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ANALE ŞTIINŢIFICE - Baza de date a revistelor ştiinţifice

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7. Nicolai<strong>de</strong>s K.H., K. Spencer, K. Avgidou, S. Faiola and O. Falcon, Multicenter study<br />

of first-trimester screening for trisomy 21 in 75 821 pregnancies: results and estimation of the<br />

potential impact of individual risk-orientated two-stage first-trimester screening, Ultrasound<br />

Obstet Gynecol 25 (2005), pp. 221-226.<br />

8. Spencer K., R. Bindra and K.H. Nicolai<strong>de</strong>s, Maternal weight correction of maternal<br />

serum PAPP-A and free beta-hCG MoM when screening for trisomy 21 in the first trimester of<br />

pregnancy, Prenat Diagn 23 (2003), pp. 851-855.<br />

9. Spencer K., A.W. Liao, H. Skentou, S. Cicero and K.H. Nicolai<strong>de</strong>s, Screening for<br />

triploidy by fetal nuchal translucency and maternal serum free beta-hCG and PAPP-A at 10-14<br />

weeks of gestation, Prenat Diagn 20 (2000), pp. 495-499.<br />

10. Spencer K., C.E. Spencer, M. Power, C. Dawson and K.H. Nicolai<strong>de</strong>s, Screening for<br />

chromosomal abnormalities in the first trimester using ultrasound and maternal serum<br />

biochemistry in a one-stop clinic: a review of three years prospective experience, BJOG 110<br />

(2003), pp. 281-286.<br />

11. Ozturk M, A Milunsky and B Brambati, Abnormal maternal levels of hCG subunits in<br />

trisomy. American Journal of Medical Genetics 36 (2000), pp. 480-483.<br />

12. METODE SE SCREENING ÎN DEPISTAREA ANOMALIILOR CONGENITALE.<br />

Tun<strong>de</strong> Kovacs, F. Stamatian, Alin Butnaru, Adina Gheorghe, Gabriela Caracostea.Obstetrica şi<br />

Ginecologia, vol.LII, nr.2, pg. 117-128 ; 2004.<br />

IMPACTUL HIPERHOMOCISTEINEMIEI ÎN COMPLICAŢIILE OBSTETRICALE<br />

Carolina Glijin<br />

(Conducător ştiinţific - dr. hab. med., profesor universitar Marin Rotaru)<br />

Laboratorul Ştiinţific <strong>de</strong> Obstetrică a IMSP ICŞDOSC şi C<br />

Summary<br />

The hyperhomocysteinemie impact in obstetrical complications<br />

Hyperhomocysteinemie is an in<strong>de</strong>pen<strong>de</strong>nt risk factor for vascular disease which causes<br />

microcirculatory disturbance and hypercoagulabylity. In this article are exposed data about<br />

hyperhomocysteinemie impact on the <strong>de</strong>velopment of the possible pregnancy and maternal-fetal<br />

complications. This material presents a summary of recent data from contemporary literature,<br />

which eluci<strong>date</strong>s the hypehomocysteinemie physiopathogenesis states in obstetrics and their<br />

possibilities of correction.<br />

Rezumat<br />

Hiperhomocisteinemia este un factor <strong>de</strong> risc in<strong>de</strong>pen<strong>de</strong>nt pentru patologia vasculară,<br />

cauzînd tulburarea microcirculaţiei şi hipercuagulare. În acest articol sînt expuse <strong>date</strong> <strong>de</strong>spre<br />

impactul hiperhomocisteinemiei asupra evoluţiei sarcinii şi complicaţiile materno- fetale<br />

posibile. Materialul dat prezintă o sinteză a <strong>date</strong>lor recente din literatura contemporană, care<br />

eluci<strong>de</strong>ază fiziopatogenia stărilaor <strong>de</strong> hipehomocisteinemie în obstetrică şi posibilităţile <strong>de</strong><br />

corecţie ale acestora.<br />

Actualitate<br />

Hiperhomocisteinemia reprezintă un factor <strong>de</strong> risc in<strong>de</strong>pen<strong>de</strong>nt pentru apariţia patologiei<br />

vasculare: cardiace, cerebrale şi periferice, manifestate prin ateroscleroză, tromboze arteriale şi<br />

venoase [13,14]. Se consi<strong>de</strong>ră că hiperhomocisteinemia poate sta la baza apariţiei complicaţiilor<br />

sarcinii, legate <strong>de</strong> tulburarea microcirculaţiei şi hipercuagulare [6,17,27]. Există un număr relativ<br />

mare <strong>de</strong> complicaţii consi<strong>de</strong>rate astăzi ca fiind cauzate <strong>de</strong> creşteri ale nivelelor <strong>de</strong> homocisteină:<br />

anomalii cromozomiale, <strong>de</strong>fecte <strong>de</strong> tub neural, pier<strong>de</strong>rea recurentă <strong>de</strong> sarcină, hipotrofia fetală,<br />

gestoze tardive, <strong>de</strong>colarea prematură <strong>de</strong> placentă normal inserată, tromboze [17, 18, 27].<br />

130

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