Possibilities for prediction and prevention of preeclampsia in women with diabetes mellitus

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Abstract


Based on the analysis of literature data, the role and serum levels of the main angiogenic (placental growth factor (PlGF)) and antiangiogenic vascular factors (endoglin (sENG), soluble fms-like type 1 tyrosine kinase (sFlt-1)) have been assessed in pregnant women with different types of diabetes mellitus (DM) in both the plasma and placenta. We evaluated the effectiveness of administration of low doses of acetylsalicylic acid for preventing preeclampsia in diabetic pregnancy. In addition, the effectiveness of using the sFlt-1/PlGF and PlGF/sENG ratios as possible test systems for prediction of the complication in this patient population was evaluated. It has been found that the synthesis of the studied biomarkers fails in the diabetic pregnancy, with the expression levels of sENG and sFlt-1 increased and PlGF reduced. However, the insufficient research does not allow us to make unambiguous conclusions about the practical validity of the evaluation of the plasma content of these vascular factors and their ratios for the preeclampsia prediction in pregnant women with DM. The presented data on acetylsalicylic acid administration to these women are also controversial. Given the high incidence of adverse perinatal outcomes associated with DM during pregnancy, an additional assessment of the prognostic risk model for the development of preeclampsia and the appropriateness of aspirin administration is needed. Therefore, further randomized studies are required to address this issue.


Roman V. Kapustin

Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Author for correspondence.
Email: kapustin.roman@gmail.com

Russian Federation, Saint Petersburg

MD, PhD

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