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CLINICAL AND PATHOGENETIC VARIANTS OF MALADAPTATION TO PREGNANCY AT EARLY STAGES OF GESTATION

https://doi.org/10.17749/2313-7347.2017.11.1.005-013

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Abstract

The aim of the study was to classify clinical and pathogenetic variants of early toxicosis in pregnant women based on clinical manifestations and markers of gestational maladaptation.

Materials and methods. In the first trimester of gestation, 45 healthy pregnant women and 160 pregnant women with early toxicosis of varying severity were examined. The comparison group was comprised of 33 healthy non-pregnant women. In addition to the clinical symptoms, a number of laboratory markers were measured. Those included the indicators of inflammation, energy balance of the reproductive system, endometrial functional activity, vascular endothelial and hemostatic disorders, as well as blood biochemistry.

Results. The obtained data were used to quantify the factors of "physiological damage" and "mechanisms of gestational adaptation" in the case of physiological gestation, and to identify the embryo-placental dysfunction as a major mechanism of maladaptation in the early stages of pregnancy. The results allowed us to propose four clinical and pathogenetic variants of early toxicosis.

Conclusion. The suggested selective approach to clinical and laboratory manifestations of early toxicosis based on its classification and severity, makes it possible to rationalize the therapy, predict the risk of severe and late obstetrical complications, and reduce the risk of adverse perinatal outcomes.

About the Authors

I. S. Lipatov
Samara State Medical University
Russian Federation

MD, Professor, Professor of the Department of obstetrics and gynecology №1 SBEI HPE Samara state medical University. Address: Chapaevskaya ul., 89, Samara, Russia, 443099



Yu. V. Tuzikov
Samara State Medical University
Russian Federation

MD, head of the Department of obstetrics and gynecology №1 sbei HPE Samara state medical University. Address: Chapaevskaya ul., 89, Samara, Russia, 443099



O. A. Kutuzova
Samara State Medical University
Russian Federation

postgraduate student of the Department of obstetrics and gynecology №1 sbei HPE Samara state
medical University. Address: Chapaevskaya ul., 89, Samara, Russia, 443099



A. V. Prikhod'ko
Samara State Medical University
Russian Federation

postgraduate student of the Department of obstetrics and gynecology №1 sbei HPE Samara state  
medical University. Address: Chapaevskaya ul., 89, Samara, Russia, 443099



N. A. Frolova
Samara State Medical University
Russian Federation

PhD student, Department of obstetrics and gynecology №1 sbei HPE Samara state medical University. Address: Chapaevskaya ul., 89, Samara, Russia, 443099



S. A. Ryabova
Samara State Medical University
Russian Federation

postgraduate student of the Department of obstetrics and gynecology №1 sbei HPE Samara state
medical University. Address: Chapaevskaya ul., 89, Samara, Russia, 443099



References

1. Strizhakov A.N., Tezikov Ju.V., Lipatov I.S., Agarkova I.A. Voprosy ginekologii, akusherstva i perinatologii. 2011; 6 (10): 26-31.

2. Tezikov Ju.V., Lipatov I.S. Akusherstvo i ginekologija. 2012; 1: 35-43.

3. Strizhakov A.N., Lipatov I.S., Tezikov Ju.V., Sharypova M.A. Voprosy ginekologii, akusherstva i perinatologii. 2014; 3 (13): 5-12.

4. Tezikov Ju.V., Lipatov I.S., Esartija M.A. Ural'skij medicinskij zhurnal. Akusherstvo. Ginekologija. 2010; 3 (68): 42-48.

5. Tezikov Ju.V. Pathogenetic rationale for the prediction, early diagnosis and prevention of severe forms of placental insufficiency. Phd. Diss. [Patogeneticheskoe obosnovanie prognozirovanija, rannej diagnostiki i profilaktiki tjazhelyh form placentarnoj nedostatochnosti: Avtoref. dis. … dokt. med. Nauk (in Russian)]. Samara. 2013; 51 s.

6. Lipatov I.S. Clinical evaluation of immune manifestations of damage to the vascular wall under physiological and pregnancy complicated by preeclampsia. Phd. Diss. [Klinicheskaja ocenka immunnyh projavlenij povrezhdenija sosudistoj stenki pri

7. fiziologicheskoj i oslozhnennoj gestozom beremennost. Avtoref. dis. … kand. med. nauk]. Samara. 1993; 24 s.

8. Lipatov I.S., Tezikov Ju.V., Bykov A.V., Nasihullina R.N., Ergunova G.A. Vestnik Samarskogo gosudarstvennogo universiteta. 2006; 44: 4:220-226.

9. Lipatov I.S, Tezikov Ju.V. Saratovskij nauchno-medicinskij zhurnal. 2011; 1 (7): 52-59.

10. Kravchenko Ju.L., Lipatov I.S., Danilova N.N., Toporova I.B., Tezikov Ju.V., Krylova O.L. Chelovek i Vselennaja. 2006; 56: 3: 119-132.

11. Lipatov I.S., Kupaev I.A., Babkin S.M., Jakimova N.A. A method for diagnosing vascular disorders in pregnant women at an early stage of development of the pathological course of gestation: RF patent №2061960, priority of 01.03.1994. Bull. Inventions. 16: 259. [Sposob diagnostiki sosudistyh narushenij u beremennyh na rannem jetape razvitija patologicheskogo techenija gestacii: patent RF na izobretenie №2061960, prioritet ot 01.03.1994. Bjul. Izobretenija. 16: 259 (in Russian)].

12. Lipatov I.S. Pathogenesis, diagnosis and prevention of vascular disorders in the early stage of formation of an abnormal pregnancy. Phd. Diss. [Patogenez, diagnostika i profilaktika sosudistyh narushenij na rannem jetape formirovanija patologicheskoj beremennosti: Avtoref. dis. … dokt. med. nauk]. Moscow. 1996; 46 s.

13. Tezikov Ju.V., Lipatov I.S., Agarkova I.A. Kazanskij medicinskij zhurnal. 2011; 3 (XCII): 372-376.

14. Govoruhina E.M., Ivanov I.P. Voprosy ohrany materinstva. 2005; 5: 47-51.

15. Ignatko I.V., Gonijanc G.G. Voprosy ginekologii, akusherstva i perinatologii. 2008; 7 (6): 25-32.

16. Gricak E.E., Rogozhina I.E. Fundamental'nye issledovanija. 2010; 9: 101-114.

17. Thrombohemorrhagic complications in obstetric practice: a guide for physicians. Ed. A.D. Makatsaria [Trombogemorragicheskie oslozhnenija v akushersko- ginekologicheskoj praktike: Rukovodstvo dlja vrachej. Pod red. A.D. Makacarii (in Russian)]. Moscow. 2011; 1056 s.

18. Potapova I.A., Purygin P.P, Belousova Z.P., Selezneva E.S., Lipatov I.S., Tezikov Y.V. Syntesis and biological activity of aliphatic and aromatic sulfonical acid azolides. Pharmaceutical Chemistry Yournal. 2001; 11(35): 588-590.

19. Mel'nikov V.A., Kupaev I.A., Lipatov I.S. Akusherstvo i ginekologija. 1992; 3-7: 19-21.

20. Tezikov Ju.V., Lipatov I.S., Zavalko A.F. Aktual'nye voprosy akusherstva i ginekologii. 2001; 1: 35.

21. Strizhakov A.N., Lipatov I.S., Tezikov Ju.V. Placental insufficiency: Pathogenesis. Forecasting. Diagnostics. Prevention. Obstetric tactics [Placentarnaja nedostatochnost': Patogenez. Prognozirovanie. Diagnostika. Profilaktika. Akusherskaja taktika (in Russian)]. Samara. 2014; 239 s.

22. Tezikov Ju.V., Lipatov I.S., Santalova G.V., Valeeva G.R. Ural'skij medicinskij zhurnal. Perinatologija. 2009; 10 (64): 121-128.

23. Lipatov I.S., Tezikov Ju.V., Santalova G.V., Ovchinnikova M.A. Rossijskij vestnik akushera-ginekologa. 2014; 4 (14): 63-68.

24. Tezikov Ju.V., Lipatov I.S. Rossijskij vestnik akushera-ginekologa. 2011; 5 (11): 71- 78.

25. Tezikov Ju.V., Mel'nikov V.A., Lipatov I.S. Vestnik Volgogradskogo gosudarstvennogo medicinskogo universiteta. 2010; 2: 64-67.

26. Tezikov Ju.V., Lipatov I.S. Medicinskij al'manah. 2011; 6: 60-63.

27. Bitsadze V.O., Makatsariya A.D., Hizroeva D.H., Makatsariya N.A., Jashenina E.V. Prakticheskaja medicina. 2012; 5 (60): 22-29.

28. Strizhakov A.N., Lipatov I.S., Tezikov Ju.V. Akusherstvo i ginekologija. 2012; 3: 20-25.

29. Strizhakov A.N., Tezikov Ju.V., Lipatov I.S., Agarkova I.A., Sharypova M.A. Voprosy ginekologii, akusherstva i perinatologii. 2012; 1 (11): 5-11.

30. Lipatov I.S., Tezikov Ju.V., Esartija M.A. Rossijskij vestnik akushera- ginekologa. 2008; 2 (8): 30-36.

31. Tezikov Ju.V., Lipatov I.S., Ural'skij medicinskij zhurnal. Akusherstvo. Ginekologija. 2009; 3 (57): 33-41.


For citation:


Lipatov I.S., Tuzikov Y.V., Kutuzova O.A., Prikhod'ko A.V., Frolova N.A., Ryabova S.A. CLINICAL AND PATHOGENETIC VARIANTS OF MALADAPTATION TO PREGNANCY AT EARLY STAGES OF GESTATION. Obstetrics, Gynecology and Reproduction. 2017;11(1):5-13. (In Russ.) https://doi.org/10.17749/2313-7347.2017.11.1.005-013

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