Prediction and Early Diagnosis of Placental Dysfunction (Literature Review)

Borzenko, I. B.

doi:10.26693/jmbs05.02.007

Cited by 2 publications

(8 citation statements)

References 27 publications

(32 reference statements)

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“…Taking into account the fact that one of the most frequent causes of the development of pathology of the fetal environment is a urogenital infection [1,2,14,27], we evaluated the role of viral and bacterial agents in this category of patients. Determination of reproductively significant infections showed that the leading infection is ureaplasma, antibodies to which were detected in both studied groups, and the frequency of diagnosis is significantly higher (56.3% vs. 6.7% in the control group, p<0.001).…”

Section: Results and Their Discussionmentioning

confidence: 99%

“…Some authors associate the manifestation of gestational complications with the reactivation of viruses of the herpes group [1,2,11,14,27]. Since infection with the above-mentioned viruses met with the same frequency, it is fair to say that the isolated effect of an infectious factor of a herpesvirus nature is of secondary importance, and its endothelial effect can be manifested in combination with the action of other pathological factors.…”

Section: Results and Their Discussionmentioning

confidence: 99%

“…The organometric method included measurement of placenta mass and its dimensions (maximum and minimum diameter, maximum and minimum thickness), diameter and thickness of the umbilical cord, as well as placental-fetal coefficient [2,3,6,8]. During the macroscopic examination, the integrity of the placenta tissues and its reconstruction were determined.…”

Section: Methodsmentioning

confidence: 99%

“…I n recent years, scientific views on perinatal protection of the fetus have shifted to earlier periods of pregnancy -to the first trimester, because the formation of fetoplacental complex, laying of organs and tissues take place at this stage of gestation, which in most cases determines the further course of pregnancy [1,2,4,5]. The process of blastocyst implantation in the endometrium is regulated by many factors, first of all -by vascular-endothelial growth factors, the state of hemodynamics in the basal and spiral arteries of the uterus, steroid hormones of the ovaries, as well as their interaction with endometrial receptors [2,5,6,11].…”

Section: дисбаланс ангіогенезу як відправна точка формування плацента...mentioning

confidence: 99%

“…One should not exclude the fact that in the structure of the causes of perinatal morbidity and mortality, the pathology of the fetal environment is of great importance, in particular, idiopathic polyhydramnios and oligohydramnios, which are closely related to the formation of the placental complex and its function [6]. This requires the search for early criteria for the diagnosis and prognosis of placental dysfunction and its negative consequences, to which a rather large number of literary scientific reports are devoted [1,2,7,17,18,21].…”

Section: дисбаланс ангіогенезу як відправна точка формування плацента...mentioning

confidence: 99%

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Angiogenic imbalance as a starting point for the development of placental dysfunction and pregnancy complications in patients with pathology of the fetal environment

Макарчук

Zhurakivska

Островська

et al. 2023

RHW

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In recent years, scientific views on perinatal protection of fetus have shifted to earlier periods of pregnancy – to the I trimester, because from this stage the formation of the fetoplacental complex and laying of organs and tissues take place, which in most cases determines the further course of pregnancy. The objective: to clarify the role of the imbalance of angiogenic growth factors as one of the pathogenetic mechanisms in the development of placental dysfunction, and to conduct a postnatal macromorphometric study of placenta and umbilical cord in women with pathology of the fetal environment. Materials and methods. The object of the study were 80 pregnant women (the main group) with a singleton pregnancy, selected from the cohort of patients from the risk group for the development of preeclampsia and miscarriage. Among them, at 30–32 weeks of gestation oligohydramnios was diagnosed in 40 patients (the first group) and polyhydramnios – in 40 women (the second group). The control group included 30 somatically healthy pregnant women with a normal volume of amniotic fluid and a physiological course of pregnancy.The concentrations of placental growth factor (PlGF), vascular endothelial growth factor-1 (VEGF-1), and an anti-angiogenic marker of neovasculogenesis, soluble fms-like tyrosine kinase (sFlt-1), were performed at 12–16 and 28–32 weeks of pregnancy by enzyme immunoassay method. The study of the structural and functional features of the placenta and umbilical cord included sonographic and organometric methods. The variational statistical method of analysis of the obtained results was carried out using the «STATISTICA for Windows®-6.0» package.Results. In the women of the main group in the I trimester the ultrasound signs of pathology of the embryo and extraembryonic structures were significantly more often observed: low placement of the fertilized egg (33.8 %), its deformation (27.5 %), and partial detachment of the chorion (28.5 %). At 12–16 weeks of pregnancy, a pronounced vascular imbalance was established with a 2.5-fold decrease in the concentration of PlGF in the case of oligohydramnios compared to control data, a 1.8-fold decrease in the level of free VEGF-1 (in the case of oligohydramnios), and an increased level of antiangiogenic growth factors (sFlt-1).The postnatal examination of the placenta and umbilical cord showed that in the pregnant women of the main group a predominance of abnormal forms of placenta (16.3 %), a predominance of eccentric and marginal types of attachment of the umbilical cord (53.8 %), main and intermediate types of vascular branching (63.7 %), changes in the diameter of the umbilical cord (17.5 %), a combination of these features in a third of cases (31.3 %) were found. In the women of the main group, there was a decrease of the placental-fetal coefficient compared to the individuals of the control group, which was especially pronounced in pregnant women with oligohydramnios (up to 0.11±0.01 units compared to control data - 0.16±0.01 units).Conclusions. In the period of 12–16 weeks of pregnancy a vascular imbalance was established at the stage of placentation in patients who were diagnosed pathology of the perinatal environment at 30–32 weeks. In particular, by oligohydramnios there is a 2.5-fold decrease in the concentration of PlGF compared to the control data, a 1.8-fold decrease in the level of VEGF-1, and an increased antiangiogenic growth factor (sFlt-1), which became a prerequisite for the development of placental dysfunction.The results of the postnatal examination of the placenta and umbilical cord became an indirect reflection of placentation conditions. They demonstrated the predominance of abnormal forms, the predominance of the eccentric and marginal type of attachment of the umbilical cord, the main and intermediate type of vascular branching, an increased rate of umbilical cord pathology (Warton’s jelly deficiency, anomalies of the umbilical cord vessels) and a decreased placental-fetal ratio in women with amniotic fluid pathology, which was it is especially pronounced with oligohydramnios.

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Section: Results and Their Discussionmentioning

confidence: 99%

Section: Results and Their Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: дисбаланс ангіогенезу як відправна точка формування плацента...mentioning

confidence: 99%

Section: дисбаланс ангіогенезу як відправна точка формування плацента...mentioning

confidence: 99%

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Angiogenic imbalance as a starting point for the development of placental dysfunction and pregnancy complications in patients with pathology of the fetal environment

Макарчук

Zhurakivska

Островська

et al. 2023

RHW

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Algorithm for the diagnosis and treatment of primary placental dysfunction in pregnant women of risk groups

Беленичев

2021

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Research objective: to evaluate the effectiveness of diagnosis and complex therapy of placental dysfunction (PD) in early stages of gestation.Materials and methods. We examined 110 pregnant women with risk for the primary PD. Exclusion criteria were multiple pregnancies, anomalies of fetal development and internal genital organs of the mother, pregnancy resulting from assisted reproductive technologies.The diagnosis of PD was established in 56 women (group I) based on the assessing the state of extraembryonic structures and blood flow in the spiral and uterine arteries at 12–13 weeks of gestation. The rest of the patients (54 women) entered the control group without PD (group II).Results. All pregnant women with verified PD at 12–13 weeks were prescribed complex drug treatment, which included micronized progesterone, venotonic Normoven, Magnicum, and Artihol. As a result of treatment, already at 22–24 weeks of gestation, the average value of blood flow (resistance index) in the uterine and spiral arteries did not differ significantly in the groups. There was no significant difference in fetometry and placentometry indices at 35–36 weeks of gestation. Complications of the gestational period in patients in the study groups were also almost the same.Conclusions. History of hormonal disorders and miscarriage, clinical signs of miscarriage in early gestation, abnormal embryo placement, extragenital pathology, and genital tract infections are risk factors for PD. Determination of the state of extraembryonic structures at 7–8 weeks of pregnancy (ovum volume, blood flow in the corpus luteum) and at 12–13 weeks (chorion volume, vascularization index, blood flow in the spiral and uterine arteries) can serve as a verification criterion for the PD development. Complex drug therapy, which began from the early stages of gestation (micronized progesterone, Normoven, Magnicum, Artihol) has established itself as an effective method of treating primary PD in pregnant of risk groups.

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Prediction and Early Diagnosis of Placental Dysfunction (Literature Review)

Cited by 2 publications

References 27 publications

Angiogenic imbalance as a starting point for the development of placental dysfunction and pregnancy complications in patients with pathology of the fetal environment

Angiogenic imbalance as a starting point for the development of placental dysfunction and pregnancy complications in patients with pathology of the fetal environment

Algorithm for the diagnosis and treatment of primary placental dysfunction in pregnant women of risk groups

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