Prognostic criteria for preeclampsia

Буштырева, И. О.; Kurochka, M. P.; Gaida, O. V.

doi:10.17116/rosakush201717259-63

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…A combination of many factors underlies the pathogenesis of PE. So far, there have been several different theories on the development of this pregnancy complication, therefore, prediction and prevention of PE are still far from perfect [ 3 , 4 ]. Practitioners are offered to use a number of possible PE predictors that can be applied to predict the development of this pathology, both separately and in combination.…”

Section: Introductionmentioning

confidence: 99%

Technologies for Prediction of Preeclampsia

Rokotyanskaya¹,

Panova

Малышкина

et al. 2020

Sovrem Tehnol Med

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The aim of the study was to develop technologies for predicting the development of preeclampsia (PE) based on biomedical and molecular-genetic predictors and the calculation of individual risks for this pregnancy complication.Materials and Methods. The study involved 457 pregnant women. Of them, 147 women had chronic arterial hypertension (CAH); 109 pregnant women had CAH and secondary preeclampsia (PE); 201 patients had PE. The control group consisted of 105 pregnant women without hypertensive disorders or proteinuria. We performed a retrospective analysis of gestation course and labor outcomes, calculated risk factors using the Open Epi system and logistic regression method. Polymorphisms of genes controlling the vascular tone were identified in venous blood.Results. There were identified risk factors for developing PE, including those in women with CAH: chronic pyelonephritis; baseline mean AP above 95 mm Hg and diastolic AP above 80 mm Hg; body mass index over 30; family history of arterial hypertension. The following were identified as additional predictors of PE: perinatal loss; premature labor; spontaneous miscarriage; PE and closed craniocerebral injuries in the past medical history; threatening miscarriage in the first trimester. Additional risk factors for PE in women with CAH were found: lack of regular antihypertensive therapy before pregnancy and in the first trimester; chronic gastritis; first pregnancy; tobacco smoking.Polymorphic variants of the NOS3 (-786)C allele in the genotype in combination with the heterozygous genotype in the AGTR2 1675G/A gene are associated with a high risk of CAH. The presence of alleles NOS3 (-786)T/C and NOS3 (-786)C, as well as a combination of alleles NOS3 (-786)C and NOS3 894G/T, is associated with PE. The presence of alleles AGT 704C, CYP11B2 (-344)T, and GNB3 825T/T in the genotype, both individually and in combination, is a risk factor for the development of PE secondary to CAH. The data obtained made it possible to develop a method for predicting the onset of PE in women with CAH and a model for calculating the individual risk of PE, which formed the basis for a computer program. Conclusion.Calculating the individual risks of PE using the technologies proposed by the authors allows identifying pregnant women belonging to the high-risk group on a timely basis, which ensures high-quality implementation of preventive measures, provides a personalized approach and the possibility to prove the need for additional examination of this category of patients.

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Section: Introductionmentioning

confidence: 99%

Technologies for Prediction of Preeclampsia

Rokotyanskaya¹,

Panova

Малышкина

et al. 2020

Sovrem Tehnol Med

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“…Preeclampsia can develop in any pregnancy, but the probability of this complication risk is associated with a combination of several factors in one woman [8]. At the same time, there is evidence that preeclampsia does not always develop in the presence of certain risk factors, and, by contrast, this complication may develop even in the absence of predictors [9][10][11] -all this makes it difficult to predict and prevent preeclampsia.…”

Section: Introductionmentioning

confidence: 99%

The Neural Network Technology Application for Prediction of Preeclampsia in Pregnant Women with Chronic Arterial Hypertension

Panova¹,

Rokotyanskaya²,

Yasinskiy³

et al. 2018

Sovrem Tehnol Med

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The aim of the study was to assess biomedical risk factors for preeclampsia in pregnant women with chronic arterial hypertension (CAH) and on this basis to create the neural network system for calculating the probability of developing preeclampsia in these women. Materials and Methods. Pregnancy and delivery outcomes were analyzed in 548 patients with pre-existing arterial hypertension (AH): 318 with CAH and 230 with preeclampsia secondary to CAH. Risk factors were calculated using the OpenEpi program (UK). A combined method of global optimization and neural network method of information compression were used when training the developed neural network system. Results. There were identified the main risk factors for developing preeclampsia in pregnant women with CAH: hereditary burden of hypertension; hypertensive disorders in previous pregnancies; hypertension during more than five years; the initial diastolic blood pressure being more than 80 mm Hg; body mass index more than 30; tobacco smoking; nulliparity; chronic pyelonephritis and gastritis; hypertensive disease stage II; degree II and III AH; hypertensive retinal angiopathy; left ventricular hypertrophy; lack of regular antihypertensive therapy before and during pregnancy; late treatment initiation. The data obtained were used to train and test the neural network software and to develop the "Neuro_Chronic-neural network system for predicting secondary preeclampsia in pregnant women with chronic arterial hypertension". The system includes two modules. The first module is designed to train the neural network software model using a given set of images, the second module provides evaluation of preeclampsia developing during pregnancy in a particular patient in the form of five probability options-from very low to very high-after entering the parameters obtained during the anamnestic and clinical examination into the corresponding fields. Conclusion. Revealing the proposed predictors of preeclampsia in pregnant women with CAH and entering these data into the developed computer program will enable physicians to determine the probability of preeclampsia developing during gestation at the outpatient stage and to take timely preventive measures in pregnant women at high-risk.

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“…Изменения, лежащие в основе развития ПЭ, закладываются в «ранние» сроки «гестации». На фоне прогрессирования сосудистого спазма и нарушения в факторах свертывания крови, формируется комплекс микроциркуляторных нарушений [3][4][5][6].…”

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Analysis of the Reasons Which Are the Cornerstone of Pathogenesis of the Preeclampsia (Review)

Симанов¹

2020

MedFarm

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Вопрос о причинах развития преэклампсии недостаточно изучен, поскольку он носит «многосторонний» характер и требует тщательной диагностики уже на «прегравидарном» этапе. Цель исследования-анализ причин, лежащих в основе патогенеза преэклампсии, по данным литературы. Проведен анализ 29 отечественных и 16 зарубежных литературных источников. Все причины развития преэклампсии делились на «социальные» и отражающие показатели соматического и репродуктивного здоровья. Сочетание 2-3 причин повышали риск развития «тяжелой» преэклампсии, а более 3-развитие эклампсии. Большинство ученых к отягощающим «социальным» причинам относили неблагоприятные условия труда, быта, плохое питание. Среди отягощающих причин анамнеза выделялись такие, как «низкий» паритет, заболевания сосудисто-почечного генеза. Основные причины преэклампсии, находящиеся в «социальной» и плоскости здоровья женщин требуют диагностики до наступления беременности. Однако данные меры должны носить глубокий системный характер и проводиться на «популяционном» уровне. Знание степени влияния каждой клинической причины может оказать существенную помощь практикующему врачу, как на этапе планирования беременности, так и в процессе принятия важных решений. ABSTRACT The question of the reasons of development of a preeclampsia is insufficiently studied as it has "multilateral" character and demands careful diagnostics already at a before pregnancy stage. A research objective-the analysis of the reasons which are the cornerstone of pathogenesis of a preeclampsia according to literature. The analysis of 29 domestic and 16 foreign references is carried out. All reasons of development of a preeclampsia were divided into the "social" and reflecting indicators of somatic and reproductive health. A combination of 2-3 reasons more than 3 increased risk of development of a "heavy" preeclampsia, and-development of an eclampsia. Most of scientists carried unfavorable conditions of work, life, bad food to the burdening "social" reasons. Were distinguished from the burdening reasons of the anamnesis such as "low" parity, diseases of vascular and renal genesis. The basic reasons of a preeclampsia which are in "social" and the planes of health of women demand diagnostics before pregnancy. However, these measures have to have deep system character and be carried out at the "population" level. Knowledge of extent of influence of each clinical reason can provide substantial assistance to the practicing doctor, both at a pregnancy planning stage, and in the course of adoption of important decisions.

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Prognostic criteria for preeclampsia

Cited by 3 publications

References 5 publications

Technologies for Prediction of Preeclampsia

Technologies for Prediction of Preeclampsia

The Neural Network Technology Application for Prediction of Preeclampsia in Pregnant Women with Chronic Arterial Hypertension

Analysis of the Reasons Which Are the Cornerstone of Pathogenesis of the Preeclampsia (Review)

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