CURRENT TREATMENT POLICY IN PATIENTS WITH VARYING SEVERITY OF PREECLAMPSIA

Objective. To evaluate the efficiency of therapy for mild and moderate gestosis on the basis of the clinical course and changes in the concentrations of markers of endothelial dysfunction. Subjects and methods. The concentrations of the markers of endothelial dysfunction, such as VEGF, TNF-a, VCAM, ICAM, and, NSE, in varying severity of preeclampsia (PE) were studied in 80 pregnant women (a study group) and 20 healthy pregnant ones (a control group) in the third trimester. The study group included 65 women with moderate PE (blood samples were taken on admission to hospital and 7-10 days after start of therapy) and 15 women with severe PE (blood samples were taken before and after delivery). Results. As compared with the healthy pregnant women, the study group showed a progressive reduction in the concentrations of VEGF, a rise in the levels of TNF-a, VCAM, ICAM, and NSE with the higher severity of PE. During treatment for moderate PE, there was a significant increase in the concentrations of VEGF and a slight fall of the levels of TNF-a, VCAM, ICAM, and NSE. Therapy for severe PE was ineffective. Conclusion. In moderate PE, pregnancy may be prolonged using combination infusion therapy for at least 2—5 times a week. This policy enables perinatal outcomes to be improved. Treatment for severe preeclampsia is ineffective and requires preterm delivery in any period of pregnancy.

VEGF, TNF-a, VCAM, preeclampsia, endothelial dysfunction, VEGF, TNF-a, VCAM, ICAM, NSE, therapy for preeclampsia