Differential diagnostic capabilities of calculating the level of neutrophil extracellular traps in the venous blood of pregnant women: a comparative prospective study

Abstract

Introduction. Severe preeclampsia in early stages can be detected by isolated thrombocytopenia, which makes it difficult to diagnose it in time and carry out the necessary therapeutic measures. As a rule, the diagnosis of severe preeclampsia can be declared with a detailed clinical and laboratory researches, and it increases the risks for the mother and the embryo. However, if there are no clinical symptoms of preeclampsia except of thrombocytopenia, there is a problem of differential diagnosis between thrombocytopenia, which has the same symptoms as preeclampsia and gestational thrombocytopenia, which is a physiological peculiarity and does not require any medical interventions and restrictions. Nowadays there are no screening methods for differential diagnosis of these conditions. Objectives. To estimate the possibilities of determing the level of neutrophil extracellular traps (NETs) during the differential diagnosis of preeclampsia and gestational thrombocytopenia. Materials and methods. The comparative analysis of the level of NETs was carried out in three groups of pregnant women. Group 1 included patients with severe preeclampsia (n = 45), group 2-patients with gestational thrombocytopenia (n = 44) and group 3 consisted of healthy pregnant women (n = 44). Results. The research revealed significant increase in the level of NETs in the group of patients with preeclampsia (15.26 %,) compared with the groups of healthy patients (7.65 %, p = 0.001) and patients with gestational thrombocytopenia (7.04 %, р = 0.002). There were no significant differences in the level of NETs between the groups of healthy patients and patients with gestational thrombocytopenia. Conclusions. A significant increase of the level of NETs among the patients with severe preeclampsia allows us to consider the method of calculating the level of NETs among patients with thrombocytopenia which can be detected after the 20th week of pregnancy, if there are no other laboratory and clinical signs of preeclampsia as a screening method for early diagnosis of this complication.

Neutrophil extracellular traps in the pathogenesis of obstetric complications in COVID-19 (brief review)

“…Считается, что чрезмерная воспалительная реакция при COVID-19 и развитие ОРДС связаны с высоким уровнем цитокинемии, лимфопенией и значительной инфильтрацией лейкоцитами тканей легких, сердца, селезенки, почек и других органов, что наблюдается при посмертном анализе [25]. Высокий уровень НВЛ, зарегистрированный у таких пациентов, рассматривают как критерий высокого риска летального исхода.…”