Pathogenetic features of angiogenesis in pregnancy with fetal growth restriction syndrome

• E.V. Volkova
• Yu.V. Kopylova
• O.V. Makarov

Abstract

Aim. Estimate the role of proangiogenic and antiangiogenic vascular growth factors in the pathogenesis of placental insufficiency and fetal growth disorders.

Material and methods. The study included 168 pregnant women. Study group comprised 116 patients with placental insufficiency and fetal growth restriction syndrome; control group comprised 52 healthy pregnant patients. Identified: vascular proangiogenic factor; placental growth factor and vascular antiangiogenic factors; soluble fms-like tyrosine kinase 1 (sFlt-1) and soluble endoglin (sEng).

Results. There were significant differences in the level of plasma vascular growth factors in group of patients whose pregnancy was complicated by placental insufficiency and fetal growth restriction syndrome as compared with healthy pregnant women data. Proangiogenic factor level was significantly lower in pregnant women with placental insufficiency as compared with healthy women, while the level of antiangiogenic factors in pregnant women with placental insufficiency was significantly higher as compared with control group data. In the event of placental insufficiency and severe fetal growth restriction syndrome (from mild to moderate to severe), as compared with healthy pregnant women, of placental growth factor decreased 1,5, 6 and 11.5 times, respectively; sFlt-1 increased 5, 7, and 9.8 times, respectively; soluble endoglin increased 2 and more times. Angiogenic coefficient (Ka), calculated in formule sFlt-1/PlGF×10, sharply increased in case of placental insufficiency exaggeration.

Conclusion. Placental insufficiency is characterized by an imbalance of vascular growth factors, increasing levels of antiangiogenic vascular factors and a reduced rate of proangiogenic factors. Ka increasing is typical for placental insufficiency and fetal growth restriction syndrome exaggeration.

Keywords:angiogenesis, placental insufficiency, fetal growth restriction syndrome, vascular growth factors, angiogenic coefficient

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