A scientifically based system for predicting preeclampsia


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Abstract

Objective. To develop and substantiate a predictive system for the management of pregnant women with risk factors of preeclampsia. Subjects and methods. A prospective cohort study was conducted in 150 pregnant women at risk for preeclampsia. Of them, there were 42 patients who subsequently developed preeclampsia (18 had early preeclampsia, 24 had late preeclampsia), 108 had no preeclampsia. A multivariate comparative analysis of anamnestic, clinical, and functional characteristics was carried out in pregnant women who subsequently developed preeclampsia. The time course of changes in the biomarkers of endothelial, placental dysfunction and impaired blood-brain barrier (BBB) permeability, such as TNF-α, VCAM, ICAM, VEGF, PIGF, sFlt-1, NSE, and GFAP, were traced. Results. A model was developed and scientifically substantiated to determine the likelihood of preeclampsia in risk-group pregnant women, which encompassed the assessment of anamnestic characteristics, uterine artery blood flow, daily changes in daily blood pressures, and alterations in the biomarkers of endothelial, placental dysfunction, and impaired BBB permeability. Conclusion. The pathophysiological changes preceding the clinical manifestation of preeclampsia permit prediction of its development just from the end of the first trimester of pregnancy.

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About the authors

Iraida Stepanovna Sidorova

I.M. Sechenov First Moscow State Medical University

MD, Professor, RAS Corresponding Member, Honoured Scientist of the Russian Federation; Therapeutic Faculty, Department of Obstetrics and Gynaecology № 1

Natalya Aleksandrovna Nikitina

I.M. Sechenov First Moscow State Medical University

Email: natnikitina@list.ru
Candidate of Medical Sciences, Associate Professor of the Chair of Obstetrics and Gynaecology № 1; Therapeutic Faculty, Chair of Obstetrics and Gynaecology № 1.

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