THE PREDICTION AND DIAGNOSIS OF THE SEVERE FORMS OF PLACENTAL INSUFFICIENCY

Objective. To estimate the prognostic and diagnostic possibilities of markers of endothelial dysfunction, decidualization, apoptosis, and cellular proliferation to identify the severe forms of placental insufficiency (PI). Subjects and methods. One hundred and fifty-four women at high risk for the severe forms of PI and a control group of 30 healthy pregnant women were examined over time during their second and third trimesters of pregnancy. Clinical, immunological, and instrumental studies were used. Results. In the second trimester, the prognostically significant criteria for decompensated PI are increases in the antiendothelial antibody cytotoxicity index up to 36.9±4.2%, total immunoglobulin E up to 351±18 ng/ml, placental a1-microglobulin up to 74.4±6.5 ng/ml, Fas/APO-1/CD 95-receptor-expressing lymphocytes up to 48.3±3.2%, and tumor necrosis factor-a up to 202±18 pkg/ml and a reduction in serum placental growth factor concentrations to 248±13 pkg/ml. Conclusion. The prediction and early diagnosis of the severe forms of PI can be made, by mon itoring the blood levels of endothelial dysfunction markers, maternal placental membrane proteins, apoptosis, and cellular proliferation

placental insufficiency, prediction, diagnosis