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Новые аспекты патогенеза плацентарной недостаточности
Новые аспекты патогенеза плацентарной недостаточности
Зефирова Т.П., Железова М.Е. Новые аспекты патогенеза плацентарной недостаточности. Consilium Medicum. 2018; 20 (6): 46–49. DOI: 10.26442/2075-1753_2018.6.46-49
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Аннотация
Плацентарная недостаточность осложняет значительное количество беременностей и приводит к гипоксии и задержке развития плода. При однотипности своих клинических проявлений плацентарная недостаточность является многофакторным состоянием. Одной из важных причин дисфункции плаценты считается нарушение реологических свойств крови. Текучесть крови ухудшается при анемическом синдроме и синдроме гемоконцентрации, что необходимо учитывать при выборе терапии у женщин с подобными состояниями. Другой причиной альтерации плаценты считается активация тромбоцитов матери. В этих случаях оправдано использование препаратов с дезагрегантным действием. Дипиридамол положительно влияет на реологию крови и снижает активность тромбоцитов, поэтому может быть использован для профилактики и лечения плацентарной недостаточности у названных категорий беременных женщин.
Ключевые слова: плацентарная недостаточность, беременность, реология крови, гемоконцентрация, анемический синдром, агрегация тромбоцитов, дипиридамол.
Ключевые слова: плацентарная недостаточность, беременность, реология крови, гемоконцентрация, анемический синдром, агрегация тромбоцитов, дипиридамол.
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Placental insufficiency complicates the significant amount of pregnancies and leads to a hypoxia and fetal growth retardation. At uniformity of the clinical manifestations, a placental insufficiency is a multifactorial state. The considerable reason of a placental disfunction is halting of rheological properties of blood. Flowability of blood worsens at an anemic syndrome and a syndrome of hemoconcentration, it is necessary to consider at the choice of therapy at women with similar states. Other reason of alteration of a placenta is an activation of mother’s thrombocytes. Dipiridamole positively influences a hemorheology and reduces activity of thrombocytes therefore it can be used for prevention and treatment of a placental insufficiency to the categories of women listed above.
Key words: placental insufficiency, pregnancy, hemorheology, hemoconcentration, anemic syndrome, thrombocytes aggregation, dipyridamole.
Key words: placental insufficiency, pregnancy, hemorheology, hemoconcentration, anemic syndrome, thrombocytes aggregation, dipyridamole.
Полный текст
Список литературы
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2. Lithell UB, Vagero D, Koupilova I, Leon DA. Social determinants of birthweight, ponderal index and gestational age in Sweden in the 1920s and the 1980s. Acta Paediatr 1999; 88 (4): 445–53.3. John VI, Tsilou E, Fisher S et al. Placental Origins of Adverse Pregnancy Outcomes: Potential Molecular Targets – An Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Am J Obstet Gynecol 2016; 215: 1–46.
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________________________________________________
1. Morgan TK. Role of the Placenta in Prenerm Birth: A Review. Am J Perinatol 2016; 33 (3): 258–66.
2. Lithell UB, Vagero D, Koupilova I, Leon DA. Social determinants of birthweight, ponderal index and gestational age in Sweden in the 1920s and the 1980s. Acta Paediatr 1999; 88 (4): 445–53.
3. John VI, Tsilou E, Fisher S et al. Placental Origins of Adverse Pregnancy Outcomes: Potential Molecular Targets – An Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Am J Obstet Gynecol 2016; 215: 1–46.
4. Roitman E.V., Firsov N.N., Dementeva M.G. Terminy, ponyatiya i podhody k issledovaniyam reologii krovi v klinike. Tromboz, gemostaz i reologiya. 2000; 3 (3): 5–12. [in Russian]
5. Gonzales GF, Steenland K, Tapia V. Maternal hemoglobin level and fetal outcome at low and high altitudes. Am J Physiol RegulIntegr Comp Physiol 2009; 297: 1477–85.
6. Muravev A.V., Kislov N.V., Tihomirova I.A. i dr. Ros. zhurn. biomehaniki. 2013; 17 (2, 60: 75–83. [in Russian]
7. Soliman AA, Csorba R, Yilmaz A et al. Rheologic results and their correlation to hemostatic changes in patients with moderate and severe preeclampsia: an observational cross-sectional study. Clin Hemorheol Microcirc 2015; 59 (1): 1–15.
8. Cordina M, Bhatti S, Fernandez M et al. Association between maternal haemoglobin at 27–29 weeks’ gestation and intrauterine growth restriction. Рregnancy Hypertens 2015; 5 (4): 339–45.
9. Aranda N, Hernández-Martínez C, Arija V et al. Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour. Public Health Nutr 2017; 20 (8): 1405–13.
10. Rao R, Georgieff MK. Early nutrition and brain development. In the Effects of Early Adversity on Neurobehavioral. Psychology Press 2015; May 7: 346.
11. Zefirova T.P., Sabirov I.H., Zhelezova M.E. Vliyanie narushenij reologicheskih svojstv krovi materi na vnutriutrobnoe razvitie ploda. Effektivnaya farmakoter. 2016; 14: 22–6. [in Russian]
12. Salov I.A., Lysenko L.V., Marshalov D.V., Petrenko A.P. Zavisimost tkanevoj oksigenacii ot urovnya gemoglobina u beremennyh i rozhenic s anemiej. Fundamentalnye issledovniya. 2014; 4 (1): 163–6. [in Russian]
13. Sharawy N. Effects of haemoglobin levels on the sublingual microcirculation in pregnant women. J Clinl Hemorheol Microcircul 2016; 64 (2): 205–12.
14. Dodd JM, McLeod A, Windrim RC, Kingdom J. Antithrombotic therapy for improving maternal or infant health outcomes in women considered at risk of placental dysfunction. Cochrane Database Syst Rev 2013; 7: CD006780.
15. WHO recommendations for prevention and treatment of preeclampsia and eclampsia – World Health Organization. 2011.
16. Cohen H, O'Brien P. Disorders of Thrombosis and Hemostasis in Pregnancy. A Guide to Management 2015; 64 (1): 435–8.
17. Petruhin V.A., Novikova S.V., Pavlova T.V., Leonova V.Yu. Akusherstvo i ginekologiya. 2017; 3 (2): 44–8. [in Russian]
18. Adam S, Elfeky O, Kynhal V et al. Rewiev: Fetal-maternal communication via extracellular vesicles – Implications for complications of pregnancies. Placenta 2017; 54: 83–8.
19. Kohli S, Isermann B. Placental hemostasis and sterile inflammation: New insights into gestational vascular disease. Thromb Res 2017; 151: 30–3.
2. Lithell UB, Vagero D, Koupilova I, Leon DA. Social determinants of birthweight, ponderal index and gestational age in Sweden in the 1920s and the 1980s. Acta Paediatr 1999; 88 (4): 445–53.
3. John VI, Tsilou E, Fisher S et al. Placental Origins of Adverse Pregnancy Outcomes: Potential Molecular Targets – An Executive Workshop Summary of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Am J Obstet Gynecol 2016; 215: 1–46.
4. Roitman E.V., Firsov N.N., Dementeva M.G. Terminy, ponyatiya i podhody k issledovaniyam reologii krovi v klinike. Tromboz, gemostaz i reologiya. 2000; 3 (3): 5–12. [in Russian]
5. Gonzales GF, Steenland K, Tapia V. Maternal hemoglobin level and fetal outcome at low and high altitudes. Am J Physiol RegulIntegr Comp Physiol 2009; 297: 1477–85.
6. Muravev A.V., Kislov N.V., Tihomirova I.A. i dr. Ros. zhurn. biomehaniki. 2013; 17 (2, 60: 75–83. [in Russian]
7. Soliman AA, Csorba R, Yilmaz A et al. Rheologic results and their correlation to hemostatic changes in patients with moderate and severe preeclampsia: an observational cross-sectional study. Clin Hemorheol Microcirc 2015; 59 (1): 1–15.
8. Cordina M, Bhatti S, Fernandez M et al. Association between maternal haemoglobin at 27–29 weeks’ gestation and intrauterine growth restriction. Рregnancy Hypertens 2015; 5 (4): 339–45.
9. Aranda N, Hernández-Martínez C, Arija V et al. Haemoconcentration risk at the end of pregnancy: effects on neonatal behaviour. Public Health Nutr 2017; 20 (8): 1405–13.
10. Rao R, Georgieff MK. Early nutrition and brain development. In the Effects of Early Adversity on Neurobehavioral. Psychology Press 2015; May 7: 346.
11. Zefirova T.P., Sabirov I.H., Zhelezova M.E. Vliyanie narushenij reologicheskih svojstv krovi materi na vnutriutrobnoe razvitie ploda. Effektivnaya farmakoter. 2016; 14: 22–6. [in Russian]
12. Salov I.A., Lysenko L.V., Marshalov D.V., Petrenko A.P. Zavisimost tkanevoj oksigenacii ot urovnya gemoglobina u beremennyh i rozhenic s anemiej. Fundamentalnye issledovniya. 2014; 4 (1): 163–6. [in Russian]
13. Sharawy N. Effects of haemoglobin levels on the sublingual microcirculation in pregnant women. J Clinl Hemorheol Microcircul 2016; 64 (2): 205–12.
14. Dodd JM, McLeod A, Windrim RC, Kingdom J. Antithrombotic therapy for improving maternal or infant health outcomes in women considered at risk of placental dysfunction. Cochrane Database Syst Rev 2013; 7: CD006780.
15. WHO recommendations for prevention and treatment of preeclampsia and eclampsia – World Health Organization. 2011.
16. Cohen H, O'Brien P. Disorders of Thrombosis and Hemostasis in Pregnancy. A Guide to Management 2015; 64 (1): 435–8.
17. Petruhin V.A., Novikova S.V., Pavlova T.V., Leonova V.Yu. Akusherstvo i ginekologiya. 2017; 3 (2): 44–8. [in Russian]
18. Adam S, Elfeky O, Kynhal V et al. Rewiev: Fetal-maternal communication via extracellular vesicles – Implications for complications of pregnancies. Placenta 2017; 54: 83–8.
19. Kohli S, Isermann B. Placental hemostasis and sterile inflammation: New insights into gestational vascular disease. Thromb Res 2017; 151: 30–3.
Авторы
Т.П.Зефирова*, М.Е.Железова
Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 420012, Россия, Казань, ул. Муштари, д. 11
*tzefirova@gmail.com
Казанская государственная медицинская академия – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России. 420012, Россия, Казань, ул. Муштари, д. 11
*tzefirova@gmail.com
________________________________________________
T.P.Zefirova*, M.E.Zhelezova
Kazan State Medical Academy – a branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 420012, Russian Federation, Kazan, ul. Mushtari, d. 11
*tzefirova@gmail.com
Kazan State Medical Academy – a branch of the Russian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation. 420012, Russian Federation, Kazan, ul. Mushtari, d. 11
*tzefirova@gmail.com
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