CONNECTIVE TISSUE HEART DYSPLASIA IN PREGNANT WOMEN AND PERINATAL CONSEQUENCES
(LITERATURE REVIEW AND OWN RESEARCH)
DOI:
https://doi.org/10.11603/24116-4944.2020.2.11841Keywords:
pregnancy, connective tissue dysplasia, idiopathic mitral valve prolapse, obstetric complicationsAbstract
The aim of the study – the role of connective tissue dysplasia of the heart with idiomatic mitral valve prolapse in the development of complications of pregnancy and childbirth in women, as well as the choice of optimal methods of pregnancy, prognosis, treatment and prevention of obstetric complications. The article presents modern world ideas about the influence of nonspecific connective tissue dysplasia of the heart on pregnancy, childbirth, fetal condition and postpartum period. Scientists from the world᾽s leading schools, who have achieved significant success in studying the problem of nonspecific connective tissue dysplasia over the last 10 years, state the global prevalence of dysplastic syndromes among young people, their significant impact on clinical manifestations and the course of most "common" diseases and 100 % dependence on adverse factors fetal period. Connective tissue is involved in key processes that determine the success of human reproduction. Mitral valve prolapse is considered to be one of the cardiac manifestations of connective tissue dysplasia syndrome (idiopathic or primary mitral valve prolapse), which has a proven genetic determination. Given the relatively high prevalence of mitral valve prolapse in the young population, the above complications are quite common (20–25 %) in pregnant women. Moreover, in pregnant women mitral valve prolapse is more severe, characterized by a higher incidence of various cardiovascular and obstetric complications, including a number of phenotypic and visceral heart abnormalities that can be inherited in children, which demonstrates the higher general clinical significance of the heart dysplasia problem just for pregnancy. The role of metabolic disorders, immune response, electrolyte imbalance, coagulopathy in the development of functional disorders of the life support systems of pregnancy and uterine-placental-fetal complex in women with connective tissue dysplasia of the heart and idiopathic mitral valve prolapse was detected. The analysis indicates the need for isolation in pregnant women with connective tissue dysplasia of the heart special clinical and biochemical markers for the prediction of obstetric and perinatal complications.
References
Dzhobava, E.M., & Dobrokhotova, Yu.E. (2013). Disfunktsiya endoteliya i sistema gemostaza u beremennykh iz grupp vysokogo riska. Sistemnyy podkhod k diagnostike i terapii [Endothelial dysfunction and hemostatic system in pregnant women from high risk groups. Systemic approach to diagnostics and therapy]. Moscow: OOO «Teler» [in Russian].
Lyzyn, M.A., & Datsun, I.H. (2012). Matkovo-platsentarnyi kompleks pry syndromi zatrymky rostu vahitnoi matky (kliniko-morfofunktsionalna kharakterystyka) [Uterine-placental complex in the syndrome of growth retardation of the pregnant uterus (clinical and morphofunctional characteristics)]. Ivano-Frankivsk: Typovit [in Ukrainian].
Faiz, S.A., Al-Meshari, A.A., & Sporrong, B.G. (2016). Pregnancy and valvular heart disease. Saudi Med. J., 24 (10), 1098-1101.
Gazazyan, M.G. (2017). Osobennosti techeniya beremennosti i rodov u patsiyentok s displaziyey soyedinitelnoy tkani [Features of the course of pregnancy and childbirth in patients with connective tissue dysplasia]. Akusherstvo y ginekologiya – Obstetrics and Gynecology, 1, 121-126 [in Russian].
Nazarenko, L.H. (2010). Dysplaziia spoluchnoi tkanyny: rol v patolohii liudyny i problemakh hestatsiinoho periodu (Ohliad) [Connective tissue dysplasia: a role in human pathology and problems of the gestational period (Review)]. Zhinochyi likar – Woman᾽s Doctor, 1, 42-48 [in Ukrainian].
Nechaeva, G.I., Jakovlev, V.M., Konev, V.P., Druk, I.V., & Morozov, S.L. (2008). Displaziya soyedinitelnoy tkani: osnovnyye klinicheskiye sindromy, postanovka diagnoza i lecheniya [Connective tissue dysplasia: basic clinical syndromes, formulation of diagnosis and treatment]. Lechashchiy vrach – Attending Physician, 2 (08) [in Russian].
Nesterenko, Z.V. (2012). Displaziya soyedinitelnoy tkani – mediko-sotsialnyy fenomen XXI veka [Connective tissue dysplasia is the medico-social phenomenon of the XXI century]. Bil. Suhloby. Khrebet – Pain. Joints. Spine, 1 (5), 17-23 [in Russian].
Siromakha, S.O., Davydova, Yu.V., Volkova, N.I., & Lazoryshynets, V.V. (2020). Syndrom marfana ta vahitnist [Marfan syndrome and pregnancy]. Aktualni pytannia pediatrii, akusherstva ta hinekolohii – Actual Problems of Pediatrics, Obstetrics and Gynecology, 1, 94-101 [in Ukrainian].
Kildiyarova, R.R., & Uglova, D.F. (2015). Displaziya soyedinitelnoy tkani kak konstitutsionalnaya osnova vrozhdennykh porokov serdtsa u zhenshchin i ikh novorozhdennykh detey [Dysplasia of connective tissue as a constitutional basis of congenital heart defects in women and their newborn children]. Arkhiv vnutrenney meditsiny – Archive of Internal Medicine, 4, 38-42 [in Russian].
Smolnova, T.Yu., Buyanova, S.N., & Savelyev, S.V. (2013). Fenotipicheskiy simptomokompleks displazii soyedinitelnoy tkani u zhenshchin [Phenotypic symptom complex of connective tissue dysplasia in women]. Klinich. meditsina – Clin. Medicine, 8, 42-48 [in Russian].
Osipenko, I.P. (2013). Biokhimicheskiye markery nedifferentsirovannoy displazii soyedinitelnoy tkani u patsiyentov s idiopaticheskim prolapsom mitralnogo klapana [Biochemical markers of undifferentiated connective tissue dysplasia in patients with idiopathic mitral valve prolapse]. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I. P. Pavlova. – I. P. Pavlov Russian Medical Biological Herald, 21, 1, 37-43 [in Russian].
Lukina, T.S., Pavlov, O.G., & Kozina, Ye.A. (2015). Vedeniye beremennykh zhenshchin s nedifferentsirovannoy displaziyey soyedinitelnoy tkani [Management of pregnant women with undifferentiated connective tissue dysplasia]. Vestnik novykh meditsinskikh tekhnologiy – Bulletin of New Medical Technologies, 4, 2-5. DOI: 10.12737/16165.
Murphy-Ryan, M., Psychogios, A., & Lindor, N. (2010). Hereditary disorders of connective tissue: a guide to the emerging differential diagnosis. Genet. Med., 12 (6), 344-354.
Smolnova, T.Yu. (2015). Pokazaniya k viboru medikamentoznoy terapii u bolnykh s displaziyey soyedinitelnoy tkani v akusherstve i ginekologii [Indications for the choice of drug therapy in patients with connective tissue dysplasia in obstetrics and gynecology]. Proceedings of the first All-Russian conf. «Aktualnyye voprosy vnutrenney patologii. Displaziya soyedinitelnoy tkani» – ‘‘Topical issues of internal pathology. Connective tissue dysplasia’’. Omsk: OmGA [in Russian].
Dobrokhotova, Yu.E., & Borovkova, Ye.I. (2017). Pregravidarnaya podgotovka i vedeniye beremennosti u patsiyentok s displaziyey soyedinitelnoy tkani [Pregravid preparation and management of pregnancy in patients with connective tissue dysplasia]. Ginekologiya – Gynecology, 19 (5), 44-49 [in Russian].
Makarchuk, O.M., Rymarchuk, O.M., & Drohomyretskyi, L.V. (2015). Nedyferentsiiovana dysplaziia spoluchnoi tkanyny yak faktor imovirnykh hestatsiinykh uskladnen [Undifferentiated connective tissue dysplasia as a factor of probable gestational complications]. Akusherstvo. Hinekolohiya. Henetyka – Obstetrics. Gynecology. Genetics, 2, 18-19 [in Ukrainian].
Kononenko, I.S. (2020). Polimorfizmy genov transformiruyushchego rostovogo faktora β1 i matriksnoy metalloproteinazy 9 kak molekulyarno-geneticheskiye prediktory formirovaniya istmiko-tservikalnoy nedostatochnosti u patsiyentok s nedifferentsirovannoy displaziyey soyedinitelnoy tkani [Polymorphisms of the genes of the transforming growth factor β1 and matrix metalloproteinase 9 as molecular genetic predictors of the formation of isthmic-cervical insufficiency in patients with undifferentiated connective tissue dysplasia]. Vestnik VGMU – Bulletin VSMU, 19, 3, 50-58 [in Russian].
Jeresaty, R.M. (2017). Mitral valve prolapse. An update. JAMA, 254 (6), 793-795.
Filipenko, P.S., & Malookaya, Yu.S. (2016). Rol displazii soyedinitelnoy tkani v formirovanii prolapsa mitralnogo klapana [The role of connective tissue dysplasia in the formation of mitral valve prolapse]. Klin. med. – Clin. Med., 84 (12), 13-19 [in Russian].
Tang, L.C., Chan, S.Y.,& Wong, V.C. (2015). Pregnancy in patients with mitral valve prolapse Int. J. Gynaecol. Obstet., 23 (3), 217-221.
Chia, Y.T., Yeoh, S.C., & Lim, M.C. (2016). Pregnancy outcome and mitral valve prolapse. Asia Oceania J. Obstet. Gynaecol., 20 (4), 383-388.
Jana, N., Vasishta, K., & Khunnu, B. (2017). Pregnancy in association with mitral valve prolapse. Asia Oceania J. Obstet. Gynaecol., 19 (1), 61-65.
Kucharczyk-Petryka, E., Mamcarz, A., & Braksator, W. (2016). Mitral valve prolapse at pregnancy: is it a real clinical problem? Pol. Arch. Med. Wewn., 114 (5), 1084-1088.
Hameed, A., Karaalp, I.S., & Tummala, P.P. (2015). The effect of valvular heart disease on maternal and fetal outcome of pregnancy. J. Am. Coll. Cardiol., 37 (3), 893-899.
Artal, R., Greenspoon, J.S., & Rutherford, S. (2016). Transient ischemic attack: a complication of mitral valve prolapse in pregnancy. Obstet. Gynecol., 71 (6), 1028-1030.
Nikiforova, L.N. (2011). Prolaps mitralnogo klapana i beremennost [Mitral valve prolapse and pregnancy]. proCARDIO, 1 (147), 24-29 [in Russian].
Caddell, J.L. (2011). The apparent impact of gestational magnesium (Mg) deficiency on the sudden infant death syndrome (SIDS). Magnes. Res., 14 (4), 291-303.
Lichodziejewska, B., Klos, J., & Rezler, J. (2017). Clinical symptoms of mitral valve prolapse are related to hypomagnesaemia and attenuated by magnesium supplementation. Amer. J. Cardiol., 79 (6), 768-772.
Torshin, I.Yu., & Gromova, O.A. (2008). Displaziya soyedinitelnoy tkani, kletochnaya biologiya i molekulyarnyye mekhanizmy vozdeystviya magniya [Connective tissue dysplasia, cellular biology and molecular mechanisms of magnesium exposure]. RMZh – RMJ, 16, 4, 3-11 [in Russian].
Heryak, S.M., Dobrianska, V.Yu., Dobrianskyi, T.O., Korda, I.V., Shved, M.I., & Petrenko, N.V. (2019). Elektrolitni porushennia yak predyktor rozvytku akusherskykh ta perynatalnykh uskladnen u vahitnykh z polapsom mitralnoho klapana [Electrolyte disorders as a predictor of obstetric and perinatal complications in pregnant women with mitral valve polapse]. Zbirnyk naukovykh prats akusheriv-hinekolohiv Ukrainy – Collection of Scientific Works of Obstetricians and Gynecologists of Ukraine,11-19 [in Ukrainian].
Osypenko, I.P., & Solyeyko, O.V. (2012). Protsesy hormonalnoi dezadaptatsii u patsiientiv iz idiopatychnym prolabuvanniam mitralnoho klapana [Processes of hormonal maladaptation in patients with idiopathic mitral valve prolapse]. Visnyk morfolohii – Bulletin of Morphology, 18, 2, 321-325 [in Ukrainian].
Glotov, A.V., & Miniyevich, O.L. (2005). Sosudisto-trombotsitarnyy gemostaz pri displazii soyedinitelnoy tkani i zabolevaniyakh, assotsiirovannykh s ney [Vascular-platelet hemostasis in connective tissue dysplasia and diseases associated with it]. Omskiy nauchnyy vestnik – Omsk Scientific Bulletin, 1 (30), 107-110 [in Russian].
Kotovshchikova, E.F., Buevich, E.I., Penkova, E.V., Kulikov, V.P., Chudimov, V.F., Siulzhina, E.N., …, & Bochkarev, A.P. (2012). The mutation of genes of hemostasis system in patients with venous cerebral angiodystonia against the background of connective tissue dysplasia. Klin. Lab. Diagn., 8, 33-36.
Yashchuk, A.G., Maslennikov, A.V., & Shiryayev, A.A. (2016). Funktsionirovaniye sistemy gemostaza u beremennykh na fone nedifferentsirovannoy displazii soyedinitelnoy tkani [Functioning of the hemostasis system in pregnant women against the background of undifferentiated connective tissue dysplasia]. Prakticheskaya meditsina – Practical Medicine, 1 (93), 37-40 [in Russian].
Soleyko, Ye.V., Osipenko, I.P., & Soleyko, L.P. (2014). «Biokhimicheskiy portret» sindroma nedifferentsirovannoy displazii soyedinitelnoy tkani [‘‘Biochemical portrait’’ of the syndrome of undifferentiated connective tissue dysplasia]. Liky Ukrainy – Medicine of Ukraine, 1 (177), 6-14 [in Russian].
Nanna, M., & Stergiopoulos, K. (2017). Pregnancy complicated by valvular heart disease: an update. J. Am. Heart Assoc., 3 (3), 76-80.
Kazachkova, E.A. (2017). Sindrom displazii soyedinitelnoy tkani serdtsa i beremennost [Syndrome of dysplasia of the connective tissue of the heart and pregnancy]. Akusherstvo y ginekologiya – Obstetrics and Gynecology, 1, 127-132 [in Russian].
Uglova, D.F., & Kildiyarova, R.R. (2014). Perinatalnyye iskhody na fone profilaktiki preparatami magniya beremennykh s displasticheskoy patologiyey serdechno-sosudistoy sistemy [Perinatal outcomes against the background of magnesium prophylaxis in pregnant women with dysplastic pathology of the cardiovascular system]. Nauchnyye vedomosti. Seriya Meditsina. Farmatsiya – Scientific Bulletin. Medicine Series. Pharmacy, 24 (195), 28 (1), 48-52 [in Russian].
Ben Salkha, M., & Repina, N.B. (2016). Klinicheskaya diagnostika nedifferentsirovannoy displazii soyedinitelnoy tkani [Clinical diagnosis of undifferentiated connective tissue dysplasia]. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I. P. Pavlova – I. P. Pavlov Russian Medical and Biological Bulletin, 24, 4, 164-172. DOI: 10.23888/PAVLOVJ20164164-172.
Grigoryeva, Yu.V., Yamshchikov, N.V., Chemidronov, S.N., Rents, N.A., & Bormotov, A.V. (2015). Kollagen III tipa v sheyke matki krys pri beremennosti i rodakh [Collagen III type in the neck of the rat uterus during pregnancy and childbirth]. Mezhdunarodnyy zhurnal prikladnykh i fundamentalnykh issledovaniy – Int. J. Applied Fund. Res., 1 (part 1), 72-75 [in Russian].
Pavlenko, M. (2018). Istmiko-tservikalna nedostatnist: opys, prychyny, likuvannia [Isthmic-cervical insufficiency: description, causes, treatment]. Retrieved from: https://umec.com.ua/istmiko-tservikalna-nedostatnist.
Anum, E.A., Hill, L.D., Pandya, A., & Strauss, J.F. 3rd (2009). Connective tissue and related disorders and preterm birth: clues to genes contributing to prematurity. Placenta, 30 (3), 207-215. DOI: 10.1016/j.placenta.2008.12.007.
Chen, C.H., Huang, M.C., Liu, H.C., Huang, C.-J., Lin, H.-C., & Kou, Y.R. (2011). Increased risk of preterm birth among women with mitral valve prolapse: a nationwide, population-based study. Ann. Epidemiol., 21 (6), 391-398. DOI: 10.1016/j.annepidem.2011.02.004.
Saryyeva, O.P., Peretyatko, L.P., Vakhromeyev, A.P., & Pareyshvili, V.V. (2019). Patomorfologiya vneplatsentarnykh obolochek pri ikh prezhdevremennom razryve i nedifferentsirovannoy displazii soyedinitelnoy tkani u zhenshchin [Pathomorphology of extra-placental membranes with their premature rupture and undifferentiated connective tissue dysplasia in women]. Arkhiv patologii – Archive of Pathology, 81 (4), 26-32. DOI: https://doi.org/10.17116/patol20198104126 [in Russian].
Tetelyutina, F.K., Lagutko, N.N., Sushentsova, T.V., Badriyeva, Y.N., & Akhmedyanova, R.D. (2018). Pokazateli biopolimerov soyedinitelnotkannoy displazii v otsenke platsentarnoy nedostatochnosti [Indicators of biopolymers of connective tissue dysplasia in the assessment of placental insufficiency]. Vyatskiy meditsinskiy vestnik – Vyatka Medical Bulletin, 2 (58), 27-31 [in Russian].
Aksenenko, V.A., & Babenko, T.I. (2012). Osobennosti immuniteta u beremennykh s displaziyey soyedinitelnoy tkani v tretyem trimestre beremennosti [Features of immunity in pregnant women with connective tissue dysplasia in the third trimester of pregnancy]. Astrakhanskiy meditsinskiy zhurnal – Astrakhan Medical Journal, 3, 7, 28-31 [in Russian].
Nazarenko, L.H., & Savon, O.L. (2012). Nedyferentsiiovana spoluchnotkanynna dysplaziia – nezalezhnyi i znachushchyi faktor ryzyku rozvytku tiazhkykh form piznoho hestozu [Undifferentiated connective tissue dysplasia – an independent and significant risk factor for the development of severe forms of late preeclampsia]. Zdorovya zhinky – Women's Health, 1, 149-152 [in Ukrainian].
Smirnova, T.L., Gerasimova, L.I., Sidorov, A.Ye., Chernyshov, V.V., & Gubanova, Ye.A. (2018). Osobennosti techeniya beremennosti i rodov u zhenshchin s sindromom nedifferentsirovannoy displazii soyedinitelnoy tkani [Features of the course of pregnancy and childbirth in women with the syndrome of undifferentiated connective tissue dysplasia]. Prakticheskaya meditsina – Practical Medicine, 16, 6, 39-44 [in Russian].
Ilina, Yu.I., & Chikisheva, A.A. (2020). Osobennosti techeniya beremennosti u patsiyentok s displaziyey soyedinitelnoy tkani [Features of the course of pregnancy in patients with connective tissue dysplasia]. RMZh. «Mat i ditya» – RMJ. ‘‘Mother and Child’’, 3, 182-188 [in Russian].
Gaisin, I.R., Valeeva, R.M., Maksimov, N.I., Iskhakova, A.S., Khodyrev, L.A., & Shilina, L.V. (2013). Magnesium orotate in treatment of chronic hypertension in pregnant women. Kardiologiia, 53 (9), 33-39.
Veropotvelyan, P.N., Tsekhmistrenko, I.S., Veropotvelyan, N.P., & Gatselyuk, S.V. (2016). Strategicheskiy vzglyad na faktory riska prolapsa genitaliy i sposoby ikh korrektsii [Strategic view of risk factors for genital prolapse and methods of their correction]. Medychni aspekty zdorovia zhinky – Medical Aspects of Women's Health, 3 (100), 66-74 [in Russian].
Gurbanova, S.R. (2009). Vozmozhnosti optimizatsii akusherskoy taktiki vedeniya beremennosti i rodov u patsiyentok s istmiko-tservikalnoy nedostatochnostyu i markerami nedifferentsirovannoy displazii soyedinitelnoy tkani [Possibilities of optimization of obstetric tactics of pregnancy and childbirth in patients with isthmic-cervical insufficiency and markers of undifferentiated connective tissue dysplasia]. Vestnik RUDN. Seriya: Meditsina – Bulletin PFUR. Series: Medicine, 6, 196-200 [in Russian].
Kerimkulova, N.V., Serov, V.N., Nikiforova, N.V., Torshin, I.Yu., Gromova, O.A., Peretyatko, L.P., & Kuznetsov, R.A. (2013). Vliyaniye nedifferentsirovannoy displazii soyedinitelnoy tkani na iskhody beremennosti i rodov: klinicheskiye aspekty, morfologicheskiye i immunogistokhimicheskiye osobennosti platsenty [Influence of undifferentiated connective tissue dysplasia on pregnancy and childbirth outcomes: clinical aspects, morphological and immunohistochemical characteristics of the placenta]. Zemskiy vrach – Zemsky Doctor, 3 (20), 28-31 [in Russian].
Sitnikova, O.G., Pareyshvili, V.V., Nazarov, S.B., Vakhromeyev, A.P., Kuzmenko, G.N., & Popova, I.G. (2015). Svobodnoradikalnoye okisleniye lipidov i antioksidantnaya aktivnost u beremennykh s nedifferentsirovannoy displaziyey soyedinitelnoy tkani pri nedonoshennoy beremennosti [Free radical oxidation of lipids and antioxidant activity in pregnant women with undifferentiated connective tissue dysplasia in premature pregnancy]. Tavricheskiy mediko-biologicheskiy vestnik – Tavrida Medical and Biological Bulletin, 18, 1 (69), 120-122 [in Russian].
Anikin, V.V., & Beganskaya, N.S. (2013). Izmeneniye tsitokinovogo profilya kak mekhanizm adaptatsii pri soyedinitelnotkannoy displazii [Changes in the cytokine profile as an adaptation mechanism in connective tissue dysplasia]. Sovremennyye problemy nauki i obrazovaniya – Modern Problems of Science and Education, 3. Retrieved from: https://www.science-education.ru/ru/article/view?id=9567 [in Russian].
Dobryanska, V.Yu., Heryak, S.M., & Shved, M.I. (2018). Predyktory ekstrasystolichnoi arytmii ta yii likuvannia u vahitnykh iz pervynnym prolapsom mitralnoho klapanu [Predictors of extrasistic arrythmia and its treatment in pregnant military valve prolapses]. Zdobutky klinichnoi i eksperymentalnoii medytsyny – Achievements of Clinical and Experimental Medicine, 2, 48-52. DOI:10.11603/1811-2471.2018.v0.i2.8912.
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