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CNAA / Theses / 2017 / July /

The role of angiogenic factors in Abruptio Placentae


Author: Sagaidac Irina
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2018
Scientific adviser: Valentin Friptu
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 6 July, 2017
Approved by NCAA on the 11 May, 2018

Abstract

Adobe PDF document – 1.40 Mb / in romanian

Thesis

CZU 618.36-007.281-039.11-07

Adobe PDF document 13.38 Mb / in romanian
211 pages

Keywords

abruptio placentae, hemostasis, endothelial dysfunction, angiogenic factors.

Summary

The present thesis is written on 131 pages and includes: introduction, 5 chapters, conclusions, recommendations, bibliography of 231 sources, 10 annexes, 51 figures and 29 tables. The achieved results are published in 14 scientific journals, including 5 articles without co-authors.

The research area: Medicine

Study aim. Evaluation of the ethiopathogenetic mechanisms, of clinical and morphopathological aspects and the relevance of angiogenic factors in the development of Abruptio placentae (AP).Study objectives.Clinical study of pregnancies and births in patients with AP; estimation of regional risk factors and prognostic criteria for developing AP; determining the role of proangiogenic and anti-angiogenic factors and pro-inflammatory mediators of AP; assessment of morphological changes in the placenta and placental bed, in order to identify the pathological structural factors in the development of AP; developing a clinical protocol in AP, considering the term of pregnancy and the seriousness of this obstetric emergencies.

The novelty and the scientific originality.The conducted study has elucidated the clinical features of pregnancy and childbirth complicated with AP. Risk factors for developing AP were calculated. The role of proinflammatory cytokines and angiogenic factors, which have contributed significantly to the pathogeny of AP were assessed. The study of vascular growth factors has given the possibility to establish criteria for early diagnosis of AP.

The scientific solved problem. As a result, of the study risk factors for AP were determined and pathophysiological mechanisms involving angiogenic factors were assessed, underlying AP processes, confirmed by morphological and immunohistochemical study of placental complexes.

The theoretical significance. The present study – based on clinical, biochemical, morphological and immunohistochemical investigations and statistical methods used in the analysis of pregnancies with AP – has contributed to establishing new pathogenic aspects in the development of the pathological condition concerned.

The applicable value of this study. Regional share of the risk factors involved in triggering AP was determined. Evaluation of SFlt-1/PlGF ratio can be recommended as additional diagnostic criterion for early development of AP. Based on the conducted study a national clinical protocol has been developed that will allow optimization of care of AP complicated pregnancy and childbirth, at national level.

Implementation of scientific results. The study results were implemented in clinical work, teaching and research at IMSP Mother and Child Institute, IMSP Clinical Hospital No.1 (Chisinau), Medical University „Nicolae Testemitanu” (Implementation certificate – Annex 10). 7