Basic clinical and pathogenetic aspects of developing the complications during multiple pregnancies

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Biology

Background:

• Multiple pregnancies carry a higher risk of gestational complications compared to singleton pregnancies.
• Placental growth factor (PlGF) plays a crucial role in placental development and function.
• Early identification of risk factors is essential for managing multiple pregnancies.

Purpose of the Study:

• To evaluate the predictive value of Placenta Growth Factor (PlGF) for gestational complications in multiple pregnancies.
• To investigate the relationship between PlGF levels in the first trimester and adverse pregnancy outcomes.
• To assess the impact of PlGF on the gestational process in multiple pregnancies.

Main Methods:

• A prospective study involving 320 women with multiple pregnancies and 40 with singleton pregnancies.
• Measurement of serum PlGF levels using solid-phase enzyme immunoassay in the first trimester.
• Evaluation of hemostasis system indicators and Dopplerometry of placental and fetal blood flow.

Main Results:

• Multiple pregnancies showed high rates of premature births (67.8%), feto-placental dysfunction, and pre-eclampsia (17.5%).
• Low serum PlGF levels were significantly associated with premature labor, feto-placental dysfunction, and pre-eclampsia in multiple pregnancies.
• Significantly lower PlGF levels were observed in women with complications compared to those with single pregnancies (111.23 ± 8.4 pg/ml vs. 418.2 ± 10.4 pg/ml).

Conclusions:

• Low first-trimester PlGF levels serve as a prognostic marker for gestational complications in multiple pregnancies.
• Timely medical interventions, including micronized progesterone and low molecular weight heparins, can prolong pregnancy.
• Treatment strategies improved pregnancy duration, particularly in monochorionic pregnancies, leading to more favorable outcomes.