Cerebrovascular disorders associated with severe preeclampsia and eclampsia


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Aim: The aim of the research was to study the pathomorphological and immunohistochemical features of brain damage in cases of the most severe forms of preeclampsia and eclampsia that ended with death. Materials and methods: Tissue samples taken from 10 women during autopsy, who died from from preeclampsia and eclampsia, were examined, as well as tissue samples for comparison from 3 women, who died from other reasons. The markers of mature neurons (y-NSE) and endotheliocytes (CD-34) were used for immunohistochemistry of postmortem brain tissue. Results: The study of autopsy material from patients, who died from severe preeclamsy and eclampsy detected some features of the pathogenesis of cerebrovascular complications associated with preeclampsia: 1) pronounced vasogenic and cytotoxic cerebral edema with multiple foci of ischemia, subarachnoid and intracerebral hemorrhages; 2) the signs of severe ischemic encephalopathy, death of cortical neurons and glial cells; 3) Brain capillary endothelium destructive damage with impaired blood-brain barrier (BBB) integrity and the release of neurospecific proteins from the brain tissue into the peripheral blood flow. Conclusion: The major pathophysiological mechanisms of cerebrovascular complications of preeclampsia and eclampsia are disruption of cerebral blood flow autoregulation, destructive damage of brain capillary endothelium, impaired BBB integrity, and possibly neuroinflammation.

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作者简介

Iraida Sidorova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: sidorovais@yandex.ru
Dr. Med. Sci., Professor, Academician of the RAS, Merited Scholar of the Russian Federation, Department of Obstetrics and Gynecology № 1, NV. Sklifosovsky Institute of Clinical Medicine 119991, Russia, Moscow, Trubetskaya str., 8-2

Natalya Nikitina

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: natnikitina@list.ru
Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology № 1, NV. Sklifosovsky Institute of Clinical Medicine 119991, Russia, Moscow, Trubetskaya str., 8-2

Mikhail Ageev

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: mikhaageev@yandexru
Ph.D., Teaching Assistant at the Department of Obstetrics and Gynecology №1, N.V. Sklifosovsky Institute of Clinical Medicine 119991, Russia, Moscow, Trubetskaya str., 8-2

Albert Kokin

V.V. Veresaev City Clinical Hospital (Maternity Hospital) Moscow Healthcare Department Anesthesiology and Intensive Care Unit

Email: alberkokin@yandex.ru
Head of Anesthesiology and Intensive Care Unit

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