akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2022.324akusherstvo-1348Research ArticleОRIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИThe role of coagulation hemostasis for development of early-onset preeclampsia in low-risk patientsРоль коагуляционного гемостаза в реализации ранней преэклампсии у пациенток низкого рискаhttps://orcid.org/0000-0001-9459-5698НиколаеваМ. Г.NikolaevaM. G.

Николаева Мария Геннадьевна – д.м.н., профессор кафедры акушерства и гинекологии с курсом ДПО; старший научный сотрудник

Scopus Author ID: 57191960907.

Россия, 656038 Барнаул, пр. Ленина, д. 40

Россия, 656045 Барнаул, ул. Ляпидевского, д. 1

Mariya G. Nikolaeva – MD, Dr Sci Med, Professor, Department of Obstetrics and Gynecology with the Course of Professional Postgraduate Education; Senior Researcher

Scopus Author ID: 57191960907.

40 Lenin Avе., Barnaul 656038, Russia

1 Lyapidevskogo Str., Barnaul 656045, Russia

https://orcid.org/0000-0001-9968-0744ЩеклеинаК. В.ShchekleinaK. V.

Щеклеина Ксения Владимировна – младший научный сотрудник лаборатории гемостаза; врач акушер-гинеколог, врач ультразвуковой диагностики центра антенатальной охраны плода. 

Россия, 656038 Барнаул, пр. Ленина, д. 40

Россия, 656019 Барнаул, ул. Гущина, д. 179

Ksenia V. Shchekleina – MD, Junior Researcher, Laboratory of Hemostasis; Obstetrician-Gynecologist, Ultrasound Diagnostician, Antenatal Fetal Care Center 

40 Lenin Avе., Barnaul 656038, Russia

179 Gushchina Str., Barnaul 656019 Russia

schekleinakv@gmail.comhttps://orcid.org/0000-0002-8413-5484МомотА. П.MomotA. P.

Момот Андрей Павлович – д.м.н., профессор, руководитель лаборатории гемостаза; директор

Россия, 656038 Барнаул, пр. Ленина, д. 40

Россия, 656045 Барнаул, ул. Ляпидевского, д. 1

Andrey P. Momot – MD, Dr Sci Med, Professor, Head of the Laboratory of Hemostasis; Director. Scopus Author ID: 6603848680.

40 Lenin Avе., Barnaul 656038, Russia

1 Lyapidevskogo Str., Barnaul 656045, Russia

https://orcid.org/0000-0003-0695-6145ТерехинаВ. Ю.TerekhinaV. Yu.

Терехина Василиса Юрьевна – ассистент кафедры акушерства и гинекологии с курсом ДПО; акушер-гинеколог кабинета диспансерного наблюдения беременных группы высокого риска.

Россия, 656038 Барнаул, пр. Ленина, д. 40

Россия, 656019 Барнаул, ул. Гущина, д. 179

Vasilisa Yu. Terekhina – MD, Assistant, Department of Obstetrics and Gynecology with the Course of Professional Postgraduate Education; Obstetrician-Gynecologist of an Office of Ooutpatient Supervision for Pregnant Women of High Risk Group 

40 Lenin Avе., Barnaul 656038, Russia

179 Gushchina Str., Barnaul 656019 Russia

https://orcid.org/0000-0001-9637-766XГригорьеваЕ. В.GrigorievaE. V.

Григорьева Елена Владимировна – к.м.н., старший научный сотрудник лаборатории гемостаза института клинической медицины; младший научный сотрудник лаборатории гемостаза

Россия, 656038 Барнаул, пр. Ленина, д. 40

Россия, 656045 Барнаул, ул. Ляпидевского, д. 1

Elena V. Grigorieva – MD, PhD, Senior Researcher, Laboratory of Hemostasis, Institute of Clinical Medicine; Junior Researcher, Laboratory of Hemostasis 

40 Lenin Avе., Barnaul 656038, Russia

1 Lyapidevskogo Str., Barnaul 656045, Russia

ФГБОУ ВО «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Алтайский филиал ФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской ФедерацииРоссияAltai State Medical University, Health Ministry of Russian Federation; Altay Branch of National Medical Research Center for Hematology, Health Ministry of Russian FederationRussian FederationФГБОУ ВО «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации; КГБУЗ «Алтайский краевой клинический перинатальный центр»РоссияAltai State Medical University, Health Ministry of Russian Federation; Altai Regional Clinical Perinatal CenterRussian FederationФГБОУ ВО «Алтайский государственный медицинский университет» Министерства здравоохранения Российской Федерации; Алтайский филиал ФГБУ «Национальный медицинский исследовательский центр гематологии» Министерства здравоохранения Российской ФедерацииРоссияAltai State Medical University, Health Ministry of Russian Federation; Altay Branch of National Medical Research Center for Hematology, Health Ministry of Russian FederationRussian Federation202227062022164391400Copyright © Nikolaeva M.G., Shchekleina K.V., Momot A.P., Terekhina V.Y., Grigorieva E.V., 20222022Николаева М.Г., Щеклеина К.В., Момот А.П., Терехина В.Ю., Григорьева Е.В.Nikolaeva M.G., Shchekleina K.V., Momot A.P., Terekhina V.Y., Grigorieva E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1348Aim

Aim: to determine a role of specific parameters of coagulation hemostasis for development of severe early-onset preeclampsia (еPE) in low-risk patients.

Materials and Methods

Materials and Methods. A single-center prospective study included 40 patients with a physiological course of pregnancy and term delivery (control group) as well as 41 pregnant women with developed severe еPE (study group). Patients at the gestational age of 19–21 and 27–28 weeks in the comparison groups were examined for serum tissue factor (TF) activity; tissue factor pathway inhibitor (TFPI) and potential to generate thrombin in calibrated thrombography test.

Results

Results. Patients with developed ePE vs. control group were found to have significantly increased TF activity at both time points: 49.1 pmol/ml vs. 5.3 pmol/ml (p < 0.0001) and 56.7 pmol/ml vs. 6.6 pmol/ml (p < 0.0001); respectively. At gestational age of 19–21 weeks; patients in the study vs. control group had serum TFPI level significantly lower (1.1 U/ml vs. 1.6 U/ml; p < 0.0001) that was significant elevated up to 2.1 U/ml by 82 % at 27–28 weeks of pregnancy. At both time points; a significantly increased thrombin generation was detected in women with developed ePE.

Conclusion

Conclusion. The development of ePE is characterized by increased potential to generate thrombin. TF has been identified as a more sensitive marker of activated coagulation hemostasis; and its significantly increased activity was recorded at gestational age of 19–21 weeks that allows us to consider TF as a prognostic biomarker.

Цель

Цель: определение роли отдельных параметров коагуляционного гемостаза в реализации тяжелой ранней преэклампсии (рПЭ) в группе пациенток низкого риска ее развития.

Материалы и методы

Материалы и методы. Одноцентровое проспективное исследование включало 40 пациенток с физиологическим течением беременности и родами в срок (контрольная группа) и 41 беременную с реализованной тяжелой рПЭ (основная группа). В сроках гестации 19–21 и 27–28 нед исследовали активность тканевого фактора (англ. tissue factor; TF); ингибитора пути тканевого фактора (англ. tissue factor pathway inhibitor; TFPI) и способность к генерации тромбина в тесте калиброванной тромбографии.

Результаты

Результаты. У пациенток с реализованной рПЭ зарегистрировано достоверное повышение активности TF относительно контрольной группы в обеих точках исследования: 49;1 пмоль/мл против 5;3 пмоль/мл (р < 0;0001) и 56;7 пмоль/мл против 6;6 пмоль/мл (р < 0;0001); соответственно. Уровень TFPI в сроки 19–21 нед в основной группе отличался значимо низким показателем относительно контрольной группы (1;1 Ед/мл против 1;6 Ед/мл; р < 0;0001) с достоверным его повышением на 82 % к сроку 27–28 нед гестации до 2,1 Ед/мл. В обеих точках исследования выявлено статистически значимое повышение генерации тромбина в группе женщин с реализованной рПЭ.

Заключение

Заключение. Развитие рПЭ характеризуется повышенной способностью к генерации тромбина. В качестве более чувствительного маркера активации коагуляционного гемостаза определен TF, достоверно значимое повышение активности которого регистрируется в сроке 19–21 нед, что позволяет рассматривать TF в качестве прогностического биомаркера.

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The authors declare that there are no conflicts of interest present.