Development of complications of gestation in pregnant women with preeclampsia associated with thrombophilia.

In order to determine the impact of acqui red , inherite d , and combined multigenic thrombophilia in the development of obstetric and perinatal complications in preeclampsia , 133 women in the second and third trimesters of pregnancy were examined. 46 pregnant women with pre-eclampsia and obstetric and/or perinatal complications were included in the main group. P lacentae abruption – 8.7%, eclampsia – 2,17%, HELLP- syndrome – 2.17%, FGR – 50.0%, antenatal fetal death – 13.04%, fetal distress during pregnancy – 45.65% were considered a s complications . 87 pregnant women with preeclampsia, but without above mentioned complications formed group of comparison. The method of allele-specific polymerase chain reaction was performed to determine polymorphisms in the genes of factor V Leiden 1691 G → A, prothrombin 20210 G → A, plasminogen activator inhibitor type-1 5G / 4G, fibrinogen β 455 G → A, paraoxonase-1 192 Q → R, methylenetetrahydrofolate reductase (MTHFR) 677 C → T and angiotensinogen 235 M → T. To determine the causes of acquired thrombophilia antiphospholipid antibody level and concentration of homocysteine in plasma (ELISA) were studied . There were determined factors that increase relative risk of obstetric and perinatal complications in pregnant women with pre-eclampsia: first delivery, the onset of symptoms of preeclampsia at term less than 28 weeks of pregnancy, severe or moderate ly sever e forms of preeclampsia, the duration of pre-eclampsia more than 5 weeks. S uch genotypes as 1691 GA of Factor V Leiden – increases the risk by in 2.9 times (95% CI 1,94-4,33); prothrombin 20210 GA – by 2.36 times (95% CI: 1,54-3,6); p rothrombin 20210 AA – by 3.12 times (95% CI 2,4-4,0) a combination of three or more pathologic polymorphisms – by 2.58 times (95% CI 1,64-4,05); pathological level of AFA – by 1.7 times (95% CI 1,08-2,67); combined thrombophilia – by 1.76 times (95% CI 1,12-2,76); h omocysteine concentration of more than 15 µmol/l – by 2.31 times (95% CI 1.5-3.5) are m arkers of predisposition to the development of obstetric and perinatal complications in pregnant women with pre-eclampsia