Thrombophilia in the pathogenesis of fetal growth retardation
https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.223
Abstract
Fetal growth retardation (FGR) is a complication of pregnancy that determines perinatal morbidity and mortality. It is a complex and multifaceted medical problem that does not lose its relevance. Impaired fetal development and delayed growth result from various etiopathogenesis of pathological processes occurring in the "mother–placenta–fetus" interface. Thrombophilia is one of the factors that can initiate disturbed placental function and the utero-placental blood flow. Here we describe the clinical FGR variants and etiopathogenetic factors of developing this complication of pregnancy (placental, maternal, and fetal). Special attention is paid to genetic and acquired thrombophilia (due to the circulation of antiphospholipid antibodies) and their role in development of such complication of pregnancy.
About the Authors
E. A. Orudzhova
Maternity Hospital № 1 – Branch of Vorokhobov City Clinical Hospital № 67, Moscow Healthcare Department
Russian Federation
Russian Federation
Esmira A. Orudzhova – MD, Head of Outpatient Medical Care Center
2/44 Salyama Adilya Str., Moscow 123423
N. A. Samburova
Sechenov University
Russian Federation
Russian Federation
Natalia V. Samburova – MD, PhD, Associate Professor, Department of Pathophysiology, Institute of Clinical Medicine
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991
E. V. Anichkova
Sechenov University
Russian Federation
Russian Federation
Elizaveta V. Anichkova – 5th year Student, International School «Medicine of the Future»
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991
K. E. Gotsiridze
Chachava Clinic
Georgia
Georgia
Ketevan E. Gotsiridze – MD, Obstetrician-Gynecologist, Head of the Center for Reproductive Health
38 Merab Kostava Str., Tbilisi 0179
V. O. Bitsadze
Sechenov University
Russian Federation
Russian Federation
Viktoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health
Scopus Author ID: 6506003478. Researcher ID: F-8409-2017.
2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991
References
1. Zarudskaya O.M., Churnosov M.I. The role of hereditary thrombophilia in the development of chronic fetal-placental insufficiency and intrauterine growth retardation. [Rol' nasledstvennoj trombofilii v razvitii hronicheskoj feto-placentarnoj nedostatochnosti i sindroma vnutriutrobnoj zaderzhki rosta ploda]. Nauchnye vedomosti Belgorodskogo gosudarstvennogo universiteta. Seriya: Medicina. Farmaciya. 2012;(10):132–6. (In Russ.).
2. Abheiden C., van Hoorn M.E., Hague W.M. et al. Does low-molecularweight heparin influence fetal growth or uterine and umbilical arterial Doppler in women with a history of early-onset uteroplacental insufficiency and an inheritable thrombophilia? Secondary randomised controlled trial results. BJOG. 2016;123(5):797–805. https://doi.org/10.1111/1471-0528.13421.
3. Jamal A., Hantoshzadeh S., Hekmat H., Abbasi S. The association of thrombophilia with fetal growth restriction. Arch Iran Med. 2010;13(6):482–5.
4. Murki S., Sharma D. Intrauterine growth retardation – a review article. J Neonatal Biol. 2014;3(3):135. https://doi.org/10.4172/2167-0897.1000135.
5. Levine T.A., Grunau R.E., McAuliffe F.M. et al. Early childhood neurodevelopment after intrauterine growth restriction: a systematic review. Pediatrics. 2015;135(1):126–41. https://doi.org/10.1542/peds.2014-1143.
6. Strizhakov A.N., Makatsariya A.D., Timohina E.V. et al. A clinical significance of acquired and hereditary forms of thrombophilia in the pathogenesis of fetal growth retardation syndrome. [Klinicheskoe znachenie priobretennyh i nasledstvennyh form trombofilij v patogeneze sindroma zaderzhki rosta ploda]. Voprosy ginekologii, akusherstva i perinatologii. 2009;8(2):16–21. (In Russ.).
7. Mastrolia S., Novak L., Thachil J. et al. LMWH in the prevention of preeclampsia and fetal growth restriction in women without thrombophilia. A systematic review and meta-analysis. Thromb Haemost. 2016;116(5):868–78. https://doi.org/10.1160/TH16-02-0169.
8. Ndour D.D., Gassama O. Intrauterine growth retardation, fetal growth restriction: impact on brain development. EC Paediatrics. 2019;8(9):810–9.
9. Goel P., Radotra A., Singh I. et al. Effects of passive smoking on outcome in pregnancy. J Postgrad Med. 2004;50(1):12–6.
10. Figueras F., Gardosi J. Should we customize fetal growth standards? Fetal Diagn Ther. 2009;25(3):297–303. https://doi.org/10.1159/000235875.
11. Yang Q., Witkiewicz B.B., Olney R.S. et al. A case-control study of maternal alcohol consumption and intrauterine growth retardation. Ann Epidemiol. 2001;11(7):497–503. https://doi.org/10.1016/S1047-2797(01)00240-X.
12. Motta M., Tincani A., Meroni P.L. et al. Follow-up of children exposed antenatally to immunosuppressive drugs. Rheumatology (Oxford). 2008;47(3):11132–4. https://doi.org/10.1093/rheumatology/ken149.
13. Veiby G., Daltveit A.K., Engelsen B.A. et al. Fetal growth restriction and birth defects with newer and older antiepileptic drugs during pregnancy. J Neurol. 2014;261(3):579–88. https://doi.org/10.1007/s00415-013-7239-x.
14. Peebles D.M. Fetal consequences of chronic substrate deprivation. Semin Fetal Neonatal Med. 2004;9(5):379–86. https://doi.org/10.1016/j.siny.2004.03.008.
15. Dvoryansky S.A., Iutinsky E.M. Placental insufficiency (clinical picture, diagnosis, treatment, outcome). [Fetoplacentarnaya nedostatochnost' (klinika, diagnostika, lechenie, iskhod)]. Kirov, 2009. 105 p. (In Russ.).
16. Macharashvili E.T., Radzinsky V.E., Itkes A.B., Startseva N.M. Prediction of fetal growth retardation and prematurity by maternal and fetal genotypes. [Prognozirovanie zaderzhki razvitiya ploda i nedonashivaniya po genotipam materi i ploda. VI Rossijskij forum «Mat' i Ditya»: tezisy dokladov]. Moscow, 2004. 129. (In Russ.).
17. Tower C., Baker P. The Genetics of fetal growth restriction: Implications for management. Reviews in Gynaecological and Perinatal Practice. 2006;6:99–105.
18. Wolstenholme J., Wright C. Genes, chromosomes and IUGR. In: Intrauterine Growth Restriction. London: Springer Verlag, 2000. 7–28.
19. Strizhakov A.N., Voloshchuk I.N., Timokhina E.V., Kozlova U.A. Morphofunctional changes in the placenta with placental insufficiency of varied severity. [Morfofunkcional'nye izmeneniya v placente pri placentarnoj nedostatochnosti razlichnoj stepeni tyazhesti]. Voprosy ginekologii, akusherstva i perinatologii. 2010;9(2):5–11. (In Russ.).
20. Churnosov M.I., Kokorina O.S. Genetic studies of chronic placental insufficiency and fetal growth retardation syndrome. [Geneticheskie issledovaniya hronicheskoj placentarnoj nedostatochnosti i sindroma zaderzhki rosta ploda]. Rossijskij vestnik akushera-ginekologa. 2014;14(1):27–32. (In Russ.).
21. Rab A., Szentpéteri I., Kornya L. et al. Placental gene expression patterns of epidermal growth factor in intrauterine growth restriction. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):96–9. https://doi.org/10.1016/j.ejogrb.2013.05.020.
22. Demina T.N., Khvesik A.A. The role of genetically determined thrombophilia in the development of gestational and perinatal complications, their prevention and treatment (literature review). [Rol' geneticheski obuslovlennoj trombofilii v razvitii gestacionnyh i perinatal'nyh oslozhnenij, ih profilaktika i lechenie (obzor literatury)]. Mediko-social'nye problemy sem'i. 2020;25(1):73–85. (In Russ.).
23. Arias M.F., Mazarico E., Gonzalez A. et al. Genetic risk assessment of thrombophilia in patients with adverse obstetric outcomes. PLoS One. 2019;14(2):e0211114. https://doi.org/10.1371/journal.pone.0211114.
24. Louis-Jacques A.F., Maggio L., Romero S.T. Prenatal screening for thrombophilias: indications and controversies, an Update. Clin Lab Med. 2016;36(2):421–34. https://doi.org/10.1016/j.cll.2016.01.016.
25. Demina T.N., Khvesik A.A. Clinical and anamnestic characteristics of pregnant women with a genetic form of thrombophilia. [Klinikoanamnesticheskaya harakteristika beremennyh s geneticheskoj formoj trombofilii]. Mediko-social'nye problemy sem'i. 2020;25(2):15–20. (In Russ.).
26. Firsova N.A., Demina T.N., Zheleznaya A.A. The role of maternal and fetal thrombophilia in the development of fetal growth retardation syndrome and fetal thrombotic vasculopathy. [Rol' materinskoj i fetal'noj trombofilii v razvitii sindroma zaderzhki rosta ploda i fetal'noj tromboticheskoj vaskulopatii]. Akusherstvo i ginekologiya Sankt-Peterburga. 2018;(2):19– 19a. (In Russ.).
27. Dłuski D., Mierzyński R., Poniedziałek-Czajkowska E. et al. Adverse pregnancy outcomes and inherited thrombophilia. J Perinat Med. 2018;24;46(4):411–7. https://doi.org/10.1515/jpm-2017-0059.
28. Said H.M., El-Gharbawi N.M., Moneim S.E.A.E. et al. Association of hereditary antithrombin deficiency with intrauterine growth restriction. Blood Coagul Fibrinolysis. 2018;29(5):442–5. https://doi.org/10.1097/MBC.0000000000000740.
29. Khachatryan Z.V., Lomova N.A., Khachaturyan A.A. et al. Prevention of fetal growth restriction in placental insufficiency. [Profilaktika zaderzhki rosta ploda pri placentarnoj nedostatochnosti]. Medicinskij sovet. 2018;(13):27–32. (In Russ.). https://doi.org/10.21518/2079-701X-2018-13-27-32.
30. Nacea J.G., Rotaru I., Niculescu M. et al. Correlations between clinical and placental histopathological and immunohistochemical features in women with and without hereditary thrombophilia. Rom J Morphol Embryol. 2019;60(1):195–203.
31. Strizhakov A.N., Makatsaria A.D., Timokhina E.V. et al. Fetal thrombophilias and their role in the pathogenesis of placental insufficiency. [Fetal'nye trombofilii i ih rol' v patogeneze placentarnoj nedostatochnosti]. Voprosy ginekologii, akusherstva i perinatologii.2009;8(6):5–10. (In Russ.).
32. Scherbina N.A., Makarenko M.V., Kuzmina I.Yu. The role of fetal inherited thrombophilia in development of various forms of fetal growth restriction syndrome. [Rol' fetal'nyh nasledstvennyh trombofilij v razvitii razlichnyh form sindroma zaderzhki rosta ploda]. Klinicheskaya medicina Kazahstana. 2014;(4):49–53. (In Russ.).
33. Abdulrab A.S. The role of thrombophilia in the development of fetal growth retardation syndrome. [Rol' trombofilii v razvitii sindroma zaderzhki rosta ploda: Avtoref. dis. kand. med. nauk]. Moscow, 2006. (In Russ.).
34. Pyurbeeva E.N., Zainulina M.S. Some issues of thrombophilia in placental insufficiency in the practice of a family doctor. [Nekotorye voprosy trombofilii v praktike semejnogo vracha]. Novye Sankt-Peterburgskie vrachebnye vedomosti. 2007;(1):51–3. (In Russ.).
Review
For citations:
Orudzhova E.A., Samburova N.A., Anichkova E.V., Gotsiridze K.E., Bitsadze V.O. Thrombophilia in the pathogenesis of fetal growth retardation. Obstetrics, Gynecology and Reproduction. 2021;15(2):189-200. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2021.223
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