Prevention of preeclampsia in pregnant women with obesity
Keywordsvascular endothelial growth factor, circulating endothelial microparticles CD32 CD40 , endothelial dysfunction, preeclampsia, pregnancy, obesity
Reducing the occurrence of preeclampsia is one of the key tasks in modern obstetrics, especially in pregnant women with concomitant obesity, who are at high risk for preeclampsia, the leading pathogenetic segment of which is endothelial dysfunction. The purpose of this work is to evaluate the effectiveness of the integrated therapeutic and preventive complex (TPC) in order to prevent preeclampsia in pregnant women. These parameters were evaluated using such markers as the concentration of vascular endothelial growth factor (VEGF) in blood serum and the content of circulating endothelial microparticles (CEM) CD32+CD40+ in peripheral blood in pregnant women with obesity of varying severity over the course of treatment we proposed. 110 pregnant women were included in the study: women with physiological body weight (n=26); women with class I obesity (n=42), and women with class II-III obesity. The groups of pregnant women with concomitant obesity were divided into two equal subgroups; one of the subgroups received the TPC (acetylsalicylic acid, calcium supplements, L-arginine, diosmin). The findings obtained demonstrate a significant improvement of endothelial status over the course of the therapy that is manifested with an increase in the serum VEGF concentration and a decrease in the content of CD32+CD40+ CEM in the peripheral blood. Our clinical assessment of pregnancy course, childbirth and the postpartum period in women with obesity and physiological body weight has shown a decrease in the occurrence of complications due to taking the integrated TPC. We have registered a decrease in the incidence of preeclampsia, placental dysfunction, occurrence of miscarriage, operative delivery and postpartum complications.
Chooi Y.C., Ding С., Magkos F. The epidemiology of obesity. Metabolism. 2019; 92: 6-10. https://doi.org/10.1016/j.metabol.2018.09.005.
Коrytko, О. О. Vplyv nadmirnoi masy tila ta ozhyrinnia na fertylnist i vynoshuvannia vahitnosti [Influence of overweight and obesity on reproductive health and carrying of a pregnancy]. International journal of endocrinology. 2016; 7: 22-26 (in Ukrainian). http://dx.doi.org/10.22141/222407188.8.131.526.86415.
Christians J.K., Huicochea Munoz M.F. Pregnancy complications recur independently of maternal vascular malperfusion lesions. PLOS ONE. https://doi.org/10.1371/journal.pone.0228664 February 6, 2020.
Spradley F.T., Palei A.C., Granger J.P. Increased risk for the development of preeclampsia in obese pregnancies: weighing in on the mechanisms. Am J Physiol Regul Integr Comp Physiol. 2015; 309 (11): 1326-1343. https://doi.org/10.1152/ajpregu.00178.2015
Mochan S., Dhingra M., Gupta S., Saxena S., Arora P., Yadav V., Rani N., et al. Status of VEGF in preeclampsia and its effect on endoplasmic reticulum stress in placental trophoblast cells. European Journal Of Obstetrics & Gynecology And Reproductive Biology: X. 2019; 4: 100070. https://doi.org/10.1016/j.eurox.2019.100070
Amosco M.D., Villar V.A., Naniong J.M., David-Bustamante L.M., Jose P.A., Palmes-Saloma C.P. VEGF-A and VEGFR1 SNPs associate with preeclampsia in a Philippine population. Clin Exp Hypertens. 2016; 38 (7): 578-585. https://doi.org/10.3109/10641963.2016.1174252
Kutsenko N.L., Savchenko L.G., Kaydasheva E.I., Kutsenko L.A., Solochina I.L., Kaydashev I.P. Determination of circulating CD32+ CD40+- microparticles - modification of degradation assessment of endothelial cells. Clinical Laboratory Dіagnostics. 2011; 7: 20-23.
Berezin A.E. The endothelial progenitor cell dysfunction in hypertension: the diagnostic and predictive values. Vessel Plus. 2018; 2: 22. http://dx.doi.org/10.20517/2574-1209.2018.23
Camarena Pulido E.E., García Benavides L., Panduro Barón J.G., Pascoe Gonzalez S, Madrigal Saray A.J., Garcia Padilla F. E, et al. Efficacy of L-arginine for preventing preeclampsia in high-risk pregnancies: a double-blind, randomized, clinical trial. Hypertens Pregnancy. 2016; 35 (2): 217-225. https://doi.org/10.3109/10641955.2015.1137586
Lakhno I. Sovremennye vozmozhnosti prognozirovanija i profilaktiki prejeklampsii [Modern possibilities of prediction and prevention of preeclampsia]. Zdorov'e zhenshhiny. 2016; 7 (113): 44-48 (in Russian). https://doi.org/10.15574/HW.2016.113.44
Lutsenko, N., (1986). Beremennost' i rody u zhenshhin s ozhireniem. [Pregnancy and childbirth in women with obesity]. Health. 112 p. [in Russian].
Butalia S., Audibert F., Côté A.M., Firoz T., Logan A.G., Magee L.A., et al. Hypertension Canada's Guidelines for the Management of Hypertension in Pregnancy. Canadian Journal of Cardiology. 2018; 34 (5): 526-531. https://doi.org/10.1016/j.cjca.2018.02.021.
Syusyuka V., Kolokot G., Belenichev I. Otsiniuvannia vplyvu kompleksnoi terapii vahitnykh iz zatrymkoiu rostu ploda na akusherski ta perynatalni naslidky rozrodzhennia. [Evaluation of the influence of complex therapy of pregnant women with fetal growth retardation on obstetric and perinatal consequences of childbirth]. Zdorovia zhinky. 2019; 10 (146): 55-61 (in Ukrainian). https://doi.org/10.15574/HW.2019.146.55
Shashar M., Chernichovski T., Pasvolsky O., Levi Sh., Grupper A., Hershkovitz R., Weinstein T. Vascular Endothelial Growth Factor Augments Arginine Transport and Nitric Oxide Generation via a KDR Receptor Signaling Pathway. Kidney Blood Press Res. 2017; 42: 201-208. https://doi.org/10.1159/000476016
Vaschenko V., Likhachov V., Dobrovolska L., Taranovska, O. Vplyv vtorynnoi profilaktyky rozvytku preeklampsii u zhinok hrupy vysokoho ryzyku na pokaznyky fetoplatsentarnoho krovotoku [Effect of secondary prevention of preeclampsia on fetoplacental blood flow rates in highrisk women]. Vistnyk problem biolohii i medytsyny. 2020; 3 (1): 94-97 (in Ukrainian). https://doi.org/10.29254/2077-4214-2020-3-157-94-97
Gopchuk E.N. Vozmozhnosti ispol'zovanija l-arginina v akusherstve i ginekologii dlja lechenija patologij, vyzvannyh jendotelial'noj disfunkciej. [Possibilities of using l-arginine in obstetrics and gynecology for the treatment of pathologies caused by endothelial dysfunction]. Zdorov'e zhenshhiny. 2017; 2(118): 50-54. (in Russian). doi 10.15574/HW.2017.118.50
Frolova N., Tezikov Y., Lipatov I. Obosnovanie vybora angioprotektora diosmina v kachestve profilakticheskogo agenta preeklampsii. [Rationale for the choice of angioprotector diosmin as a preventive agent for preeclampsia]. Izvestija Samarskogo nauchnogo centra Rossijskoj akademii nauk. 2015; 17 (2): 398-403 (in Russian).
Lukyanova Yu.S., Gureev V.V., Kolesnichenko P.D., Danilenko L.M., Gudyrev O.S., Pokrovskaya T.G., Sernov L.N., Artyushkova E.B., Provotorov V.Y. Comparative study of the pharmacological effects of Venarus Plus, Venarus, and Detralex on L-NAME-induced endothelial dysfunction, venous tone and platelet aggregation. AVFT Archivos Venezolanos de Farmacología y Terapéutica. 2020; 39(5): 550-555. https://doi.org/10.5281/zenodo.4266493
Romanenko T.G., Sulimenko O.M. Prevention of preeclampsia in women with multiple pregnancy after assisted reproduction. Wiad Lek. 2020; 73(3): 494-497. PMID: 32285820. DOI: 10.36740/WLek202003116
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