Aim. To identify additional criteria for the diagnosis of severe preeclampsia (PE) in pregnant women based on an investigation of the expression of the early adhesion molecules, chemokine receptors, and markers of endothelial dysfunction in venous blood neutrophils and monocytes. Material and methods. One hundred and fifty patients with PE (74 with moderate PE, 76 with severe PE) and 70 women with a physiological course of pregnancy were tested for venous blood neutrophils and monocytes expressing adhesion molecules CD62L, CD11b, chemokine receptors CCR2 and CX3CR1, and the number of circulating endothelial cells (CECs). Results. When compared with women having uneventful pregnancy and patients with moderate PE, patients with severe PE had significantly lower levels of CD62L+neutrophils, but higher levels of CX3CR1+monocytes and neutrophils, and a greater number of CECs. The diagnostic thresholds for these parameters are informative in the diagnosis of PE severity. Conclusion. Measuring the relative levels of CD62L+, CX3CR1+ neutrophils and the number of CECs in the blood can be used for stratifying severity of PE with greater accuracy.
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.
The aim of the investigation was to study expression characteristics of neutrophil and monocyte adhesion molecules (CD49b, CD11b, CD51 and CD99) in the venous blood of pregnant women with various hypertensive disorders and on the basis of these findings to find new criteria for differential diagnosis and to develop a diagnostic algorithm for the given pathology.Materials and Methods. The study involved 205 women at 20-34 weeks' gestation: 62 women with preeclampsia (PE), 44 women with chronic arterial hypertension (CAH), 44 women with CAH and secondary PE, 55 women without hypertensive disorders. The concentration of CD11b + , CD49b + , CD51 + and CD99 + neutrophils and monocytes in venous blood was measured by means of multicolor flow cytofluometry. Results. As compared to the control group the level of CD49b + neutrophils was the highest in women with PE and CAH with secondary PE, the content of CD99 + neutrophils was higher in pregnant women with CAH and CAH with secondary PE, and the level of CD51 + neutrophils and CD11b + monocytes appeared to be lower in pregnant women with CAH. In contrast to the group of women with CAH, in case of PE increase of CD49b + and CD99 + neutrophils as well as CD11b + monocytes was observed. unlike pregnant women with CAH, women with CAH and secondary PE showed increase in CD49b + neutrophils, CD11b + monocytes and, unlike PE women, increase in CD99 + neutrophils. using ROC-analysis of parameters under study we identified new immunological criteria for diagnosing various hypertensive disorders in pregnancy and developed a differential diagnostic algorithm of the given pathology.Conclusion. Changes in concentration of CD11b + , CD49b + and CD99 + neutrophils and monocytes in venous blood of pregnant women with hypertension may be regarded as additional differential diagnostic criteria for identifying its nosological form, which enables to determine patient managing tactics, as well as timely and differential approach to therapy.
Aim. To determine the morphological parameters of chronic placental insufficiency in pregnancy complicated by preeclampsia, also in women with chronic arterial hypertension (CAH). Materials and Methods. The analysis of history data, peculiarities of pregnancy and childbirth in women with hypertensive disorders was carried out. A review histology of 40 placentas in moderate preeclampsia, 40 placentas in severe preeclampsia, and 35 placentas of women with CAH and associated preeclampsia was performed. The control group consisted of 20 placentas of women with uncomplicated pregnancy without hypertensive disorders. Immunohistochemical examinations were performed on paraffin sections according to standard methods using primary goat antibodies to annexin V (R-20, sc-1929) and rabbit antibodies to erythropoietin (H-162, sc-7556) in a working dilution 1:200 with Super Sensitive IHC polymer detection system. Results. Based on the results of pathomorphological examination of placentas of women with hypertensive disorders, two forms of chronic placental insufficiency were identified. The defining form of placental insufficiency in women with CAH and associated preeclampsia was fetoplacental insufficiency, and in preeclampsia of moderate severity and in severe one utero-placental form of chronic placental insufficiency. Based on the study of the dynamics of expression of annexin V and erythropoietin, morphological parameters of the placental compensatory potential and placental hemostasis disorders in hypertensive disorders in pregnant women were determined. Conclusion. Diagnostic morphological criteria for fetoplacental insufficiency in women with hypertensive disorders are a combination of maternal and fetal malperfusion with obliterative angiopathy of stem villi vessels; in the utero-placental form obliterative angiopathy of spiral arteries, placental hypoperfusion with the development of local hypoxia and hemostatic disorders in the form of thrombosis of the intervillous space and villi infarcts.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.