Z.S. YUSUPOVA¹, V.A. NOVIKOVA², A.S. OLENEV²

¹Kuban State Medical University, 4 Sedin Str., Krasnodar, Russian Federation, 4350063

²Peoples’ Friendship University of Russia (RUDN), 6 Miklukho-Maklay Str., Moscow, Russian Federation, 117198

  Yusupova Z.S. ― postgraduate student of the Department of Obstetrics, Gynecology and Perinatology, Faculty of Advanced Studies and Professional Retraining of Specialists, tel. (861) 222-01-14, e-mail: zaira-yusupovagad83@rambler.ru

Novikova V.A. ― D. Sc. (medicine), Professor of the Department of Obstetrics and Gynecology with a course of perinatology, e-mail: vladislavan@mail.ru, ORCID ID: 0000-0002-6109-7331

Olenev A.S. ― PhD (medicine), Associate Professor of the Department of Obstetrics, Gynecology with a course of perinatology, tel. (495) 613-45-09, e-mail: olenevAS@zdrav.mos.ru

Objective ― to study modern literature data devoted to the study of the pathogenesis of pre-eclampsia, possibilities for its diagnosis and prognosis.

Material and methods. This literature review is based on 35 literature sources, which reflect current views on various mechanisms that cause the development of preeclampsia of varying severity with early and late debut.

Results. Up to the present time debatable and controversional views remain, concerning the etiopathogenesis of preeclampsia. The pathogenetically substantiated approach to the search for reliable markers of preeclampsia prognosis at the earliest stage of its development is considered. The role of microbiota and immunological and proinflammatory processes in the probable genesis of preeclampsia is proved.

Conclusion. Despite the fact that preeclampsia is a pathological condition that occurs only during pregnancy, the etiopathogenesis of preeclampsia is of interest not only for obstetricians and gynecologists, but also for specialists in various fields of medicine. Polyetiology of preeclampsia makes it difficult for prediction and early diagnosis. Long-term risks of preeclampsia persist for decades after delivery.

Key words: preeclampsia, early preeclampsia, pathogenesis of preeclampsia, maternal mortality, maternal morbidity.

(For citation: Yusupova Z.S., Novikova V.A., Olenev A.S. Current conceptions of preeclampsia ― pathogenesis, diagnosis, prediction (literature review). Practical Medicine. 2018)

REFERENCES

1. Radzinskiy V.E., Fuks A.M. Akusherstvo. Uchebnik [Obstetrics. Textbook]. Moscow: GOEHTAR-Media, 2016. 1040 p.
2. Gipertenzivnye rasstroystva vo vremya beremennosti, v rodakh i poslerodovom periode. Preehklampsiya. Ehklampsiya: Klinicheskie rekomendatsii (protokol lecheniya) [Hypertensive disorders during pregnancy, in childbirth and the postpartum period. Pre-eclampsia. Eclampsia: Clinical guidelines (treatment protocol)]. Moscow, 2016. 72 p.
3. Ulʹyanina E.V., Fatkullin I.F., Khayrullina G.R. Markers of angiogenesis and ultrasound in assessing the severity of fetal growth retardation syndrome. Vestnik sovremennoy klinicheskoy meditsiny, 2016, vol. 9, iss. 5, pp. 79-82 (in Russ.).
4. Townsend R., O’Brien P., Khalil A. Current best practice in the management of hypertensive disorders in pregnancy. Integr. Blood Press Control, 2016, no. 9, rr. 79-94. doi: 10.2147/IBPC.S77344.
5. Oksenoyt G.K., Nikitina S.Yu., Ageeva L.I. et al. Zdravookhranenie v Rossii. Stat. sb. Rosstat [Health care in Russia. Stat. Sat. Rosstat]. Moscow, 2017. 170 p.
6. Rekomendatsii VOZ po profilaktike i lecheniyu preehklampsii i ehklampsii [WHO recommendations for the prevention and treatment of pre-eclampsia and eclampsia]. Zheneva, 2014. 48 p.
7. Vnedrenie tsikla Analiza Kriticheskikh Sluchaev v akusherskoy praktike na urovne statsionara. Evropeyskoe regionalʹnoe byuro VOZ [Implementation of the Critical Case Analysis cycle in the obstetric practice at the hospital level. WHO Regional Office for Europe]. Kopengagen, 2017. 104 p.
8. Naderi S., Tsai S.A., Khandelwal A. Hypertensive Disorders of Pregnancy. Curr. Atheroscler. Rep, 2017, no. 19 (3), r. 15. doi: 10.1007/s11883-017-0648-z.
9. Fingar K.R., Mabry-Hernandez I., Ngo-Metzger Q., et al. Delivery Hospitalizations Involving Preeclampsia and Eclampsia, 2005–2014: Statistical Brief #222. Source Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2006-2017 Apr. 26 p.
10. El Farra J., Bean C., Martin J.N. Jr. Management of Hypertensive Crisis for the Obstetrician/Gynecologist. Obstet. Gynecol. Clin. North. Am, 2016, no. 43 (4), rr. 623-637. doi: 10.1016/j.ogc.2016.07.005.
11. Ndoni E., Hoxhallari R., Bimbashi A. Evaluation of Maternal Complications in Severe Preeclampsia in a University Hospital in Tirana. Maced J. Med. Sci, 2016, no. 4 (1), rr. 102-106. doi: 10.3889/oamjms.2016.025.
12. Kim S.M., Kim J.S. A Review of Mechanisms of Implantation. Dev Reprod, 2017, no. 21 (4), rr. 351-359. doi: 10.12717/DR.2017.21.4.351.
13. Wang Y., Li Y., Hyett J., et al. HtrA3 Isoform-Specific ELISAs for Early Detection of Preeclampsia. J. Biomol. Screen, 2016, r. 1087057116682425. [Epub ahead of print]. PMID: 27932697 DOI: 10.1177/1087057116682425
14. Villa P.M., Marttinen P., Gillberg J. et al. Cluster analysis to estimate the risk of preeclampsia in the high-risk Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study. PLoS One, 2017, no. 12 (3), r. e0174399. doi: 10.1371/journal.pone.0174399.
15. Kalafat E., Thilaganathan B. Cardiovascular origins of preeclampsia. Curr. Opin. Obstet. Gynecol, 2017, no. 29 (6), r. 383-389. doi: 10.1097/GCO.0000000000000419.
16. Smyth A., Ronco C., Garovic V.D. Preeclampsia: a Cardiorenal Syndrome in Pregnancy. Curr. Hypertens. Rep, 2017, no. 19 (2), r. 15. doi: 10.1007/s11906-017-0714-5.
17. Kirsanova T.V., Vinogradova M.A., Fedorova T.A. Imitators of severe preeclampsia of the HELLP syndrome: various types of thrombotic microangiopathy associated with pregnancy. Akusherstvo i ginekologiya, 2016, no. 12, pp. 5-14 (in Russ.).
18. Baghli S., Abendroth C., Farooq U., Schaub J.A. Atypical Presentation of Pregnancy-Related Hemolytic Uremic Syndrome. Am. J. Kidney Dis, 2018, rr. S0272-6386(17)31099-5. doi: 10.1053/j.ajkd.2017.11.006.
19. Pelzer E., Gomez-Arango L.F., Barrett H.L., Nitert M.D. Review: Maternal health and the placental microbiome. Placenta, 2017, no. 54, rr. 30-37. doi: 10.1016/j.placenta.2016.12.003.
20. Nourollahpour Shiadeh M., Behboodi Moghadam Z., Adam I., et al. Human infectious diseases and risk of preeclampsia: an updated review of the literature. Infection, 2017, no. 45 (5), rr. 589-600. doi: 10.1007/s15010-017-1031-2.
21. Winship A., Dimitriadis E. Interleukin-11 is upregulated in preeclampsia and leads to inflammation and preeclampsia features in mice. J. Reprod. Immunol, 2018, no. 125, rr. 32-38. doi: 10.1016/j.jri.2017.11.004.
22. Cornelius D.C. Preeclampsia: From Inflammation to Immunoregulation. Clin. Med. Insights Blood Disord, 2018, no. 11, rr. 1179545X17752325. doi: 10.1177/1179545X17752325.
23. Bounds K.R., Chiasson V.L., Pan L.J., et al. MicroRNAs: New Players in the Pathobiology of Preeclampsia. Front Cardiovasc. Med, 2017, no. 4, r. 60. doi: 10.3389/fcvm.2017.00060.
24. McMaster K., Vaka V., LaMarca B. Mitochondrial dysfunction in preeclampsia demonstrated by increased reactive oxygen species production. Poster Session II (Poster 337). American Journal of Obstetrics and Gynecology, 2018, no. 218 (1, Supplement), pp. S209-S210.
25. Chang R.Q., Li D.J., Li MQ. The role of indoleamine-2,3-dioxygenase in normal and pathological pregnancies. Am. J. Reprod. Immunol, 2018, no. 79 (4), r. e12786. doi: 10.1111/aji.12786.
26. Goetzinger K.R., Tuuli M.G., Cahill A.G. et al. Development and validation of a risk factor scoring system for first-trimester prediction of preeclampsia. Am. J. Perinatol, 2014, no. 31 (12), rr. 1049-56. doi: 10.1055/s-0034-1371705.
27. Skråstad R.B., Hov G.G., Blaas H.G. et al. A prospective study of screening for hypertensive disorders of pregnancy at 11-13 weeks in a Scandinavian population. Acta Obstet. Gynecol. Scand, 2014, no. 93 (12), rr. 1238-47. doi: 10.1111/aogs.12479.
28. Torchinov A.M., Kuznetsov V.M., Akudenko A.V. et al. Method of personalized prediction of the development of pre-eclampsia based on anamnestic, phenotypic and genotypic predictors. Problemy reproduktsii, 2018, no. 1, pp. 87-91 (in Russ.).
29. Vilchez G., Hoyos L.R., Leon-Peters J. et al. Differences in clinical presentation and pregnancy outcomes in antepartum preeclampsia and new-onset postpartum preeclampsia: Are these the same disorder? Obstet. Gynecol. Sci, 2016, no. 59 (6), rr. 434-443. doi: 10.5468/ogs.2016.59.6.434
30. Koopmans C.M., van der Tuuk K., Groen H. et al. HYPITAT study group. Prediction of postpartum hemorrhage in women with gestational hypertension or mild preeclampsia at term. Acta Obstet. Gynecol. Scand, 2014, no. 93 (4), rr. 399-407. doi: 10.1111/aogs.12352.
31. White W.M., Mielke M.M., Araoz P.A. et al. A history of preeclampsia is associated with a risk for coronary artery calcification 3 decades later. Am. J. Obstet. Gynecol, 2016, no. 214 (4), R. 519.e1-519.e8. doi: 10.1016/j.ajog.2016.02.003.
32. Bokslag A., Teunissen P.W., Franssen C. et al. Effect of early-onset preeclampsia on cardiovascular risk in the fifth decade of life. Am. J. Obstet. Gynecol, 2017, no. 216 (5), rr. 523.e1-523.e7. doi: 10.1016/j.ajog.2017.02.015.
33. Mathew M., Salahuddin A., Mathew N.R., Nandhagopal R. Idiopathic intracranial hypertension presenting as postpartum headache. Neurosciences (Riyadh), 2016, no. 21 (1), rr. 52-5. doi: 10.17712/nsj.2016.1.20150304.
34. Miller E.C., Yaghi S., Boehme A.K. et al. Mechanisms and outcomes of stroke during pregnancy and the postpartum period: A cross-sectional study. Neurol. Clin. Pract, 2016, no. 6 (1), rr. 29-39.
35. Bergink V., Laursen T.M., Johannsen B.M. et al. Preeclampsia and first-onset postpartum psychiatric episodes: a Danish population-based cohort study. Psychol. Med, 2015, no. 45 (16), rr. 3481-3489. doi: 10.1017/S0033291715001385.