4G/4G polymorfismus genu pro inhibitor aktivátoru plazminogenu 1 (PAI-1) jako nezávislý rizikový faktor placentární insuficience, způsobující u plodu hemodynamickou centralizaci

English version

Autoři: Souza P. C. P. ¹; Alves J. A. G. ¹; S. M. Maia ^1,2; Edward Araujo Júnior ³ ; Santana E. F. M. ³; Da Silva Costa F. ⁴
Působiště autorů: Department of Public Health, State University of Ceará (UECE), Fortaleza-CE, Brazil ¹; University of Fortaleza (UNIFOR), Fortaleza-CE, Brazil ²; Department of Obstetrics, Paulista School of Medicine – São Paulo Federal University (EPM-UNIFESP), São Paulo-SP, Brazil ³; Pregnancy Research Centre, Department of Perinatal Medicine and Department of Obstetrics and Gynecology, University of Melbourne, The Royal Women’s Hospital, Melbourne, Victoria, Australia ⁴
Vyšlo v časopise: Ceska Gynekol 2015; 80(1): 74-79

Souhrn

Cíl:
Cílem je popsat případ, kdy 4G/4G polymorfismus genu pro inhibitor aktivátoru plazminogenu 1 (PAI-1) je nezávislým rizikovým faktorem pro vznik placentární insuficience.

Design:
Kazuistika.

Pracoviště:
Ústav veřejného zdravotnictví, State University of Ceará (UECE), Fortaleza-CE, Brazílie.

Kazuistika:
Dědičná hypofibrinolýza, způsobená 4G/4G homozygotním stavem genu kódujícího inhibitor aktivátoru plazminogenu 1, je nezávislým rizikovým faktorem pro vznik komplikací v průběhu těhotenství. Ke vzniku placentární insuficience dochází pravděpodobně indukcí trombózy. V našem případě se jednalo o těhotnou s nízce rizikovým těhotenstvím bez jakýchkoliv klinických projevů v průběhu gravidity. Na počátku 3. trimestru se u této těhotné zjistila růstová retardace plodu s centralizací oběhu a bylo vysloveno podezření na insuficienci placenty. Ihned po porodu se u pacientky objevila hluboká žilní trombóza dolní končetiny. Při anatomicko-patologickém rozboru placenty byly popsány infarkty různého stáří. Příčinou vzniku těchto komplikací u pacientky byl pravděpodobně zjištěný homozygotní stav genu 4G/4G kódující inhibitor aktivátoru plazminogenu 1 (PAI-1).

Klíčová slova:
inhibitor aktivátoru plazminogenu 1, insuficience placenty, fetální distres, žilní trombóza, dopplerometrická ultrasonografie, růstová retardace plodu

Zdroje

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