Pathophysiological adaptive features in “mother - fetus” system at metabolic syndrome and preeclampsia

The objective of the paper is to study adaptive mechanisms of “mother-fetus” system in patients with metabolic syndrome (MS) and preeclampsia. Materials and Methods. Adaptive response was studied in 122 pregnant women with preeclampsia in the third trimester of pregnancy: 85 women had MS and preeclampsia, 37 women were with normal body weight and preeclampsia. WinHRV (St. Petersburg) was used to carry out cardiointervalogram analysis. Mode number (Mo), mode amplitude (АМо), range (ΔХ) and their derivatives were analyzed. Frequency analysis was used to examine heart rate indices: RR (SDNN, ms), VLF (ms2), LF (ms2), HF (ms2), Total (ms2), RR (RMSSD, ms). Doppler velocimetry of blood flow in vessels was carried out by convex ultrasound transducer (5.0 MHz) using ultrasonic scanner МyLab15 (ESAOTE S.p.A.). Results. In women with MS and preeclampsia normotonia was diagnosed in 36.5 %, sympathicotonia - in 48.2 %, vagotonia - in 15.3 %. Indices of frequency analysis decreased in case of sympathicotonia: SDNN - 2 times, RMSSD - 2.1 times, HF - 3.1 times, LF - 3.4 times, VLF - 3.6 times, which indicated centralized cardiac rhythm management. Indices of frequency analysis increased in case of vagotonia: SDNN - 1.7 times, RMSSD - 3.1 times, VLF - 1.9 times, which indicated self-regulation of the heart. Vagotonia influenced utero-placental and fetal-placental blood flow: in the right uterine artery SDR was 13.3 % lower, in fetal aorta it was 28.4 % lower. RI was reduced by 14 % and 6.3 % respectively. Mother’s vagotonia had the most harmful effect on the fetus and newborn. Children were born in asphyxia, with cerebral ischemia and CNS depression 5.7 times more often. Conclusion. Two variants of autonomic homeostasis are possible at MS and preeclampsia: sympathicotonia, which indicates high level of tension of regulatory system (dysaptation), and vagotonia with catatonia and lack of adaptation (maladaptation). Depletion of adaptation is a predictive factor of adverse pregnancy outcome, changes in angiogenesis and metabolic disorder progression.