A role of endothelial dysfunction in development of maternal, perinatal and pediatric morbidity
Abstract
Aim: to analyze an effect of endothelial dysfunction on development of obstetric, perinatal and pediatric pathology by using morphometric studies of peripheral blood desquamated endothelial cells (DECs).
Materials and Methods. A prospective cohort clinical study included 163 female patients with singleton pregnancy. All pregnant women in the first trimester underwent DECs computer morphometry together with clinical and statistical examining course of pregnancy, labor as well as follow-up observation of born children under the age of 1 year.
Results. The study demonstrated that endothelial damage in the first trimester of pregnancy profoundly affected maternal, perinatal and pediatric morbidity: detection of DECs in the first trimester with mean diameter less than 30 mkm increased probability of developing placental insufficiency by 52.0 %, preeclampsia - by 48.8 %, threatened preterm labor - by 32.4 %, premature detachment of the normally situated placenta - by 6.0 %. Identifying in DECs in the first trimester with mean diameter less than 40 mkm was associated with increased risk of acute fetal hypoxia in labor by 7.9 %, pediatric central nervous system disorders - by 37.9 %, increased rate of acute respiratory viral infections in children under 1 - by 17.3 %.
Conclusion. Examining state of vascular endothelium in the first trimester of pregnancy represents an important component of prenatal diagnostics and opens up new avenue for prevention and treatment of obstetric, perinatal and pediatric pathology.
Materials and Methods. A prospective cohort clinical study included 163 female patients with singleton pregnancy. All pregnant women in the first trimester underwent DECs computer morphometry together with clinical and statistical examining course of pregnancy, labor as well as follow-up observation of born children under the age of 1 year.
Results. The study demonstrated that endothelial damage in the first trimester of pregnancy profoundly affected maternal, perinatal and pediatric morbidity: detection of DECs in the first trimester with mean diameter less than 30 mkm increased probability of developing placental insufficiency by 52.0 %, preeclampsia - by 48.8 %, threatened preterm labor - by 32.4 %, premature detachment of the normally situated placenta - by 6.0 %. Identifying in DECs in the first trimester with mean diameter less than 40 mkm was associated with increased risk of acute fetal hypoxia in labor by 7.9 %, pediatric central nervous system disorders - by 37.9 %, increased rate of acute respiratory viral infections in children under 1 - by 17.3 %.
Conclusion. Examining state of vascular endothelium in the first trimester of pregnancy represents an important component of prenatal diagnostics and opens up new avenue for prevention and treatment of obstetric, perinatal and pediatric pathology.
About the Authors
A. V. Mironov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Health Ministry of Russian Federation; City Clinical Hospital № 13, Moscow Healthcare Department
Russian Federation
Alexey V. Mironov - MD, PhD, Assistant, A.I. Evdokimov Moscow State University of Medicine and Dentistry; City Clinical Hospital № 13.
20 bldg. 1, Delegatskaya Str., Moscow 127473; 1/1 Velozavodskaya Str., Moscow 115280.
Russian Federation
Alexey V. Mironov - MD, PhD, Assistant, A.I. Evdokimov Moscow State University of Medicine and Dentistry; City Clinical Hospital № 13.
20 bldg. 1, Delegatskaya Str., Moscow 127473; 1/1 Velozavodskaya Str., Moscow 115280.
M. M. Umakhanova
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Health Ministry of Russian Federation
Russian Federation
Madina M. Umakhanova - MD, Dr Sci Med, Professor, A.I. Evdokimov Moscow State University of Medicine and Dentistry.
20 bldg. 1, Delegatskaya Str., Moscow 127473.
Russian Federation
Madina M. Umakhanova - MD, Dr Sci Med, Professor, A.I. Evdokimov Moscow State University of Medicine and Dentistry.
20 bldg. 1, Delegatskaya Str., Moscow 127473.
A. M. Torchinov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Health Ministry of Russian Federation
Russian Federation
Amirkhan M. Torchinov - MD, Dr Sci Med, Professor, A.I. Evdokimov Moscow State University of Medicine and Dentistry.
20 bldg. 1, Delegatskaya Str., Moscow 127473.
Russian Federation
Amirkhan M. Torchinov - MD, Dr Sci Med, Professor, A.I. Evdokimov Moscow State University of Medicine and Dentistry.
20 bldg. 1, Delegatskaya Str., Moscow 127473.
References
1. Gris J.-Ch., Makatsariya A.D., Bitsadze V.O. et al. Antiphospholipid syndrome and pregnancy. [Antifosfolipidnyj sindrom i beremennost']. Akusherstvo iginekologiya. 2018;(10):5—11. (In Russ.). https://doi.org/10.18565/aig.2018.10.5-11.
2. Sidorova I.S., Nikitina N.A. Pathogenesis of endotheliosis in preeclampsia. [Osobennosti patogeneza endotelioza pri preeklampsii]. Akusherstvo iginekologiya. 2015;(1):72-8. (In Russ.).
3. Jim B., Sharma S., Kebede T., Acharya A. Hypertension in pregnancy: a comprehensive update. Cardiol Rev. 2010;18(4):178—89. https://doi.org/10.1097/CRD.0b013e3181c60ca6.
4. Sidorova I.S., Kurtser M.A., Nikitina N.A., Rzayeva A.A. Role of the fetus in the development of preeclampsia. [Rol' ploda v razvitii preeklampsii]. Akusherstvo i ginekologiya. 2012;(5):23—8. (In Russ.).
5. Starodubtseva N.L., Kononikhin A.S., Bugrova A.E. et al. Proteomic analysis of the urine for diagnostics in newborns. [Primenenie proteomnogo analiza mochi v diagnostike sostoyaniya novorozhdennyh detej]. Byulleten' eksperimental'noj biologii i mediciny. 2015;160(12):849-52. (In Russ.).
6. Ziganshina M.M., Shilova N.V., Khasbiullina N.R. et al. Autoantibodies against endothelial antigens in preeclampsia. [Autoantitela k antigenam endoteliya pri preeklampsii]. Akusherstvo iginekologiya. 2016;(3):24— 31. (In Russ.).
7. Moiseeva I.V., Mansur Hassan S.H. Functional indicators of endothelium in dynamics of physiological pregnancy in women (according to ischemic test of the humeral artery). [Funkcional'nye pokazateli endoteliya v dinamike fiziologicheskoj beremennosti u zhenshchin (po dannym reaktivnoj proby plechevoj arterii)]. Aspirantskij vestnikPovolzh'ya. 2015;(5—6):33—7. (In Russ.).
8. Sukhanova G.A., Mondoeva S.S., Podzolkova N.M., Kuznetsova I.V. Application of glycosaminoglycans in obstetric practice for correction of endothelial dysfunction. [Primenenie glikozaminoglikanov v akusherskoj praktike dlya korrekcii endotelial'noj disfunkcii]. Medicinskijalfavit. 2018;2(13):20-5. (In Russ.).
9. Karapetyan A.O., Baeva M.O., Baev O.R. The role of fetal extracellular DNA in predicting the great obstetric syndromes. [Rol' vnekletochnoj DNK ploda v prognozirovanii bol'shih akusherskih sindromov]. Akusherstvo iginekologiya. 2018;(4):10—5. (In Russ.). https://doi.org/10.18565/aig.2018.4.10-15.
10. Li C., Xu Y.-M., Chen R., Deng CL. An effective treatment for penile strangulation. Mol Med Rep. 2013;8(1):201-4. https://doi.org/10.3892/mmr.2013.1456.
11. Feoktistova V.S., Vavilova T.V., Sirotkina O.V. et al. The new approach to evaluation of dysfunction of endothelium: detection of number of circulating endothelium cells using flow cytometry technique. [Novyj podhod k ocenke disfunkcii endoteliya: opredelenie kolichestva cirkuliruyushchih endotelial'nyh kletok metodom protochnoj citometrii]. Klinicheskaya laboratornaya diagnostika. 2015;60(4):23-39. (In Russ.).
12. Fadini G.P., Avogaro A. Cell-based methods for ex vivo evaluation of human endothelial biology. Cardiovasc Res. 2010;87(1):12—21. https://doi.org/10.1093/cvr/cvq119.
13. Popova A.A., Berezikova E.N., Mayanskaya S.D. Mechanism of endothelial dysfunction development. [Endotelial'naya disfunkciya i mekhanizmy ee formirovaniya]. Sibirskoe medicinskoe obrazovanie. 2010;4(64):7-11. (In Russ.).
14. Gerilovich L.A., Bazina M.I., Egorova A.T. et al. Endothelin-1 at patients with various sterility forms in programs of auxiliary genesial technologies. [Endotelin-1 u pacientok s razlichnymi formami besplodiya v programmah vspomogatel'nyh reproduktivnyh tekhnologij]. Medicina i obrazovanie v Sibiri. 2013;(6):19. (In Russ.).
15. Mnikhovich M.V. Assessment of apoptosis in breast cancer results of study semi-thin sections and electron microscopy. [Ocenka apoptoza pri rake molochnoj zhelezy po dannym izucheniya polutonkih srezov i elektronnoj mikroskopii]. Morfologiya. 2011;V(2):45-8. (In Russ.).
16. Hladovec J., Prerovsky I., Stanek V., Fabian J.Circulating endothelial cells in acute myocardial infarction and angina pectoris. Klin Wochenschr. 1978;56(20):1033-6.
17. Olusola A.D., Pengo Elvira T.D.F. The peculiarity of the endothelial function of the uterine vessels in women with early reproductive losses. [Osobennost' ednotelial'noj funkcii sosudov matki u zhenshchin s rannimi reproduktivnymi poteryami. IV mezhdunarodnaya nauchnaya konferenciya «Science 4 Health»: tezisy dokladov]. Moskva: RUDN, 2012. 19-20. (In Russ.).
18. Karthikeyan V.J., Lip G.Y. Endothelial damage/dysfunction and hypertension in pregnancy. Front Biosci (Elite Ed). 2011;3:1100-8. https://doi.org/10.2741/314.
19. Saleem Alkasiy K., Al-Habib M.F., Abdulshaheed N.A. Electron microscopic study of the effect of preeclampsia on the placental endothelial cells ultra structures during pregnancy. Al-Kindy Col Med J. 2010;6(1):39-44.
20. Chistyakova G.N., Remizova I.I., Gazieva I.A., Ustyantseva L.S. Evaluation of cardiovascular system in children who were born from women with chronic hypertension. [Ocenka sostoyaniya serdechno-sosudistoj sistemy detej, rodivshihsya ot zhenshchin s hronicheskoj arterial'noj gipertenziej]. Pediatriya. Zhurnal imeni G.N. Speranskogo. 2015;94(2):8-12. (In Russ.).
21. Mikhalenko I.V., Mikhalev E.V. Humoral parameters of the vascular endothelium and hemostatic systems in preterm newborn with hypoxic CNS injury. [Gumoral'nye pokazateli sostoyaniya sistemy sosudistogo endoteliya i gemostaza u nedonoshennyh novorozhdennyh detej s gipoksicheskim porazheniem CNS]. Rossijskij vestnik perinatologii i pediatrii. 2014;59(2):61-5. (In Russ.).
For citation:
Mironov A.V., Umakhanova M.M., Torchinov A.M. A role of endothelial dysfunction in development of maternal, perinatal and pediatric morbidity. Obstetrics, Gynecology and Reproduction. 2020;14(5):600-610. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2020.136
Views: 163
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Email this article 
