PECULIARITIES OF ENDOTHELIAL FACTORS IN PREGNANT WOMEN WITH PLACENTAL DYSFUNCTION AND DIABETES
Keywords:diabetes mellitus, placental dysfunction, endothelial factors
The purpose is the early diagnosis of placental dysfunction in women with diabetes mellitus with the help of endothelial factors to optimize childbirth. Pregnancy and childbirth were analyzed in 94 pregnant women aged from 23 to 38. Pregnant women were divided into the following clinical groups: 30 pregnant women with diabetes (the first group), 34 pregnant women with diabetes and placental dysfunction (the second group) and 30 practically healthy pregnant women (the control group). During the 36–38th weeks of pregnancy, there was a significant decrease (p < 0.05) of serum CEFR indices in patients with placental dysfunction due to diabetes (69.3 ± 2.9 pg/ml), not only compared with those in women with physiological course of pregnancy (119.6 ± 5.2 pg/ml), but also in pregnant women with diabetes without placental dysfunction (87.4 ± 3.4 pg/ml) (p < 0.05). The ET-1 study showed a decrease in pregnant women with diabetes and placental dysfunction (0.97 ± 0.18 pg/ml) by almost three times compared with control group women (3.12 ± 0.41 pg/ml) and pregnant women with diabetes, but without placental dysfunction (1.54 ± 0.12 pg/ml), whose ET-1 level was two times lower than the control values (p < 0.05). There was also a decrease in the eNOS index for diabetes (from 58 pg/ml in pregnant women with diabetes and placental dysfunction to 68 pg/ml for diabetes, the norm is 79–82 pg/ml). Women with diabetes and placental dysfunction predominantly had the induced childbirth, almost half of which ended with a caesarean section. During the study we observed the following perinatal complications: shoulder dystocia due to macrosomia (19 %), hypoglycemia (15 %), jaundice (8 %), respiratory distress syndrome (5 %), perinatal mortality was 9.4 %. Changes in endothelial factors (VEGF, ET-1, eNOS) in the blood of pregnant women with diabetes mellitus may indicate the development of placental dysfunction, which requires immediate examination of the fetus and timely delivery using the induced childbirth to improve maternal and perinatal outcomes.
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