LEADING ROLE OF INFECTION IN FORMATION OF PLACENTAL INSUFFICIENCY

Aim. Evaluate the role of endotoxinemia in pregnancy complicated with placental insufficiency. Materials and methods. Complex clinical-laboratory examination of 130 pregnant women in 70 of which placental insufficiency was diagnosed (main group) was carried out. The examinees of the main group were divided into 3 subgroups: 36, 20 and 14 pregnant women with compensated, subcompensated and decompensated placental insufficiency, respectively. The control group was composed of 60 pregnant women with physiological course of gestation. Levels of LPS, LPS-binding protein and IgG against core-region, cytokines (TNF-α, IL10, IL2, IL4, IL6, IL8, IL10, IFNγ), C-reactive protein were determined in blood plasma. Infection by Сhlamydia trachomatis, Мycoplasma genitalium, Treponema vaginalis, Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum were evaluated by PCR. Results. In the main group in 64.2% of cases the presence of genital tract infection was established, in 47.0% - urinary system. An increase of LPS level, titers of IgG against LPS core-region and LPS-binding protein in blood plasma of pregnant women with placental insufficiency was shown. Cytokine profile in placental dysfunction was characterized by a significant increase of IL10, IL8, TNF-α Th1 cytokine and IL10 Th2 cytokine concentrations and a decrease of pro-inflammatory IL2, IFNγ levels. Conclusion. The results indicate a leading role of infection in formation of placental dysfunction as well as prove involvement of LPS Gram-negative bacteria in pathogenesis of this complication.

placental insufficiency, LPS, LPS-binding protein, antibodies against LPS core region, cytokines