STRATIFICATION OF PREGNANT WOMEN AT EARLY GESTATIONAL AGES BY MEANS OF OBJECTIVATION OF "PHYSIOLOGICAL ALTERATION" FACTORS, MECHANISMS OF GESTATIONAL ADAPTATION AND FETOPLACENTAL DYSFUNCTION

Abstract

Aim - allocation of clinical and pathogenetic variants of early gestosis in pregnant women based on clinical manifestations and markers of leading pathogenetic syndromes of gestational maladjustment. Materials and methods. 45 healthy pregnant women and 160 pregnant women with early morning sickness of varying severity were examined in the 1st trimester of gestation. The comparison group consisted of 33 healthy non-pregnant women. The survey included assessment of clinical symptoms, identification of the markers of inflammatory response, energy balance of reproductive system, functional activity of the endometrium, vascular endothelial and hemostatic disorders, and blood biochemical indices. Results. The study enabled quantitative objectivation of the factors of “physiological damage” and “the mechanisms of gestational adaptation” during physiological gestation, defining fetoplacental dysfunction as the key link of maladjustment in early pregnancy. The prevalence of pathogenetic mechanisms of the formation of early pregnancy toxicosis determined the allocation of 4 clinical-pathogenetic variants of the course of this complication of gestation. Conclusion. Differentiated approach to clinical and laboratory manifestations of early gestosis in pregnant women, taking into account the variants of the clinical course of this complication and severity assessment, enables targeted therapy and predicting the risk of development of severe forms and late obstetric complications, reduces the risk of adverse perinatal outcomes.

Keywords

• physiological pregnancy
• early toxicosis
• fetoplacental dysfunction
• autonomic imbalance
• leptin
• cytokines
• growth factors
• apoptosis