Neonatology & Perinatology

Biography

Biography: Ana Daneva Markova

Abstract

Accommodation of the feto-placental unit in human pregnancy requires maternal immune tolerance to this “semi allograft”. Despite close examination of the features of the process, preeclampsia remains one of the most sophisticated problems of modern obstetrics and gynecology. It generally determines maternal and perinatal morbidity and mortality. The analysis of scientific literature reveals conclusion that many aspects of the pathogenesis of preeclampsia are related to a syndrome of systemic inflammatory response characterized by development of a destructive inflammatory process, immune disorders and imbalanced cytokine regulation of gestation processes. Studies showed that in pregnancy complicated by preeclampsia, cytokine levels essentially change compared to the respective levels in physiological pregnancy. Thus, even a moderate form of preeclampsia shows directional change, i.e., elevated levels of pro and anti-inflammatory cytokines, with the exception of IL-10, while a downward trend is recorded in severe preeclampsia. The findings of significantly lower serum IL10 concentrations in patients with severe preeclampsia in comparison with respective concentrations in patients with moderate preeclampsia are highly important. These results can be considered as a major pathognomonic laboratory sign of severe preeclampsia that can be used by clinicians to make difference between severe preeclampsia and normal pregnancy, as well as between severe and moderate degree of this specific pathology. These indicators may help in recognizing patients with the highest risk of severe preeclampsia. Precisely defined time for the termination of preeclampsia pregnancy will decrease morbidity and mortality from this most difficult disease in pregnancy.