DIAGNOSTIC SIGNIFICANCE OF DETERMINING THE LEVEL OF EXTRACELLULAR FETAL DNA IN PREGNANT WOMEN WITH PREECLAMPSIA AND FETAL GROWTH RESTRICTION

Objective. To evaluate the diagnostic signif icance of determining extracellular fetal DNA in the plasma of pregnant women with preeclampsia and fetal growth restriction. Subjects and methods. Plasma samples from 55 women were investigated during the study. The pregnant women were divided into groups: 1) 17 pregnant women with preeclampsia and fetal growth restriction; 2) 19patients with a conf irmed diagnosis of preeclampsia without fetal growth restriction; 3) 19 women with physiological pregnancy. Quantitative PCR analysis was used in all the patients to measure the plasma level of extracellular fetal DNA, by determining the concentration of the hypermethylated RASSF1A gene. Results. The pregnant women with preeclampsia and growth restriction were found to have a significantly higher level of extracellular fetal DNA (284 GE/ml for impaired fetoplacental blood flow by Doppler ultrasound; 339 GE/ ml for the absence of impaired fetoplacental blood flow) than those with preeclampsia (79 GE/ml) and apparently healthy pregnant women (25 GE/ml). The level of extracellular fetal DNA in pregnant women with preeclampsia and fetal growth restriction without impaired fetoplacental blood flow was shown to be an indicator of fetal growth restriction at a threshold of 201 GE/ml with a sensitivity of 80% and a specificity of 89%. Conclusion. The findings indicate that quantitative determination of the plasma level of extracellular fetal DNA can be used to identify groups at risk for fetal growth restriction in pregnant women with preeclampsia. Quantification of the level of extracellular fetal DNA in combination with other methods for fetal assessment can assist in choosing the optimal timing and methods of delivery to improve perinatal outcomes.

RASSFM, extracellular fetal DNA, fetal growth restriction, preeclampsia, RASSF1