Naslov (srp)

Biomarkeri inflamacije i kvalitativne i kvantitativne karakteristike lipoproteina visoke gustine u proceni rizika za razvoj preeklampsije : doktorska disertacija

Autor

Marković, Gorica, 1989-

Doprinosi

Ardalić, Daniela, 1967-
Stefanović, Aleksandra, 1977-
Miković, Željko, 1960-
Zeljković, Aleksandra, 1974-

Opis (srp)

Hipertenzivne komplikacije u trudnoći, uključujući i preeklampsiju, predstavljaju najčešćeuzročnike morbiditeta i mortaliteta, kako majke, tako i fetusa. Prema preporukama Američkog društvaza ginekologiju i akušerstvo (engl. American College of Obstetricians and Gynecologists – ACOG)dijagnoza hipertenzije u trudnoći postavlja se ukoliko je sistolni pritisak ≥140mmHg i/ili dijastolnipritisak ≥90mmHg kod trudnica koje nisu do tada imale dijagnozu hipertenzije. Preeklampsija (PE) sedijagnostikuje sa pojavom de novo hipertenzije (≥140/90 mmHg) nakon 20. nedelje gestacije, sa ili bezproteinurije (≥300 mg/24 h), ali uz kliničke znake edema, hematoloških poremećaja, renalne,pulmonarne ili hepatične disfunkcije. Prosečna globalna incidenca PE iznosi oko 4,6%.Prema Internacionalnom udruženju za ispitivanje hipertenzivnih oboljenja u trudnoći (engl.International Society for the Study of Hypertension in Pregnancy ISSHP), rana PE nastupa pre 34.nedelje gestacije i karakteriše je teža klinička slika češće udružena sa intrauterusnim zastojem u rastuploda (engl. Intrauterine growth restriction, IURG) i prevremenim porođajem, dok se dijagnoza kasnePE postavlja nakon 34. nedelje gestacije, karakteriše je blaža klinička slika i u ređem broju slučajeva jepraćena prevremenim porođajem. PE je multisistemska bolest čija etiologija i patogeneza još uvekintrigira kako stručnu, tako i naučnu javnost.Prema NICE (The National Institute for Health and Care Excellence) preporukama, trudnica je uriziku da razvije PE ukoliko ima više umerenih ili jedan faktor visokog rizika za razvoj PE, pri čemu sufaktori visokog rizika: hipertenzija ili PE u prethodnoj trudnoći, hronična hipertenzija, bolesti bubrega,dijabetes mellitus tip 1 ili 2, autoimune bolesti i višeplodne trudnoće. Faktori umerenog rizika su : prvatrudnoća, starost preko 40 godina, ITM ≥ 35 kg/m2, pozitivna porodična anamneza i period izmeđutrudnoća duži od 10 godina.Skrining koji NICE i ACOG vodiči preporučuju za ranu selekciju i tretman trudnica koje su uriziku ima nisku stopu detekcije, međutim u kombinaciji sa merenjem srednjeg arterijskog pritiska ipulsatilnog indeksa krvnih sudova materice, poboljšava se stepen predikcije. FMF (The Fetal MedicineFoundation) jedini preporučuje pristup procene rizika u prvom trimestru na osnovu faktora rizika majke,ultrazvučnih merenja, merenja protoka kroz arterije materice (UtA-Pi) i merenja biohemijskih markeraangiogenze (placentalnog faktora rasta-PlGF, plazma proteina A udruženog sa trudnoćom-PAPP-A)...

Opis (srp)

Farmacija - Medicinska biohemija / Pharmacy- Medical Biochemistry Datum odbrane: 24.07.2025.

Opis (eng)

Hypertensive complications during pregnancy, including preeclampsia (PE), are among the mostcommon causes of morbidity and mortality for both the mother and fetus. According to the guidelinesfrom the American College of Obstetricians and Gynecologists (ACOG), the diagnosis of pregnancyinducedhypertension is made when the systolic blood pressure reaches ≥140 mmHg and/or diastolicblood pressure ≥90 mmHg in women who had not previously been diagnosed with hypertension.Preeclampsia is diagnosed when de novo hypertension (≥140/90 mmHg) arises after 20 weeks ofgestation, with or without proteinuria (≥300 mg/24 h), accompanied by clinical signs such as edema,hematological disorders, and dysfunction in renal, pulmonary, or hepatic systems. The global averageincidence of PE is around 4.6%.According to the International Society for the Study of Hypertension in Pregnancy (ISSHP),early-onset preeclampsia occurs before 34 weeks of gestation and is characterized by more severeclinical manifestations, often associated with intrauterine growth restriction (IUGR) and preterm birth.Late-onset preeclampsia, diagnosed after 34 weeks of gestation, typically presents with milder symptomsand is less frequently linked to preterm delivery. Preeclampsia is a multisystemic disorder, and itsetiology and pathogenesis remain a subject of ongoing interest within both clinical and scientificcommunities.The National Institute for Health and Care Excellence (NICE) recommends that pregnant womenat risk of developing PE should be identified based on the presence of multiple moderate risk factors ora single high-risk factor. High-risk factors include previous hypertension or preeclampsia, chronichypertension, kidney disease, type 1 or type 2 diabetes, autoimmune diseases, and multiple pregnancies.Moderate risk factors include primigravida status, age over 40 years, body mass index (BMI) ≥35 kg/m²,a positive family history, and a gap of more than 10 years between pregnancies.Although individual screenings are available, both NICE and ACOG guidelines continue torecommend screening for early selection and management of pregnant women at risk. Such screeningshave a low detection rate, but when combined with measurements of mean arterial pressure and theuterine artery pulsatility index (UtA-PI), the detection rate improves. The Fetal Medicine Foundation(FMF) advocates for a first-trimester risk assessment approach based on maternal factors, ultrasoundmeasurements, uterine artery blood flow (UtA-PI), and biochemical markers of angiogenesis (placentalgrowth factor - PlGF and pregnancy-associated plasma protein A - PAPP-A)...

Jezik

srpski

Datum

2025

Licenca

Ovo delo je licencirano pod uslovima licence
Creative Commons CC BY-NC-SA 3.0 AT - Creative Commons Autorstvo - Nekomercijalno - Deliti pod istim uslovima 3.0 Austria License.

http://creativecommons.org/licenses/by-nc-sa/3.0/at/legalcode

Predmet

OSNO - Opšta sistematizacija naučnih oblasti, Farmacija

High-risk pregnancy, preeclampsia, inflammation, high-density lipoprotein particles

OSNO - Opšta sistematizacija naučnih oblasti, Farmacija

Visokorizična trudnoća, preeklampsija, inflamacija, lipoproteinske čestice visoke gustine

615:618.3(043.3)