Vrednost hematoloških i serumskih biohemijskih parametara u predikciji perinatalnog ishoda kod preeklampsije
Sažetak
Preeklampsija je ozbiljan poremećaj koji se karakteriše generalizovanim maternalnim inflamatornim odgovorom udruženim sa difuznom disfunkcijom endotelnih ćelija. Preeklampsija ima dugu prekliničku fazu pre nego postane manifestna. Mogućnost predviđanja komplikacija kod preeklampsije je klinički veoma značajna, jer bi mogla doprineti smanjenju morbiditeta i mortaliteta majki i neonatusa. Cilj ovog rada je da ispita da li hematološki i serumski biohemijski parametri mogu biti od koristi u predikciji teže kliničke slike i lošijeg perinatalnog ishoda kod preeklampsije.
Prospektivna opservaciona studija obuhvatila je ispitivanu grupu od 30 jednoplodnih trudnoća sa preeklampsijom završenih carskim rezom. Ova ispitivana grupa podeljena je na dve podgrupe u odnosu na težinu preeklampsije (umerena i teška). Kontrolnu grupu činilo je 20 zdravih trudnica porođenih elektivnim carskim rezom. Analizirane su kliničke karakteristike trudnica, hematološki i serumski biohemijski parametri, kao i perinatalni ishod. Kod preeklampsije više su vrednosti hematokrita, hemoglobina, a manji broj trombocita. Takođe su više vrednosti aspartat aminotransferaze (AST), alanin aminotransferaze, laktat dehidrogenaze (LDH), gama-glutamil transferaze, holesterola, triglicerida, mokraćne kiseline, uree i kreatinina. Laboratorijski parametri koji su u našem istraživanju bili udruženi sa teškom kliničkom slikom preeklampsije i sa lošijim perinatalnim ishodom bili su trombocitopenija i povišeni nivoi AST i LDH. Međutim, uprkos tome što su pokazatelji lošijeg ishoda, ne mogu se sa apsolutnom sigurnošću i izolovano od drugih pokazatelja koristiti u predikciji lošeg perinatalnog ishoda kod preeklampsije. Donošenje odluke o trenutku za porođaj u odnosu na ekspektativni pristup, trebalo bi da bude bazirano na sveobuhvatnom sagledavanju gestacijske starosti, stanja fetusa, kliničkih i laboratorijskih maternalnih pokazatelja.
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