical Changes in Red Blood Cells in Chronic Inflammation]. Byulliten' eksperimental'noy biologii i meditsiny [Byulliten Experimental Biology and Medicine], 2004, vol. 137, no. 1, pp. 66–70. (in Russ.)
11. Aksornphusitaphong A., Phupong V. Risk Factors of Early and Late Onset Pre-Eclampsia. J. Obstet. Gynaecol. Res., 2013, vol. 39, no. 3, pp. 627–631. DOI: 10.1111/j.1447-0756.2012.02010.x
12. Poon L.C., Maiz N., Valencia C. First-Trimester Maternal Serum Pregnancy-Associated Plasma Protein-A and Pre-Eclampsia. Ultrasound Obstet. Gynecol., 2009, vol. 33, no. 1, pp. 23–33. DOI: 10.1002/uog.6280
13. Zamudio S., Wu Y., Ietta F. Human Placental Hypoxia-Inducible Factor-1Alpha Expression Correlates with Clinical Outcomes in Chronic Hypoxia in Vivo. Am J Pathol., 2007, vol. 170, no. 6, pp. 2171–2179. DOI: 10.2353/ajpath.2007.061185
14. Li X.J., Zhang G.X., Sun N. Protective Effects of Erythropoietin on Endotoxin-Related Organ Injury in Rats. Huazhong Univ Sci Technolog Med Sci., 2013, vol. 33, no. 5, pp. 680–686. DOI: 10.1007/s11596-013-1180-1
15. Santhanam A.V., d'Uscio L.V., Katusic Z.S. Erythropoietin Increases Bioavailability of Tetrahydrobiopterin and Protects Cerebral Microvasculature Against Oxidative Stress Induced by eNOS Uncoupling. J Neurochem., 2014, vol. 131, no. 4, pp. 521–529. DOI: 10.1111/jnc.12824
16. Swets J.A. Measuring the Accuracy of Diagnostic Systems. Science, 1988, no. 240, pp. 1285–1293. DOI: 10.1126/science.3287615
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Published
2017-02-01
How to Cite
Syundyukova, E., Medvedev, B., Sashenkov, S., Melnikov, I., Kulavsky, E., Ivanochkina, M., & Fartunina, Y. (2017). CLINICO-LABORATORIAL BLOOD INDICES AS POSSIBLE PREDICTORS OF PREECLAMPSIA WITH EARLY AND LATE MANIFISTATION. Human. Sport. Medicine, 17(1), 57-66. https://doi.org/10.14529/hsm170106
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Clinical and Experimental Medicine
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