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

Volodymyr I Boiko1, Alla V Boychuk2, Irina M Nikitina1

  • 1Sumy State University, Sumy, Ukraine.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|February 24, 2019
PubMed
Summary

Low placental growth factor (PlGF) levels in early pregnancy indicate a higher risk of gestational complications in multiple pregnancies. Early intervention with specific treatments can prolong pregnancy duration and improve outcomes.

Keywords:
feto placental dysfunctionmiscarriagemultiple pregnancyplacental growth factorpre-eclampsiapreterm labor

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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.