The relationships in the mother – placenta – child system in case of hematogenous thrombophilia and thrombotic state of readiness
https://doi.org/10.20538/1682-0363-2016-5-5-15
Abstract
The purpose of this study is to understand the relationships in the mother-placenta-child system in case of hematogenous thrombophilia and thrombotic state of readiness in pregnant women.
Materials and methods. The research group consisted of 454 patients, was divided into two subgroups: the 1st subgroup included 225 women (pregnant and, subsequently, obstetric patients) and the 2nd subgroup included their 229 infants who were in the perinatal center of State Novosibirsk Regional Clinical Hospital. At 3–5 days of life 75 newborns from the 2nd sub-group underwent hemostatic system assessment. 42 healthy newborns from somatically healthy mothers (without thrombophilia) were included in the control group. The assessment of their hemostatic system was carried out to determine the performance of reference values.
Results. The relationships between the health condition of newborns and hemostatic system disorders in mothers with thrombotic state of readiness, hematogenous thrombophilia, and morphohistological changes in the placenta were studied. The researchers analyzed labour and delivery records, pathomorphological examination of a placenta, neonatal records, and assessed the hemostatic system. A number of complications were detected during a gestational process and an early neonatal period. The correlation analysis has established a relationship in the mother – placenta – child system in a number of factors affecting children’s health outcomes. To correct above mentioned abnormalities preventive measures can be taken. They allow to avert the development of perinatal complications in case of hematogenous thrombophilia and (or) thrombotic readiness.
About the Authors
T. V. Belousova
Novosibirsk State Medical University (NSMU)
Russian Federation
Russian Federation
MD, Professor, Head of Department of Pediatrics and Neonatology,
52, Krasnyi Av., Novosibirsk, 630091
I. O. Marinkin
Novosibirsk State Medical University (NSMU)
Russian Federation
Russian Federation
MD, Professor, Head of Department of Obstetrics and Gynecology, Pediatric Faculty,
Novosibirsk
V. A. Plyushkin
Novosibirsk State Medical University (NSMU)
Russian Federation
Russian Federation
PhD, Assistant of Department of Pediatrics and Neonatology,
Novosibirsk
A. A. Leonova
Novosibirsk State Medical University (NSMU)
Russian Federation
Russian Federation
Assistant of Department of Pediatrics and Neonatology,
Novosibirsk
References
1. Momot A.P., Taranenko I. A., Tsyvkina L.P. Sostoyanie tromboticheskoy gotovnosti – vozmozhnosti sovremennoy diagnostiki i perspektivyi [Thrombotic state of readiness the possibilities of modern diagnosis and prospects] // Meditsinskiy alfavit. Sovremennaya laboratoriya – Medical alphabet. Motion lab. 2013; 1: 24–27 (in Russian).
2. Aylamazyan E.K., Zaynulina M.S. Nasledstvennaya trombofiliya: differentsirovannyiy podhod k otsenke riska akusherskih oslozhneniy. [Hereditary thrombophilia: a differentiated approach to assessment of risk of obstetric complications] // Akusherstvo i ginekologiya – OBGYN-obstetrics-wise. 2010; 3: 3–9 (in Russian).
3. Makatsariya A.D., Bitsadze V. O., Akinshina S. V. Trombozyi i tromboembolii v akushersko-ginekologicheskoy klinike: molekulyarno-geneticheskie mehanizmyi i strategiya profilaktiki tromboembolicheskih oslozhneniy [Thrombosis and thromboembolism in the obstetric clinic: molecular genetic mechanisms and strategy for prevention of thromboembolic complications] Rukovodstvo dlya vrachey [A guide for physicians] M: Med. inform. agency, 2007: 1064 (in Russian).
4. Aylamazyan E. K., Zaynulina M. S., N. N. Petrishchev. Rol trombofilii v razvitii akusherskoy patologii [The role of thrombophilia in the development of pathology in obstetrics] // Akusherstvo i ginekologiya – Obstetrics and gynecology. 2007; 5: 38–42 (in Russian).
5. Gray G., Nelson-Piercy C. Thromboembolic disorders in obstetrics // Best Practice a. Research: Clinic. Obstetrics a. Gynaecology. 2012; 26 (1): 53–64.
6. Momot A. P. [et al.] Evolyutsiya ucheniya Z.S. Barkagana o gematogennyih trombofiliyah [The evolution of teaching Barkagan ZS of hematogenic thrombophilia]. Barkaganovskie chteniya. Tr. III sib. nauch.-prakt. konf. gematologov [Barkagan’s read: Tr. III Sib. scientific.- pract. Conf. hematologists]. Barnaul Publ., 2010: 16–40 (in Russian).
7. Nikolaeva M. G. [et al.] Rol’ geneticheskih determinant trombofiliy v razvitii akusherskih oslozhneniy [The role of genetic determinants of thrombophilia in the development of aku-Chersky complications]. Barkaganovskie chteniya. Tr. III sib. nauch.-prakt. konf. gematologov [Barkagan’s read: Tr. III Sib. scientific.-pract. Conf. hematologists]. Barnaul Publ., 2010: 83–87 (in Russian).
8. Ignatiev N.S. [et al.] Rannyaya diagnostika trombozov u novorozhdennyih. [Early diagnosis of thrombosis in the newborn] // Pediatriya – Pediatrics. 2010; 1: 41–43 (in Russian).
9. Purbaeva E.N., Zaynulina M.S. Nekotoryie voprosyi trombofilii pri platsentarnoy nedostatochnosti v praktike semeynogo vracha [Some issues of thrombophilia in placental insufficiency in the practice of the family doctor] // Novyie Sankt-Peterburg. vracheb. vedomosti – New St.-Petersburg. medical. statements. 2007; 1: 51–53 (in Russian).
10. Gruel Y. Specificities of neonatal hemostasis and implications in pathologic situations// Arch. of Pediatrics. 2010; 17 (3): 93–100.
11. Serov V. N. [et al.]. Hereditary and acquired thrombophilic States in obstetric practice: (clinical aspects, diagnosis, tactics of the Veda-niya, approaches to therapy) hands. for the doctors. Novosibirsk, 2011: 180 (in Russian).
12. Leistra-Leistra M.J. [et al.] Fetal thrombotic vasculopathy in the placenta: a thrombophilic connection between pregnancy complications and neonatal thrombosis? // Placenta. 2004; 25 (A): S102–S105.
13. Ilyina A. Y. Antifosfolipidnyie antitela i endotoksinemiya u zhenschin s kardiovaskulyarnoy patologiey i ih novorozhdennyih [Antiphospholipid antibodies and endotoxinemia in women with cardiovascu popular pathology and their newborn infants] // Pediatriya – Pediatrics. 2004; 1: 28–33 (in Russian).
14. Tuyhy J., Harrison А. Prenatal transfer of anticardiolipin antibodies associated with fatal neona-tal aortic thrombosis // Austral. a. New Zealand J. of Obstetrics a. Gynaecology. 2005; 45(2): 175–176.
15. Karnyushina E. A., Zaynulina M. S. Disorders of hemostasis, methods of their correction and the outcomes of pregnancy in patients with thrombophilia and recurrent pregnancy loss // Thrombosis, hemostasis and rheology. 2009; 4: 71–78 (in Russian).
16. Koch N. In. Voronina E. N., Filippenko M. L. study of the influence of polymorphism of genes associated with thrombophilia, the formation of obstetric pathology (preeclampsia, vechnoe miscarriage) // Burkhanova read : Tr. III Sib. scientific.-pract. Conf. hematologists. Barnaul, 2010: 121 (in Russian).
17. Karnyushina E. A., Zaynulina M. S. Narusheniya sistemyi gemostaza, metodyi ih korrektsii i ishodyi beremennosti u bolnyih s trombofiliey i nevyinashivaniem [Disorders of hemostasis, methods of their correction and the outcomes of pregnancy in patients with thrombophilia and recurrent pregnancy loss] // Tromboz, gemostaz i reologiya – Thrombosis, hemostasis and rheology. 2009; 4: 71–78 (in Russian).
18. Koch N. In. Voronina E. N., Filippenko M. L. Issledovanie vliyaniya polimorfizma genov, assotsiirovannyih s trombofiliey, na formirovanie akusherskoy patologii (gestoz, privyichnoe nevyinashivanie beremennosti) [A study of the influence of polymorphism of genes associated with thrombophilia, the formation of obstetric pathology (preeclampsia, habitual miscarriage)] Barkaganovskie chteniya. Tr. III sib. nauch.-prakt. konf. gematologov – Barkagan’s read: Tr. III Sib. scientific.-pract. Conf. hematologists. Barnaul Publ., 2010: 121 (in Russian).
19. Helgadottir L. B. [et al.]. The association of inherited thrombophilia and intrauterine fetal death: a case-control study// Blood Coagululation a. Fibrinolysis. 2011; 22(8): 651–656.
20. Pogliani L. [et al.]. Maternal methylenetetrahydrofolate reductase (MTHFR) homozygosity and neonatal outcome: follow-up of 42 pregnancies at risk // J. of Child Neurology. 2010;. 25 (6): 701–704.
21. Pikalov I. V. Mehanizmyi, diagnostika i puti korrektsii vazhneyshih narusheniy gemostaza u nedonoshennyih novorozhdennyih [Mechanisms, diagnosis and ways of correction of critical violations hemostasis in preterm infants: author. dis. ... d-ra med. sciences]. Barnaul, 1998: 34 (in Russian).
22. Elektronnyiy resurs [Electronic resource] URL: http://www.infamed.com/stat/s05.html (in Russian).
23. Kitchens K.S., Alving B.M.,. Kessler C.M Consultative hemostasis and thrombosis [S. l.]: El-sivier, 2002: 672.
24. Idrisova M. Klinicheskoe znachenie diagnostiki i korrektsii narusheniy v sisteme gemostaza u beremennyih starshe 35 let [The clinical value of diagnostics and correction of violations in the hemostatic system in pregnant women older than 35 years] // Vrach – Doctor. 2007; 4: 69–70 (in Russian).
25. Bitsadze V. O. Printsipyi diagnostiki i patogeneticheskoy profilaktiki osnovnyih oslozhneniy beremennosti, obuslovlennyih trombofiliey [Principles of diagnostics and pathogenetic prophylaxis of the basic complications of pregnancy caused by thrombophilia]: author. dis. ... d-ra med. sciences]. M., 2003: 52 (in Russian).
26. Mello G. [et al.] Thrombophilia is significantly associated with severe preeclampsia: results of a large-scale, case-controlled study // Hypertension. 2005; 46 (6): 1270–1274.
27. Sharygin S.A. [et al.] Dopolnitelnyie markeryi platsentarnoy nedostatochnosti pri gestoze, soprovozhdayuschemsya narusheniyami rodovoy deyatelnosti [Additional markers of placental insufficiency in preeclampsia, accompanied by impaired labor activity] // Arh. patologii – Arch. pathology. 2008; 2: 12–14 (in Russian).
28. Yudaeva L.S., Makatsariya A.D. Profilaktika i korrektsiya trombogemorragicheskih oslozhneniy vo vremya beremennosti i pri kesarevom sechenii u bolnyih s vrozhdennyimi zabolevaniyami soedinitelnoy tkani [Prevention and correction of thrombohemorrhagic complications during pregnancy and cesarean section in patients with congenital over-diseases of connective tissue] // Akusherstvo i ginekologiya – Obstetrics and gynecology. 2006; 6: 20–23 (in Russian).
29. Arias F. [et al.] Thrombophilia: a mechanism of disease in women with adverse pregnancy outcome and thrombotic lesions in the placenta // J. of Matern.-Fetal Medicine. 1998; 7 (6): 277–286.
30. Levy R.A. [et al.] Placental pathology in antiphosholipid syndrome // Lupus. 1998; 7 (20): 81–85.
31. Tabolin V.A. [et al.] Klinicheskoe znachenie pokazateley gemostaza v geneze zabolevaniy novorozhdennyih rannego neonatalnogo perioda, rodivshihsya u zhenschin s cardiovaskulyarnoy patologiey [Clinical value of indicators of hemostasis in the Genesis of diseases of newborns of the early neonatal period born to women with cardiovascular pathology] // Pediatriya – Pediatrics. 2006; 1: 22–26 (in Russian).
32. Chuprova A.V. Sistema svertyivaniya krovi i ee narusheniya u novorozhdennyih (funktsionalno-strukturnyie osobennosti, metodyi diagnostiki i kontroliruemoy terapii) [The system of blood coagulation and its disorders in the newborn (functional and structural features, methods of diagnostics and controlled therapy): autoref. dis. ... d-ra med. sciences]. M., 1994: 35 (in Russian).
33. Sturov V.G. Nasledstvennyie strukturnyie anomalii fibrinogena (disfibrinogenemii): podhodyi k diagnostike i napravlennoy terapii u detey [Hereditary structural abnormalities of fibrinogen (dysfibrinogenemia-MIA): approaches to diagnosis and targeted therapy in children] // Byul. sib. meditsinyi – Bull. sib. medicine. 2008; 2: 173–174 (in Russian).
34. Franchini M. [et al.] Neonatal dysfibrinogenemias and thromboembolic emergencies // Annals of Hematology. 2006; 85 (8): 552–554.
Review
For citations:
Belousova T.V., Marinkin I.O., Plyushkin V.A., Leonova A.A. The relationships in the mother – placenta – child system in case of hematogenous thrombophilia and thrombotic state of readiness. Bulletin of Siberian Medicine. 2016;15(5):5-15. (In Russ.) https://doi.org/10.20538/1682-0363-2016-5-5-15
Views:
1287
Email this article 