The assessment of genetic risk factors of hypercoagulemic disorders

Backgraund. Pre-eclampsia has been one of the most significant obstetric problems for many years, leading to worse perinatal outcomes and increased maternal mortality. Currently, the leading mechanism for the occurrence of preeclampsia is emerging placental and immunological disorders that cause endothelial dysfunction. Despite this, the mechanisms of pathological hypercoagulability under preeclampsia are still insufficiently studied, which requires further research. Objective. The aim of the study was to study changes in the hemostasis system and microcirculation disorders in association with platelet integrin (T1565C) ITGB3, (C807T) ITGA2 and fibrinogen (G(-455) A) FGB gene polymorphisms in pregnant women with preeclampsia of varying severity. Material and methods. Clinical studies of 173 pregnant women: the first group (control) included pregnant women with a physiological course of the gestation process (n=52), the second group (n=63) — patients with moderate preeclampsia, the third group — pregnant women (n=58) with severe PE. The parameters of hemostasiogram (APTT, fibrinogen, antithrombin III), blood thromboelastograms of pregnant women (thromboelastograph TEG 5000 Thrombelastograph (USA)), microcirculation of peripheral tissues of pregnant women (LAKK-02, NPP Lazma, Russia, program LDF 1.18) were studied. Genotyping of polymorphisms of the studied genes was carried out using polymerase chain reaction by Real-time PCR using CFX96 Touch Real-Time PCR Detection System (USA). Results. In preeclampsia, a violation of the oxygen transport function of hemoglobin, the phenomenon of hypercoagulemia (a decrease in APTT, reaction time, clot formation time, an increase in fibrinogen content), was registered, which was accompanied by a violation of microcirculation. The severity of the changes correlated with the severity of the condition. In pregnant women with severe preeclampsia living in the Republic of Mordovia, the frequency of occurrence of prothrombotic alleles of the ITGB3, ITGA2 and FGB genes is significantly higher. Conclusions. In preeclampsia, hypercoagulemia correlates with microcirculation disorders in accordance with the severity of the disease. The development of a severe form of preeclampsia is associated with the carriage of prothrombotic alleles of the ITGB3 (T1565C), ITGA2 (C807T), FGB (G(-455)A) genes, which can potentially be considered as a prognostic factor for an unfavorable course of pregnancy and the development of severe forms of preeclampsia.