Technologies for Prediction of Preeclampsia.

The aim of the study was to develop technologies for predicting the development of preeclampsia (PE) based on biomedical and molecular-genetic predictors and the calculation of individual risks for this pregnancy complication. MATERIALS AND METHODS: The study involved 457 pregnant women. Of them, 147 women had chronic arterial hypertension (CAH); 109 pregnant women had CAH and secondary preeclampsia (PE); 201 patients had PE. The control group consisted of 105 pregnant women without hypertensive disorders or proteinuria. We performed a retrospective analysis of gestation course and labor outcomes, calculated risk factors using the Open Epi system and logistic regression method. Polymorphisms of genes controlling the vascular tone were identified in venous blood. RESULTS: There were identified risk factors for developing PE, including those in women with CAH: chronic pyelonephritis; baseline mean AP above 95 mm Hg and diastolic AP above 80 mm Hg; body mass index over 30; family history of arterial hypertension. The following were identified as additional predictors of PE: perinatal loss; premature labor; spontaneous miscarriage; PE and closed craniocerebral injuries in the past medical history; threatening miscarriage in the first trimester. Additional risk factors for PE in women with CAH were found: lack of regular antihypertensive therapy before pregnancy and in the first trimester; chronic gastritis; first pregnancy; tobacco smoking.Polymorphic variants of the NOS3 (-786)C allele in the genotype in combination with the heterozygous genotype in the AGTR2 1675G/A gene are associated with a high risk of CAH. The presence of alleles NOS3 (-786)T/C and NOS3 (-786)C, as well as a combination of alleles NOS3 (-786)C and NOS3 894G/T, is associated with PE. The presence of alleles AGT 704C, CYP11B2 (-344)T, and GNB3 825T/T in the genotype, both individually and in combination, is a risk factor for the development of PE secondary to CAH. The data obtained made it possible to develop a method for predicting the onset of PE in women with CAH and a model for calculating the individual risk of PE, which formed the basis for a computer program. CONCLUSION: Calculating the individual risks of PE using the technologies proposed by the authors allows identifying pregnant women belonging to the high-risk group on a timely basis, which ensures high-quality implementation of preventive measures, provides a personalized approach and the possibility to prove the need for additional examination of this category of patients.

Hydrogen sulfide content in pregnant women with preeclampsia in late gestation and their newborns.

We examined 70 women who were 22-40 weeks pregnant and their newborns. Of these, 15 women with moderate PE made up group 1, 22 women with severe PE-group 2, and 55 women with uncomplicated pregnancy without hypertensive disorders - the control group. Blood was collected from women when they were admitted to the clinic, and blood was taken from newborns for 3-5 days of life. The concentration of hydrogen sulfide was determined by the method of K. Qu et al [17]. There was a decrease in the level of hydrogen sulfide in the blood serum of women whose pregnancy was complicated by severe preeclampsia. In newborns born to mothers with preeclampsia, an increase in the concentration of hydrogen sulfide was detected in the blood, which is probably a compensatory reaction aimed at restoring vascular homeostasis during early postnatal adaptation.

Features of modern clinical research blood analysis in the assessment of erythropoiesis in deep-premature newborns.

One of the urgent problems of nursing premature babies is the timely prediction, diagnosis and treatment of anemia, the frequency of which reaches 90%. Of particular importance is the study of reticulocytic blood parameters in deep-premature newborns, since the correct assessment of hemograms is crucial in the management of this category of children. To determine the characteristics of red blood cells and reticulocyte parameters of venous blood hemogram in premature newborns 24-32 weeks of gestation in the dynamics of the neonatal period. 111 newborns were examined at 24-32 weeks of gestation in the early neonatal period (on day 3-7) and at the age of 1 month of life. Along with standard diagnostic procedures, in accordance with current clinical recommendations and standards, 28 parameters of erythrocyte and reticulocyte hemogram parameters were determined for children. Venous blood was examined using an automatic hematological analyzer ADVIA 2120i, Siemens, USA. In deep-premature newborns in the early neonatal period, there is a high activity of erythropoiesis, respectively, the severity of respiratory and metabolic disorders with rejuvenation of reticulocytic subpopulations. Negative values of Delta hemoglobin were found against the background of a decrease in the average amount of hemoglobin in reticulocytes in children 24-27 weeks of gestation, which characterizes the lowest values of iron availability for erythropoiesis in this category of newborns. It is shown that a decrease in reticulocyte counts and normochromia in all examined newborns by the age of one month are accompanied by high levels of immature reticulocyte fraction, while a third of children still have limited iron availability for erythropoiesis.

[Features of changes in levels of humoral factors regulating the system of hemostasis, in the late stages of pregnancy.]

The influence of humoral factors on the state of hemostasis in nonpregnant and pregnant women. There were 70 women aged from 22 to 32 years, of which the 1st group consisted of 50 patients with physiological pregnancy at term gestation 38-40 weeks, the 2nd group - 20 healthy non-pregnant women. All women was measured in the plasma levels of e-NOS, cGMP, PF4, ß-TG, adrenaline and noradrenaline by ELISA, in serum NOx, indicators of gemostaziogramma. The results showed a significant decrease in the blood e-NOS, NOx, cGMP, PF4, as well as increased levels of adrenaline and noradrenaline in the blood of pregnant women in 38-40 weeks of gestation in comparison with nonpregnant women.

[The polymorphism of detoxification genes system genes in very preterm infants.]

his article is devoted to the comparative analysis of polymorphism of genes of the detoxification system in premature newborns with birth weight less than 1500 g and gestational age less than 32 weeks, formed bronchopulmonary dysplasia (BPD) (n=50), and without signs of BPD (n=47). A positive association between the presence in the genotype of deletion variants of glutathioneS-transferases (GSTT1 and GSTМ1) and risk of developing BPD in preterm infants.

[Comparative characteristics of the hemostatic potential in cord blood and in blood from premature and full-term newborns after birth according to the thromboelastography.]

The comparative characteristic of indicators of thromboelastography of umbilical cord blood and venous blood for 1-3 days of life at full-term and premature newborns is carried out. The study included 40 full term and 68 preterm infants at 1-5 days of life. Body weight of children was 3413.8±54.6 g and 2039.4±75.9 g, gestational age - 40.0±0.3 and 33.5±0.33 weeks, respectively. Mixed umbilical cord blood and venous blood taken from the ulnar vein of a child for 1-3 days of life were studied. The obtained data indicate that the main focus in the performance of thromboelastograms in premature and full-term newborns in the umbilical and venous blood are preserved. In preterm infants in cord blood decreased activity of the plasma level and functional activity of platelets, as well as reduced coagulation potential in General. After birth, premature newborns in the venous blood showed a slowdown in blood clotting, a decrease in the rate of formation and strength of clots. There is also a decrease in the functional activity of platelets, coagulation index and a more pronounced change in hemostatic potential in the direction of hypocoagulation. In full-term children, changes in the functional state of platelets and clot lysis in the umbilical and venous blood after birth do not change significantly. Hypercoagulable orientation of hemostasis in these children at birth was established.

[The inherent malformations in the structure of infant mortality in Ivanovskaya oblast].

The dynamics and role of inherent malformations in the structure of infant mortality in Ivanovskaya oblast from 2007 to 2008 is analyzed. The data on the rate of inherent handicaps in population is received. The decrease of mortality among children younger than 1 year is revealed. The higher percentage of inherent malformations in the structure of infant mortality due to inherent valvular heart disease, nervous system, kidney diseases and multiple inherent malformations in male newborns are identified.

[The levels of nitrites and medium molecular-weight molecules in the blood of neonatal infants with posthypoxic cardiopathy].

A hundred and four neonatal infants underwent clinical and functional studies in early neonatality. The levels of nitrites and medium molecular-weight molecules were determined in cardiologically healthy neonatal infants and children with posthypoxic cardiopathy. The magnitude of increases in biochemical parameters was found to be associated with clinical type of cardiopathy: their level significantly elevates in transient myocardial ischemia, their values achieve the maximum level in neonatal pulmonary hypertension and in the presence of functioning fetal communications.