Prevention of preeclampsia in pregnant women with obesity

Abstract

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.