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The value of the factors of endothelial dysfunction in the development of abruption placentae
ethanoids in dry extract. Salydroside content was 3.65±0.50% Content of oligomeric proantocyanidins (epigallocathechin
gallate — EGCG and dimer of EGCG) was at trace amount (0.75±0.07%).
Fig.3. HPLC of dry R. heterodonta extract
Conclusion
The chemical constituents of dry Rhodiola heterodonta extract determining of it complex biological activities was determined. It is shown, that in dry extract preserved all of attributable for studied source constituents which are
responsible for adaptogenic and other complex activities. At the same time epigallocathechin gallate and related compounds were determined at trace level, possible of their unstability in driyng conditions, therefore this fraction of dry extract contribute to total bioactivity minimally.
References:
1. Kurmukov A. G., Belolipov I. V. Wild medicinal plants of Uzbekistan 2012; 221-223.
2. Iskandarova Sh. F., Yunuskhodjaev A. N., Sadullaeva F. G. Obtaining and standardization dry extract from roots of different dentate rhodiola heterodonta boriss//Pharmaceutical journal. 2014; 32-36.
Komilova Mastura Safarovna, Senior Research Scientist researcher, State Medical Institute.
Abu Ali Ibn Sina, Department of Obstetrics and Gynecology, Ministry of Health of the Republic of Uzbekistan Bukhara Pakhomova Zhanna Evgenevna, Professor of the Tashkent Medical Academy, Republic of Uzbekistan. E-mail: komilova1985@mail.ru
The value of the factors of endothelial dysfunction in the development of abruption placentae
Abstract: Interpretation of the value factors of endothelial dysfunction in the development of abruption placenta.
Keywords: endothelial dysfunction, premature detachment of normally located placenta.
Vasculature of the placenta has plasticity and dynamic changes during pregnancy. During vasculogenesis new capillaries are formed by migration and dfferentiation progenitor endothelial cells. These processes are controlled by these vascular factors such as vascular endothelial growth factor (VEGF), fibroblast growth factor (bFGF) and its receptors VEGF-R and FGF-R.
It is established that endothelial cells express receptors VEGF-R, whereas VEGF, trophoblast cells express providing differentiation, migration and proliferation of endothelial cells, the formation of new vasculature. Motherboard vessels transformed to provide the utero-placental blood circulation. Trophoblast invasion occurs deep in the maternal spiral arteries, which are completely destroyed, and
Section 7. Medical science
the placental labyrinth represents the open end of the spiral arteries. Further development of the placenta vasculature by angiogenesis is [l].In the endogenous regulation of angiogen-esis growth factors involved such as bFGF, VEGF, placental growth factor (PLGF). The principal sources of these factors in the placenta can be both endothelial cells themselves, or placental macrophages. VEGF has angiogenic effect, stimulating migration, proliferation, and proteolytic activity cells. PLGF potentiates endothelial proliferation stimulating action VEGF, and increases vascular permeability. In the later stages of angiogenesis, macrophages, fibroblasts and smooth muscle cells secrete angiogenic factors which inhibit the migration and proliferation of endothelial cells without affecting their viability [5].
Thus, for the normal development and function of the placenta important balance between the various mechanisms of angiogenesis, and the balance between the processes of angio-genesis and apoptosis, which is supported by the relation of proangiogenic and antiangiogenic factors secreted by both the endothelial cells and the cells microenvironment. Changing the balance of cytokines and growth factors, vascular endothelial cells in the microenvironment is the basis of pathological placentation disorders, gestational age at different stages of pregnancy and preterm delivery [2; 3].
Currently, there are a number of studies showing the marked decrease of VEGF and PLGF in preeclampsia, and noted a direct correlation depending on the severity of a pathological condition. [2] In addition, studies of several authors the opportunity of forecasting and early diagnosis of severe placental insufficiency with monitoring the blood levels of markers of endothelial dysfunction, placental proteins maternal placental membranes, apoptosis and cell proliferation [4].
Objective: In this connection, the aim of our study was to determine the role of vascular endothelial growth factor and placental, and von Will brand factor and fibronectin in the development of detachment normally situated placenta in pregnant women without hypertensive syndrome.
Material and methods
We examined 90 pregnant women and their newborns. The main group consisted of 60 pregnant women without hypertensive syndrome and premature detachment of normally situated placenta (PONRP) and their newborns. The control group consisted of 30 healthy pregnant women and their newborns.
Determined vascular endothelial factor (VEGF) and placental growth factor (PLGF), fibronectin and von Willebrand factor (vFW) in the blood of pregnant women and umbilical cord blood of newborns.
Research VEGF, PLGF and fibronectin was performed by ELISA using enzyme immunoassay analyzer AT 858 (LTD, China) using reagents: VEGF (VECTOR BEST) Novosibirsk, FER, fibronectin « ELISA» Germany (DRGPLGFE-LISAEIA-4529). Von Willebrand factor was determined on the aggregometer "Biola."
Results and discussion
We noted that among women with inflammatory diseases PONRP genitalia occurred in 24 (40.0%). Moreover, chlamydia, herpes simplex virus (HSV), cytomegalovirus (CMV), mycoplasma occurred in 52 (86.7%). Also, among women with PONRP, artificial abortion were in 10 (16.7%) pregnans. Tech-enie pregnancy in 50 (83.3%) ofwomen proceeded against the background of the threat of termination of pregnancy. Thus, the threat I had half of pregnancy in 28 (46,7%), II half of pregnancy — in 22 (36.7%). In addition, acute respiratory infection on the background of pregnancy was in 22 (36.7%) women. Fetoplacental insufficiency (FPI) was in 27 (45.0%).
Thus, pregnant women with gestational PONRP proceeds against the background of the threat of termination of pregnancy I and II half (83.3%), FPI (45.0%). Chlamydia, HSV, CMV, mycoplasmas are found in 86.7%, as well as viral respiratory infection y 36.7%, which is likely to be risk factors for placental abruption.When determining VEGF levels in pregnant women with PONRP determined significance to increase to 14,2 ± 0,73pg/ml (P <0.00l) compared to the control group. Determined sensitivity VEGF — 94.3% and specificity — 91.5%
Also, increasing the vFW to 103,6 ± 6,06% (p <0.001), and fibronectin to 392,8 ± 16,26 pg/ml (P <0.001). In determining the sensitivity vFW was 90.9%, specificity — 88.9%, and fibronectin — 92.9% and 91.8% respectively.
However, level PLGF was significantly decreased in the intervention group compared with the control group to 182,8 ± 8,24 pg/ml (P <0.001). PLGF sensitivity was 92.6%, specificity — 87.0%.The umbilical cord blood from newborns established a sister picture changes. A significant increase in VEGF to 12,6 ± 0,71 pg/ml (P <0,001), vFW — 91,8 ± 5,86% (p <0.001), fibronectin — to 319,5 ± 12,68 pg/ml (P <0.001) and decrease PLGF to 173,6 ± 9,34 pg/ml (P <0.001).Ac-cording to the literature [3; 4] PONRP activation vascular and placental growth factor, which leads to an increase in VEGF and decrease PLGF in the blood of pregnant women with PONRP compared to healthy pregnant women, which indicates the failure of the endothelium of blood vessels in the walls of the uterus and placenta, possibly contributing to the manifestation of the clinic PONRP. In this connection, it is possible to assume the possibility of using these indicators. As diagnostic criteria for the diagnosis of PONRP.
Questions the value of growth factors in the development of various pathological conditions of pregnancy has long debated in the scientific literature [2; 4]. Changing the balance of endogenous regulators ofangiogenesis and compounds that control vascular tone placenta obviously contributes to the violation of blood between mother and fetus and. therefore, it affects the entire course of metabolic processes in between. There is an imbalance on the concentration of vasoactive substances (vasodilators and vasoconstrictors), between which in normal conditions there is a relationship and a balance. The shift of the latter may lead to an increase or decrease in vascular tone, aggregation, disaggregation of blood cells, increase or decrease in the number
