Preeclampsia and the role of prediction factors in the third trimester of pregnancy: 321.15 - Obstetrics and gynecology: Summary of the doctoral thesis in medical sciences

Abstract

The structure of the dissertation. The work is presented on 103 pages, has the following structure: table of contents, annotation, list of abbreviations, introduction, bibliographic analysis on the topic of the dissertation from the specialized literature, research materials and methods, own results presented in 3 chapters, summary of the work. results obtained, general conclusions, bibliography, including 120 national and international sources, 44 figures, 6 tables, 90 applications. The obtained results were published in 9 scientific papers. Key words: preeclampsia, prognostic markers, third trimester, Doppler ultrasound. The purpose of the study. Assessing the role of predictors of preeclampsia in the third trimester of pregnancy to optimize management and improve maternal and fetal prognosis. Objectives of the study. Establishing the anamnestic and evolutionary characteristics of pregnancy in pregnant women with preeclampsia in the third trimester of pregnancy. Evaluation of risk factors that contribute to the occurrence of preeclampsia in the third trimester of pregnancy. Assessment of the level of HIF-1a, IL-6, Doppler indices of uterine arteries, and establishment of their interrelation in predicting preeclampsia. Development of an algorithm for the management of pregnant women at risk of developing preeclampsia. Scientific novelty of the results obtained. By analyzing in detail the personal and medical risk factors associated with preeclampsia, as well as the evolution of pregnancy, the research contributed to understanding the complexity of this condition. This approach allowed us to identify risk factors, and demonstrated the role of biomarkers HIF-1a, IL-6 and their interrelation with Doppler indices of uterine arteries in predicting preeclampsia. The implementation of the behavioral algorithm for predicting PE represents a contribution to medical practice, in order to prevent the occurrence of severe maternal-fetal complications. The scientific problem solved in the thesis consists in determining the role of biomarkers HIF-1a, IL-6 and Doppler indices of uterine arteries in the development of preeclampsia, and the results of this research confirm the relevance of the study. Theoretical significance of the work. The results of the study expand the theoretical basis for the use of biomarkers in predicting preeclampsia. Threshold levels for HIF1a (>320,65 pg/ml) and IL-6 (>15.08 pg/ml) were established, which together with altered uterine artery Doppler parameters (PI) are associated with an increased risk of preeclampsia. Based on the results received, a behavioral algorithm for predicting preeclampsia in the third trimester of pregnancy was developed. Applicative value of the work. The application of the proposed algorithm, which consists of identifying maternal risk factors, elevated serum levels of HIF-1a (>320.65 pg/ml) and IL-6 (>15.08 pg/ml), pathological Doppler velocimetry index (PI), allows us to identify pregnant women at risk of developing preeclampsia. Thus, the performance of these biomarkers is necessary for the prediction of PE in the third trimester of pregnancy. The results obtained provide us with extensive theoretical information that can be used in practice to optimize the management of pregnant women with preeclampsia. Implementation of scientific results. The research results were implemented in the current curative activity of IMSP SCM Gheorghe Paladi.