Features of pregnancy comlicated by preeclampsia and antiphospholipid syndrome

Abstract

Actuality. Antiphospholipid syndrome (APS) is one of the reasons for the development of obstetric and extragenital pathology. Importance is assigned to the antiphospholipid antibodies (APA), because their play an important role in vascular wall damage that underlies the pathogenesis of preeclampsia. The aim: the study to investigate the characteristics of products AFA in pregnant women with preeclampsia. Material and methods. Examined 83 pregnant at 22 to 38 weeks of gestational. Women were divided into 3 groups. The 1 group consisted of 27 pregnant with preeclampsia of varying severity and an increased level of antibodies to cardiolipin (ACL) and β2 –glycoprotein 1 (GP1). II group consisted of 31 pregnant with preeclampsia and physiological level ACL and β2GP1. The control group consisted of 25 pregnant with physiological pregnancy. All pregnant underwent a clinical examination and laboratory findings, a study of indicators of coagulation and anticoagulation systems, the level ACL, anti-β2 GP-1, antibodies to prothrombin and anexin V. Results. Analysis of severity of pre-eclampsia showed that pregnant in the group with pathological levels of APA were significantly more frequent was presence of pre-eclampsia severe – 25,0%, in the II group, severe preeclampsia is absent (p<0.05 ). Revealed earlier development of preeclampsia in pregnant with pathological level APA (13.8% of patients of the 1st group in the 22-24 weeks). It was found that for pregnant women with pathological level APA is characterized by an earlier and more severe pre-eclampsia. Installed a significantly higher level of autoantibodies to β2 GP-1 classes IgM, IgG, antibodies to anexin V class and IgM antibodies to cardiolipin. In the presence of preeclampsia on the background of the pathological level of antibodies significantly more frequently. The results of Doppler blood flow in umbilical artery, which can be explained by preeclampsia, cjnstant of pathological products APA enhanced thrombotic tendency leading to the violation of the utero-fetal blood flow. In the 1 group, these changes occurred in 22.1% of cases, and in II – 4.4% ( p<0.05). Analysis of pregnancy outcomes showed that the date of delivery in 1, and ІІ groups of pregnant women with preeclampsia (36,2±0,5 weeks) and (36,8±0,3) was significantly earlier (p<0.05) than the control (39,1±0,1). Conclusions. On the pathological level of APA accompanied the earlier development and more severe course of preeclampsia, leads to the deterioration of the fetus, accompanied by an increase in the number of premature labor and the birth of children with grous retardation. For the prevention and treatment of pregnant with preeclampsia, it should be surveys for the APA, β2-GP1, prothrombin and anexin V.