PATHOGENETIC RATIONALE FOR A DIFFERENTIATED APPROACH TO MANAGING PREGNANT WOMEN WITH ARTERIAL HYPERTENSION AND PREECLAMPSIA

Objective. To comparatively estimate the levels of the neurospecific proteins NSE and GFAP in the sera of healthy pregnant women, pregnant women with preeclampsia or chronic arterial hypertension without preeclampsia and to perform an immunomorphological study of placental tissue in women with preeclampsia or chronic arterial hypertension without preeclampsia. Subjects and methods. A prospective study was conducted in 21 pregnant women with chronic arterial hypertension, 84 pregnant women with varying degrees of preeclampsia, as well as 24 healthy pregnant women with physiological pregnancy who formed a control group. The levels of the neurospecific proteins NSE and GFAP were studied in the sera of patients in the above groups; placental tissues were immunomorphologically examined in the women with preeclampsia and chronic arterial hypertension. Results. In chronic arterial hypertension versus preeclampsia, the pregnant women’s sera and placental tissues showed no neurospecific proteins that had high immunogenic activity and were able to lead to the development of a severe immunopathological process. Pregnancy can be prolonged during adequate antihypertensive therapy and good blood pressure control. Conclusion. The development of preeclampsia is characterized by a dramatic increase in the levels of the neurospecific proteins, severe immune injury of the endothelium of macro- and microcirculatory vessels. Progression of this process can be stopped only by delivery that is indicated for eclampsia, severe preeclampsia, and ineffective therapy for its moderate form.

preeclampsia, arterial hypertension, endotheliosis, neurospecific proteins