Objective 26% of all pregnancies end in miscarriage, and up to 10% of clinically diagnosed pregnancies, and recurrent pregnancy loss is 5% among couples of childbearing ages. Although there are several known causes of pregnancy loss in the first half, including recurrent pregnancy loss, including parental chromosomal abnormalities, uterine malformations, endocrinological disorders, and immunological […] Abstract Objective 26% of all pregnancies end in miscarriage, and up to 10% of clinically diagnosed pregnancies, and recurrent pregnancy loss is 5% among couples of childbearing ages. Although there are several known causes of pregnancy loss in the first half, including recurrent pregnancy loss, including parental chromosomal abnormalities, uterine malformations, endocrinological disorders, and immunological […]

Relevance: Preeclampsia is one of the most severe complications of pregnancy, characterized by the development of arterial hypertension and proteinuria after the 20th week of gestation. In recent years, increasing interest has been shown in the study of hematological parameters as potential biomarkers for early diagnosis and prediction of preeclampsia. Mean platelet volume (MPV) is an indicator reflecting the size and activity of platelets. An increase in MPV could indicate platelet activation and an inflammatory process. Mean corpuscular volume (MCV) characterizes the average length of red blood cells and could indicate various hematological disorders. The study aimed to assess the impact of MPV, MCV, and Hb levels on the risk of developing severe preeclampsia in pregnant women. Materials and Methods: The study included 85 pregnant women divided into two groups: 55 women with severe preeclampsia (Group 1) and 30 healthy pregnant women (Group 2). We conducted a multivariate analysis using logistic regression to assess the impact of these parameters on the risk of preeclampsia. We defined inclusion and exclusion criteria. The model’s accuracy was evaluated using ROC analysis. Results: The multivariate analysis revealed that elevated MCV and MPV values were associated with a reduced risk of developing severe preeclampsia, while elevated hemoglobin (Hb) levels were associated with an increased risk. Notably, the model demonstrated a high predictive accuracy, instilling confidence in the study's results with an AUC = 0.82. Conclusion: The study's findings suggest that MCV, MPV, and Hb parameters can significantly predict the risk of severe preeclampsia. Their potential use in clinical practice could offer hope for early diagnosis and prevention of this pregnancy complication, potentially improving outcomes for pregnant women.

Introduction: Chronic hypertension and related cardiovascular diseases are some of the leading causes of maternal and perinatal morbidity and mortality in the world. Objectives: The aim of the study was to evaluate the diagnostic value of purine metabolism products in plasma and blood erythrocytes in pregnant women with chronic hypertension with superimposed preeclampsia. Patients and Methods: Around139 patients were examined, including 110 pregnant women and 29 healthy non-pregnant women of childbearing age (control group). The content of purine metabolism intermediates was determined; guanine, hypoxanthine (HX), adenine, xanthine (X) and uric acid (UA) - in plasma and erythrocytes. We also determined the level of blood platelets, proteinuria in the general analysis of urine in pregnant women with chronic arterial hypertension, severe preeclampsia, and in pregnant women with chronic hypertension with superimposed preeclampsia. Results: The level of purine catabolism intermediates significantly exceeds in the blood of pregnant women with chronic hypertension and superimposed preeclampsia compared to control group. It was determinate that purine intermediates a significant increase in pregnant women with chronic hypertension with superimposed preeclampsia compared to pregnant women with isolated chronic hypertension, pregnant women with severe preeclampsia. An analysis of correlations showed that the increase in purine intermediates in blood in pregnant women with chronic hypertension and superimposed preeclampsia is associated with an increase in proteinuria and thrombocytopenia. It indicates a diagnosis of preeclampsia to chronic hypertension. It can be an additional diagnostic criterion, along with proteinuria and thrombocytopenia. Conclusion: Determination of purine intermediates can be used as an additional diagnostic criterion in pregnancy with chronic hypertension.

BACKGROUND: Preeclampsia, chronic arterial hypertension is one of the causes of maternal and perinatal morbidity and mortality. AIM: The aim of our study was to assess the level of extracellular nucleic acids in red blood cells and blood plasma in pregnant women with severe preeclampsia, severe chronic hypertension, and pregnant women with chronic hypertension with superimposed preeclampsia. METHODS: A total of 107 pregnant women were examined who were hospitalized at the Regional Clinical Hospital and at the Regional Perinatal Center in Karaganda and 29 healthy non-pregnant women. Pregnant women were divided into four groups: 1 group – 32 pregnant with severe chronic hypertension, 2 group – 48 pregnant women with severe preeclampsia, 3 group – 35 women entered the group with chronic hypertension with superimposed preeclampsia, and group control – 29 healthy non-pregnant women of child bearing age (4th group – control). RESULTS: The content of ecNA in the erythrocytes of pregnant women with chronic hypertension with superimposed preeclampsia sharply increases relative to the control and comparison groups; in pregnant women with severe hypertension and severe preeclampsia, the level of ecNA is moderately higher relative to the control, but lower than in the main group. CONCLUSION: Our data indicate significant changes in the level of ecNA in pregnant women with various types of hypertension and require further research, but now, changes in the concentration of ecNA can be considered as one of the links in the pathogenesis of preeclampsia.

Caesarean delivery rates now exceed 30% in most high-income countries, producing a large cohort of women who face a choice between trial of labour after caesarean (TOLAC) and elective repeat caesarean delivery (ERCD) in a subsequent pregnancy. We performed a meta-analysis of studies published January 2021 – March 2026 to estimate the pooled vaginal birth after caesarean (VBAC) success rate and compare maternal and neonatal outcomes between strategies. Thirty-two studies ( N = 1,287,757 women) met pre-specified inclusion criteria. Risk of bias was assessed with the Newcastle–Ottawa Scale (NOS); pooled odds ratios (OR) with 95% confidence intervals (CI) used the DerSimonian–Laird random-effects model. The pooled VBAC success rate was 72.4% (95% CI 69.8–74.9%; I² = 63%). Uterine rupture was more frequent with TOLAC than ERCD (0.47% vs. 0.026%; OR 7.21, 95% CI 4.89–10.62; I² = 41%). TOLAC was associated with lower odds of postpartum haemorrhage requiring transfusion (OR 0.68, 95% CI 0.54–0.86) and wound infection (OR 0.52, 95% CI 0.39–0.70). NICU admission rates were not significantly different when both groups delivered at ≥ 39 weeks (OR 0.89, 95% CI 0.71–1.11). A lower uterine segment (LUS) thickness ≥ 3.0 mm was associated with a VBAC success rate of 76.8% and a rupture rate of 0.31%. Individualised, LUS-informed risk stratification is more consistent with this evidence than blanket institutional restriction of TOLAC.

Background: Contrast-induced acute kidney injury (CI-AKI) remains a concern in patients with ST-elevation myocardial infarction (STEMI) undergoing emergent percutaneous coronary intervention (PCI), but creatinine-based CI-AKI definitions incompletely capture longer-term renal trajectories. Early tubular stress biomarkers such as tissue inhibitor of metalloproteinases-2 (TIMP-2) may provide incremental risk information beyond conventional functional markers. Methods: In this prospective single-centre cohort, we enrolled 88 consecutive STEMI patients undergoing urgent coronary angiography with or without PCI. Routine laboratory parameters were obtained at admission and 48 h. Serum TIMP-2 was measured 2 h after the procedure using a standardized sandwich ELISA. Early CI-AKI was defined by conventional creatinine-based criteria within 48 h, whereas 90-day chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² or persistent creatinine elevation at 90 days. We evaluated paired changes, between-group differences by 90-day CKD status, correlations, multivariable linear and logistic regression, and receiver operating characteristic (ROC) discrimination. Results: Early CI-AKI occurred in 6/88 patients (6.8%), whereas 90-day CKD was diagnosed in 15/88 (17%), indicating substantial delayed renal dysfunction beyond the 48-h window. The median 2-h serum TIMP-2 concentration was 1.20 ± 0.38 ng/mL. TIMP-2 showed modest correlations with creatinine and urea and remained independently associated with higher 90-day creatinine in multivariable linear regression (B = + 12.0 µmol/L per 1-ng/mL increase; p = 0.016) after adjustment for baseline creatinine and clinical covariates. In parsimonious logistic models, TIMP-2 demonstrated a borderline association with 90-day CKD (odds ratio ≈ 6.38; p = 0.056), while older age was a significant predictor. Standalone ROC discrimination for 90-day CKD was limited (AUC 0.528; 95% confidence interval 0.39–0.65; p = 0.668). Conclusions: In STEMI patients undergoing emergent angiography/PCI, 90-day CKD was considerably more frequent than early creatinine-defined CI-AKI, underscoring the need for extended renal follow-up. A single 2-hour serum TIMP-2 measurement reflects early tubular stress and independently associates with 90-day creatinine, but offers only modest standalone discrimination for 90-day CKD. TIMP-2 is therefore more likely to have a role within multivariable or biomarker panel-based risk stratification pathways rather than as an isolated classifier.