Thrombophilia in the pathogenesis of fetal growth retardation

Orudzhova, E. A.; Samburova, N. A.; Anichkova, E. V.; Gotsiridze, K. E.; Bitsadze, Victoria

doi:10.17749/2313-7347/ob.gyn.rep.2021.223

Akušerstvo, ginekologiâ i reprodukciâ

2021

DOI: 10.17749/2313-7347/ob.gyn.rep.2021.223

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Thrombophilia in the pathogenesis of fetal growth retardation

E. A. Orudzhova

N. A. Samburova

E. V. Anichkova

et al.

Abstract: Fetal growth retardation (FGR) is a complication of pregnancy that determines perinatal morbidity and mortality. It is a complex and multifaceted medical problem that does not lose its relevance. Impaired fetal development and delayed growth result from various etiopathogenesis of pathological processes occurring in the "mother–placenta–fetus" interface. Thrombophilia is one of the factors that can initiate disturbed placental function and the utero-placental blood flow. Here we describe the clinical FGR varia… Show more

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Cited by 3 publications

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Stillbirth and fetal growth restriction

Волков

Kastor

2023

Akušerstvo, ginekologiâ i reprodukciâ

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Aim: to estimate the rate of early-onset and late-onset fetal growth restriction (FGR) in stillbirth, identify features of placentaassociated complications and determine respective risk factors of stillbirth (especially at early gestational age).Materials and Methods. There were retrospectively studied 61 stillbirth cases in 2016–2019 that occurred in the III level obstetric hospitals: 32 early (23–31 weeks of gestation) and late (32–39 weeks) cases; 156 live births with 8–10 Apgar scores delivered at 36–41 weeks of gestation used as controls. Quantitative parameters were compared using the mean values and standard deviation; nominal parameters were analyzed using odds ratio (OR) and adjusted OR (aOR) with 95 % confidence interval (CI).Results. More than half of stillbirths are associated with FGR with almost 60 % of early-onset phenotype of this pathology. Both in stillbirths and live births, 2/3 of FGR have extremely low weight (OR = 1.8; 95 % CI = 0.6–6.9); 1/3 of growth restricted fetuses were detected shortly before delivery (OR = 1.3; 95 % CI = 0.7–2.4); 1/4 of pregnancies complicated by placental insufficiency are not associated with FGR (OR = 1.4; 95 % CI = 0.7–2.7). Risk factors of stillbirth in pregnancy complicated by FGR are the early-onset growth restriction phenotype (aOR = 3.2; 95 % CI = 1.0–10.3), maternal age over 28 years (aOR = 6.0; 95 % CI = 1.2–29.4), miscarriages and multiple induced abortions (aOR = 3.6; 95 % CI = 1.1–11.2), non-compliance in regular clinics visiting and correction of threatening conditions (aOR = 10.9; 95 % CI = 1.3–91.6), toxoplasma infection (aOR = 6.0; 95 % CI = 1.5–24.5). Early stillbirth with FGR is associated with an older mother's age (aOR = 5.8; 95 % CI = 1.0–34.4), greater parity (aOR = 3.3; 95 % CI = 1.0–10.4), uterine diseases including endometrial polyps, endometriosis, cervix cervicitis, cervix dysplasia (aOR = 4.0; 95 % CI = 0.9–17.2), diabetes mellitus (aOR = 3.1; 95 % CI = 0.8–13.2) and preeclampsia.Conclusion. The rate of early-onset FGR in stillbirth comprises almost 60 % that is twice higher than in live birth, with the rate of late-onset phenotype being less than 30 %. In late stillbirths the early-onset phenotype also prevails. There are no prominent features for stillbirths with FGR compared to previously known risk factors regardless of hypotrophy. Early vs. late stillbirth with FGR is more associated with gynecological pathologies as well as with diabetes mellitus and preeclampsia.

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Stillbirth and fetal growth restriction

Волков

Kastor

2023

Akušerstvo, ginekologiâ i reprodukciâ

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Migraine in antiphospholipid syndrome and hereditary thrombophilia: pregnancy-related clinical and diagnostic features and therapeutic issues

Voskresenskaya,

Dashdamirova,

Khizroeva

et al. 2024

Akušerstvo, ginekologiâ i reprodukciâ

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Introduction. Migraine is one of the most common primary headaches and a risk factor for cardiovascular and cerebrovascular diseases. Antiphospholipid syndrome (APS) and hereditary thrombophilia (HT) causing pathological pregnancy are highly associated with migraine. Timely migraine recognition related to APS and HT facilitates earlier initiation of thrombophilia pathogenetic therapy and prevention of potential complications.Aim: to analyze the literature data on migraine clinical and diagnostic features in APS and HT as well as pregnancy-related therapeutic issues.Materials and Methods. A search for scientific literature was conducted in electronic databases including PubMed, Google Scholar, eLibrary from 2004 until May 2024. The search methodological basis included the presence of the following keywords and their combinations in Russian and English: "migraine", "antiphospholipid syndrome", "thrombophilia", "migraine and pregnancy", "migraine and thrombophilia", "migraine and cardiovascular diseases". As a result, a total of 184 publications were identified. Next, 62 articles were included in the review.Results. At the current stage, neurologists have no means to diagnose migraine in APS and HT based on headache-intrinsic characteristics. Pregnancy increases a risk of thrombotic complications. A migraine observed in patient's history should be crucial while assessing pregnancy-related obstetric risk. While diagnosing migraine, neurologists need to examine patient obstetric history. The data on most effective and safe therapy for pregnancy-related migraine attacks remain scarce.Conclusion. The frequent association between APS and HT with migraine, the lack of clear migraine clinical features in thrombophilia, patients’ reproductive age, and the high risk of thrombotic complications necessitate collaboration between neurologists and obstetricians-gynecologists for timely diagnostics and management of such patients. The impact of various types of antithrombotic therapy on migraine course requires further clarification. It is promising to conduct studies able to determine of whether migraine attack prevention can avoid adverse pregnancy outcomes in women with former migraine.

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Features of the course of pregnancy and health of newborns with intrauterine growth restriction

Volochaeva,

Kan,

Tyutyunnik

et al. 2023

Medicinskij sovet

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Introduction. The development of intrauterine growth restriction (IUGR) begins with fertilization and trophoblast invasion. IUGR is manifested in a decrease in fetal growth rate. However, data on risk factors for fetal growth retardation, their combination with various chronic diseases in a pregnant woman are contradictory.Objective. To study the features of the course of pregnancy, childbirth, the health status of newborns with IUGR. Materials and methods. The study was a retrospective cohort study. At the first stage, we analyzed 1574 birth histories with a diagnosis of IUGR, placental insufficiency, women with normal pregnancy who gave birth (2016–2021). According to the inclusion and exclusion criteria, 408 women were included in the study. The women were divided into 2 groups. The first group included 202 pregnant women with a diagnosis of IUGR. In the second Group – 206 pregnant women with normal pregnancy, without IUGR, delivered at the time corresponding to the terms in the main group.Results. We have clarified the risk factors and premorbid conditions involved in the development of IUGR (somatic and gynecological morbidity, pregnancy course). Their analysis is necessary to predict IUGR. The analysis of the timing and method of delivery in the studied groups was carried out. A higher incidence of complications in the early neonatal period was revealed when assessing the health status of newborns with IUGR.Conclusion. Thus, the study of the mechanisms of IUGR formation in the future will allow the development of modern pathogenetic approaches to prevention and treatment.

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Thrombophilia in the pathogenesis of fetal growth retardation

Cited by 3 publications

References 17 publications

Stillbirth and fetal growth restriction

Stillbirth and fetal growth restriction

Migraine in antiphospholipid syndrome and hereditary thrombophilia: pregnancy-related clinical and diagnostic features and therapeutic issues

Features of the course of pregnancy and health of newborns with intrauterine growth restriction

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