Early prophylaxis of preeclampsia in women at risk for changes in spiral arteries

【Objective】 To investigate the possibility of early prophylaxis of preeclampsia by mean of investigation of uteroplacental blood flow(UPB) and feto-placental complex FPC function in pregnant women with suspected dysfunction of spiral arteries and clinical signs of preeclampsia.【Method】 90 pregnant women were included in a prospective cohort study in the term of gestation from 9 to 40 weeks.The main clinical group consisted of 70 women,divided into two groups: the first-pregnant with the risk of PE,the others-with the clinical manifestation of PE.Biochemical and radioimmunoassay studies(determination of estradiol and placental lactogen(PL) in the peripheral blood),ultrasound examination with Doppler flow in the arteries of the uterus and the measurement of qualitative characteristics of the analysis of blood flow-resistance index(RI) and pulsatility index(PI),the ratio of systolic pressure for diastolic(ABP) were used.Treatment in the group of risk was directed to the correction of vascular blood flow and intravascular component(antiplatelet agents,antispasmodics,sedatives drugs,vitamins) and was conducted in terms of 9-12 weeks duration during 12-14 days.In the subgroup with PE-similar treatment in terms of 28-30 weeks.【Result】 In pregnant women of the group of risk for PE abnormal spiral artery blood flow parameters(RI,PI,ABP) in the uterine arteries were registered,indicating increased peripheral vascular resistance in the placental pool in early pregnancy,just as marked reduction of the hormonal activity of forming placental complex which testifies early placental insufficiency.Treatment,conducted in early pregnancy could significantly improve,but not normalize blood flow.【Conclusion】 Conduction of a Doppler examination for blood flow of the placenta may provide early diagnose of infusion-perfusion failure of placenta,and the appointment of a pathogenic therapy,that will provide an opportunity to avoid the development of placenta failure and PE in an group of risk.