Identification of gestosis (preeclampsia) risk and evaluation of efficiency of its prevention by means of noninvasive measurement of endothelial function

Abstract

Research included 64 pregnants in the I trimester with adverse anamnesis and/or clinical risk factors of preeclampsia and with revealed endothelial dysfunction by means of the device EndoPat-2000, on the basis of the reactive hyperemia index (RHI) less than 1.67, which is automatically measured by the device. Before detection of endothelial dysfunction all pregnants received basic prevention of preeclampsia with preparations of multivitamins, magnesium and progesterone. At identification of decrease in RHI to 1.3 preparation Norvesol containing omega-3 polyunsaturated fat acids (1 group, n = 32) was added. And at RHI value less than 1,3 a preparation of Angiofllux - capsular sulodexide, containing fraction of heparin 7000 Da was added. At pregnants accepting Norvesol, RHI grew in the II trimester to 1.85 ± 0.28 (р > 0.05), and in the III trimester to 1.95 ± 0.19 (р < 0,05 in comparison with the first research). At pregnants accepting Angioflux in the II trimester RHI increased to 1.77 ± 0.25 (р < 0.05) and in III to 1.88 ± 0.20 (р ˂ 0.01 in comparison with the first research). No significant changes of indicators of system of hemostasis in dynamics were revealed in both groups. At all examined patients the delivery occurred at the full-term pregnancy. Frequency of preeclampsia development was low (21.9 and 37.5 % respectively in 1 and 2 groups), and except 1 case of middle severity in 1 group, preeclampsia didn’t exceed mild degree and didn’t influence a way of delivery and perinatal indicators. Thus, the method of functional endothelial state assessment by means of the device EndoPat-2000, allowed to specify risk degree of preeclampsia and to control efficiency of preventive therapy. At moderate violations of endothelial functional state Norvesol’s application led to correction of endothelial dysfunction and achievement of favorable outcomes of pregnancy and delivery for mother and fetus. At the cases with expressed endothelial dysfunction addition of Angioflux (sulodexide) promoted considerable improvement of endothelial function that allowed to avoid development of middle and severe preeclampsia even at pregnants with the highest risk of its development.

Keywords

preeclampsia (gestosis) / endothelial dysfunction / EndoPat-2000 / reactive hyperemia index / Norvesol (omega3-PUFA) / Angioflux (sulodexide)

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RIGHTS & PERMISSIONS

Mozgovaya E.V., Postnikova T.B., Arzhanova O.N., Repinskaya E.A., Serdyukov S.V., Vinokurova N.V.