KOMPLIKACIJA TRUDNOĆE KAO POSLEDICA HIPOKSEMIJE UTEROPLACENTNE JEDINICE
Sažetak
Trudnoća fiziološki indukuje hemostatski sistem u pravcu hiperkoagulabinog stanja, koje raste kroz trudnoću i dostiže svoj maksimum pri terminu porođaja. Ove promene se smatraju zaštitom u periodu puerperijuma, ali ako su izraženije mogu dovesti do komplikacija i kod majke i kod ploda. Osnovna hipoteza koja se postavlja u patogenezi problema tokom trudnoće koji se javljaju kod majke i ploda, počiva na zbivanjima vezanim za formiranje krvnih sudova između uterusa i posteljice. U fazi formiranja placentalne vaskularne mreže, kao posledica neadekvatne placentacije i nastajanje placentalne vaskularne tromboze, dolazi do sekundarnih reakcija koje se manifestuju: placentalnom abrupcijom, hipoksijom i hipoksemijom ploda koji ispoljava restrikciju rasta. Takva stanja mogu biti posledice urođenih ili stečenih trombofilija.
Reference
Szecsi PB, Jorgensen M, Klajnbard A, Haemostatic reference intervals in pregnancy. Throm Haemost 2010 , 103, 718-727.
McLean H, Bernstein IM, Brummel Ziedins. Tissue factor dependent thrombin generation across pregnancy. Am. J. Obstet. Gynecol. 2012, 207,e1-e6
Lykke JA, Bare LA, Olsen J, Lagier R, Arellano AR, Tong C et al. Thrombophilias and adverse pregnancy outcomes: Results for the Danish national Birth Cohort. J Thromb Haemost. 2012, 10, 1320-1325.)
Greer IA, Brenner B, Gris JC Antitromotic treatment for pregnancy complications: Which path for the journey to precision medicine? Br J Haematol. 2014. 165, 585-599.
Myer B, Pavord S. Diagnosis adn management of antiphospholipid syndrom in pregnancy. Obst gynecol. 2011.13, 15-21
Yetman DL, Kutteh WH. Antiphospholipid antibody panels and recurrent pregnancyloss: Prevalence od anticardiolipin antibodies compared with other antiphospholipid antibodies. Fertil. Steril 1996, 66, 540-546.).
Opatrny L, David M, Kahn SR, Shrier I, Rey E. Association between antiphospholipid antibodies and recurrent fetal loss in women without autoimmune disease; A metaanalysis. J Rheumatol 2006, 33, 2214-2221
Abou-Nassar K, Carrier M, Ramsay T, Rodger MA. The association between antiphospholipid antibodies and placenta mediated complikactions: A systematic review and meta analysis. Throm. Res. 2011, 128, 77-85
Nagirnaja L, Nommemees D, Rull K, Christiansen OB, Nielsen HS, Laan M. Annexin A5 promoter haplotype M2 is not a risk factor for recurrentpregnancy lossin Northen Europe,2015,10, e0131606.
Tiscia G, Coaizzo D, Chinni E, Pisanelli D, Scianname N, Favuzzi G et al. Haplotype M2 in the annexin A5 (ANXA5) gene and the occurence of obstetric complicationas Throm.haemost.2009. 102,309-313.
Cohen H, O’Brien P. Disorders of Thrombosis and hemostsis in Pregnancy, A Guide to Management; Springer-verlag: London, UK, 2012
Bolton-Maggs, PH. The management of factor XI deficiency. Haemophil.Off. J World Fed Hemophil, 1998, 4, 683-688
Hanly JG, Gladma DD, Rose TH, Laskin CA, Urowitz MB. Lupus pregnancy. A prospective study of placental changes. Arthistis Rheum 1988,31,358-366
Empson M, Lassere M, Craig J, Scott J. Prevention of recurrent miscarriage for women with antiphospholipid antibody of lupus anticoagulant. Cohraine Datebase Syst Rev.2005,2
Kutteh WH. Antiphospholipid antibody-assiociated recurrent pregnancy loss: Treatment with heparin and low dose asirin is superior to low dose aspirin alone. Am j Obst Gynec 1996, 174, 1584-1589
Rai R, Cohen H, Dave M, Regan L. Randomised controlled trial of apirin and aspirin plus heparin in pregnant women with recurrentmiscarriage associated with phospholipid antibodiesa (or antiphospholipid antibodies). BMI 1997, 314, 253-257
Farquharson RG, Quenby S, Graves M. Antiphospholipid syndrome in pregnancy: randomized controlled trial of treatment. ObstGynecol.2002, 100, 408-413
Backos M, Rai R, Baxter N, Chilcott IT, Cohen H, Regan L. Pregnancy complications in women with recurrent mmiscarriage associated withantiphospholipid antibodies treated with low dose aspirin and heparin. Br JH Obstet Gynecol, 1999. 106, 102-107
Bogdanova N, Horst J, Chlystun M, Croucher PJ, Nebel A, Bohring A et al. A common halotype of the annexin A5 (ANXA5) gene promoter is associatedwith recurrent pregnancy loss.Hum Mol Gent 2007, 16,573-578
Louise E, Simcox D, Ormesher L, Tower C, Greer I, International Journal of Molecular Sciences, review, 2015, 16, 28418-28428
Ota S, Miyamura H, Nishiyawa H, Inagaki H, Inagaki A, Inazuka H et al. Contribution of fetal ANXA5 gene promoter polymorphisms to the onset of pre eclamsia . Placenta 2013, 34, 1202-1210.).
Ueki H, Mizushina T, Laoharatchatathanin T, Terashima R, Nishimura Y, Reianrakwong D et al. Loss of amaternal annexin A5 increases the likelihood placental platelet thrombosis and foetal loss. Sci. Rep. 2012, 2, 827
Rodger MA, Walker MC, Smith GN, Wells PS, Ramsay T, Langlois NJ et al: Is thrombophilia associated with placenta mediated pregnancy complications? A prospective study. J Thromb Haemost , 2014, 12, 469-478.)
Lykke JA, Bare LA, Olsen J, Lagier R, Arellano AR, Tong C et al. Thrombophilias and adverse pregnancy outcomes: Results for the Danish national Birth Cohort. J Thromb Haemost. 2012, 10, 1320-1325.)
Robertson L, Wu O, Langhorne P, Twaddle S, Clark P, Lowe GD et al. Thrombophilia in pregnancy: A sistematic review. Br J Haematol. 2006 132, 171-196
Preston FE, Rosendaal FR, Walker ID, Briet E, Berntorp E, Conard J al, Increased fetal loss in women with heritable trhombophilias. Lancet 1996, 348, 913-916
Baglin T, Gray E, Greaves M, Hunt BJ, Keeling D, Machin S et al. Clinical guidelines for testing for heritable thrombophilia. Br J Haematol 2010;149:209–220.
Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. VTE, thrombophilia, antithrombotic therapy, and pregnancy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians. Evidence-Based Clinical Practice Guidelines. Chest 2012;141:e691S–e736S.
Royal College of Obstetricians and Gynaecologists. Green-top Guideline No 17. The Investigation and Treatment of Couples with Recurrent First-trimester and Second-trimester Miscarriage. RCOG. 2011.
Tan WK, Lim SK, Tan LK, Bauptista D, Singapore Med J. 2012 Oct;53(10):659-63. Does low-molecular-weight heparin improve live birth rates in pregnant women with thrombophilic disorders? A systematic review.
Clark P, Walker ID, Langhorne P et al. SPIN (Scottish Pregnancy Intervention) study: a multicenter, randomized controlled trial of low-molecular-weight heparin and low-dose aspirin in women with recurrent miscarriage. Blood 2010; 115:4162-7.
Pabinger I, Vormittag R. Thrombophilia and pregnancy outcomes. J Thromb Haemost 2005; 3:1603-10.
Rodger MA, Paidas M, McLintock C et al. Inherited thrombophilia and pregnancy complications revisited. Obstet Gynecol 2008; 112:320-4