Аннотация
Objective. To define the clinical significance of a study of a number of natural autoantibodies (AAb) for the valid timely diagnosis of preeclampsia and to make a differential diagnosis of preeclampsia and chronic arterial hypertension (CAH). Subjects and methods. Seventy-six pregnant women were examined. Eighteen pregnant women were noted to have preeclampsia (Group 1 (a study group); 36 pregnant women with CAH formed a comparison group (Group 2); of them there were Subgroup 2B patients (n=10) whose pregnancy was complicated by preeclampsia; the latter was absent in Subgroup 2A (n=26). A control group (Group 3) included healthy pregnant women (n=22). Enzyme immunoassay was used to measure the serum level of AAbs to IgG class anti-double-stranded DNA, two platelet membrane antigens (TrM-001-15, TrM-015-12), two kidney antigens (KiM-05-300, KiS-07-120), and hepatic mitochondrial antigen (HMMP) in all the pregnant women. Results. The most characteristic feature of pregnant women with preeclampsia is an obvious reduction in the serum levels of all examined AAbs; those of the latter to DNA and the proteins Trm-0.01 and Kis-07-12 were especially low. There was an imbalance in AAb levels in Subgroups 2A and 2B. In mixed forms of gestosis and in Subgroup 2A, the levels of platelet antibodies may be normal, near- or above-normal. Reduced markers for kidney pathology were revealed in 100% in Subgroup 2B and only in 33.3% in the pregnant women from Subgroup 2A, which may be indubitably used for differential diagnosis. Conclusion. The study of a number of natural AAbs ensures optimization of the differential diagnosis of preeclampsia and chronic hypertensive states in pregnant women at 24—40 weeks’ gestation and serves to predict with a high probability the development and severity of gestosis 2—4 weeks before the appearance of the first clinical symptoms of this pathology, which improves perinatal outcomes and substantially reduces maternal and infant morbidity and mortality.
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