Diagnosis and prognosis of pre-eclampsia in women with retrochorionic haematomas

Aim - to develop a method for predicting the development of PE in women with retrochorionic haematomas (RCH) in the first trimester. Materials and methods. The selected patients (n=164) were divided into 3 groups: Group I - 60 women with confirmed RCH in the first trimester, group II - 77 women with a threat of miscarriage without RCH, group III - 27 pregnant women with RCH in the first trimester and PE, which complicated the course of pregnancy. In the study bibliosemantic analysis was used; anamnestic data were evaluated; polymerase chain reaction was used to determine gene polymorphisms thrombophilia and angiogenesis genes; enzyme-linked immunosorbent assay to determine hormone levels; instrumental methods (ultrasound examination to determine the to determine the state of the fetus with uterine artery Doppler). Results. The average age of women in the study groups was comparable. As a result of the study, clinical and anamnestic factors that can serve as predictors of PE development in women with RHG were identified. It was proved that the development of PE significantly correlates with pregnancy parity, primarily with the fact of the first pregnancy, and obesity, especially in patients with late PE: for the first pregnancy. The analysis of perinatal risk indicators according to the Alberta Perinatal Health Programme (APHP) scale proved the effectiveness of using this scale to assess the risk of developing PE. The study showed that the most important is the multifactorial genesis and polymorphism of genetic forms of thrombophilia and angiogenesis. Conclusions. According to ROC analysis and univariate logistic analysis, the high prognostic significance of the adapted Alberta Perinatal Health Programme antenatal risk scale was confirmed. Significant predictors of PE development in women with RCH included pregnancy parity, body mass index >30 kg/m2, heterozygous or pathological polymorphisms of the genes F7, PAI-1, ITGB3-β, NOS3 and their combinations. Mutations of the thrombophilia genes F13A1, ITGB3-β and the presence of 4-6 polymorphisms of the haemostasis system genes, changes in biochemical screening parameters are of prognostic value for the development of early PE. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.