The low predictability of the effects of autologous platelet-rich plasma (PRP) in regenerative therapy for patients with type 1 and type 2 diabetes mellitus (DM) underscores the need for further research assessing the reparative effects of PRP based on the type of DM. The aim of this study was to evaluate the regenerative potential of PRP from young donors (30–40 years old) with DM1 and DM2 in vitro, specifically its effects on human dermal fibroblast cell culture. The in vitro effects of PRP from patients with type 1 and type 2 DM were investigated using a culture of human dermal fibroblasts (hTERT-HDFa) to evaluate metabolic activity, migration, proliferation of the cells, and their ability to release growth factors and exosomes. The study of the biological effects of PRP from donors with DM on hTERT-HDFa revealed a decrease in proliferative effects, an increase in prooxidant action, and toxic influences of PRP from patients, characterized by reduced metabolic activity and cell viability in culture, along with an increase in the percentage of necrosis. These effects were most pronounced in type 1 DM. The secretory response of hTERT-HDFa upon stimulation with PRP varied depending on the type of DM. Correlations indicated the differing significance of PAI-1, TGFB-1, PDGF, VEGF, and IL-6 in assessing the reparative potential across different types of DM.

Preeclampsia (PE) and gestational hypertension (GH) occupy leading positions in the structure of pregnancy pathology and adverse perinatal outcomes.The purpose of this study was to evaluate the state of microcirculation of peripheral tissues and the hemostasis system in conjunction with proper uteroplacental circulation in pregnant women with hypertensive disorders; to determinate the patterns of changes in regional hemodynamics, significant as predictors of the occurrence and progression of hypertensive conditions.Materials and methods. A clinical study of pregnant women with gestational hypertension (GH) (n = 36) and patients with preeclampsia (PE) (n = 12); control — women with physiologic pregnancy was performed. Clinical evaluation of the woman and newborn, assessment of peripheral microcirculation (laser Doppler flowmetry), determination of coagulation profile (thromboelastography), statistical analysis of data (Statistica 13.0) were performed.Results. There is an increase in formation and density of blood clot with a decrease in fibrinolytic processes (relative to control by 19.33 % (p < 0.050) in GH, by 38.24 % (p < 0.050) in PE). Changes in average laboratory values included an increase in number of platelets in GH and a decrease in PE. Assessment of peripheral tissues microcirculation demonstrated a statistically significant decrease in tissue perfusion in patients with GH and PE relative to the control by 23.1 % (p < 0.050) and 33.2 % (p < 0.050) respectively, which was accompanied by changes in the regulation of microhemodynamics.Conclusion. Development of GH and PE is accompanied by negative dynamics of microcirculation with regulation tension and an increase of contribution of systemic regulatory mechanisms of tissue perfusion, significant hypercoagulemic changes in the hemostasis system. Impaired microcirculation in pregnant women with GH is associated with a high frequency of surgical delivery and a life-threatening condition of the newborn.

Introduction. One of the urgent problems of modern obstetrics is gestational arterial hypertension (GAH), which entails a whole range of complications for both mother and fetus. In this regard, it is necessary to search for economically accessible, informative and safe methods for early diagnosis of uteroplacental blood flow disorders in pregnant women.The aim of the study was to investigate the features of peripheral and uteroplacental blood flow in pregnant women with GAH, to assess the state of the vascular wall of pregnant women using photoplethysmography and to determine its association with uteroplacental blood flow disorders. Materials and methods. A total of 78 patients with 22 to 40 weeks of pregnancy, divided into two groups, were clinically examined: the first group (n=42) were pregnant women with GAH, the second group the control group (n=36) consisted of patients with physiological course of gestation. The study included assessment of the objective clinical status of the pregnant woman, recording and contour analysis of photoplethysmograms, ultrasound examination of the uteroplacental and fetoplacental blood flow, and statistical processing of the results.Results. When comparing the anthropometric characteristics of the studied groups, an increase in BMI was found in the group of pregnant women with GAG (p<0.05). Contour analysis of photoplethysmography (PPG) data showed an increase in the augmentation index in pregnant women with GAG by 73.47 % (p=0.054), an increase in central arterial pressure by 3.6 % (p<0.05). Changes in peripheral hemodynamics in pregnant women with hypertensive disorder were associated with impaired fetoplacental blood flow (rxy = 0.52-0.86, p < 0.05), which was accompanied by lower fetal biometry parameters (p<0.05).Conclusion. Hemodynamic disturbances in the mother-placenta-fetus system correlate with changes in the parameters of peripheral circulation, which allows us to consider the additional use of the photoplethysmography method as promising in terms of early diagnostics and prevention of perinatal complications in mother and fetus.

Introduction. Preeclampsia remains one of the most significant challenges in modern obstetrics, accounting for approximately 2–8% of maternal and perinatal losses. The complexity of the pathophysiological mechanisms underlying preeclampsia limits the available diagnostic and preventive measures for this pregnancy complication, leading to an increased incidence of preterm delivery. One promising area of research in preeclampsia pathophysiology is the study of genetic factors contributing to coagulation disorders, placental dysfunction, and hypoxic-ischemic injuries in neonates affected by preeclampsia. The objective of this study is to evaluate the role of combined mutations in genes related to the antioxidant system (SOD2 (C47T), CAT (-262C/T), GSTP1 (313AG)), platelet integrins (ITGB3 (T1565C), ITGA2 (C807T)), and fibrinogen (FGB (G(-455)A)) in the development of severe preeclampsia and adverse perinatal outcomes. Materials and methods. A single-center, observational, prospective study was conducted involving 49 female patients (2018–2022), who were divided into three groups: Group A (n = 16) comprised patients with severe preeclampsia and fewer than 6 mutant alleles of the aforementioned genes; Group B (n = 18) included patients with severe preeclampsia and 6 or more mutant alleles of the aforementioned genes; Group 0 (n = 15) consisted of patients with a physiologically normal pregnancy and fewer than 6 mutant alleles of the aforementioned genes. Thromboelastography, peripheral tissue microcirculation, and the intensity of oxidative processes in the blood were assessed. Genetic testing was performed using real-time PCR. Neonatal outcomes were evaluated using the Apgar score (4–6 points indicating moderate asphyxia, 1–3 points indicating severe asphyxia). Results. In Group B, statistically significant (p 0.05) thromboelastography changes were observed, characterized by reduced blood clot solubility, increased thrombus formation rate, and impaired oxygenation processes. A decrease in microcirculation efficiency and an intensification of oxidative stress processes were noted. Additionally, a statistically significant (p 0.05) increase in lipid peroxidation products (malondialdehyde and diene conjugates) was recorded, accompanied by reduced antioxidant activity compared to both the control group and Group A. Discussion and conclusion. The combination of mutant variants of the studied platelet integrin genes and antioxidant genes in the presence of homozygous mutant alleles is associated with impaired oxidative processes and coagulation potential in severe preeclampsia, as well as the development of severe neonatal asphyxia.

Background. At this moment, the number of cesarean section deliveries has in creased, which raises the risk of postoperative complications, especially in patients with a comorbid background. The aim of the work was to establish the features of the reparative process of the tissues of the cesarean section area with a different comorbid background (preeclampsia, obesity). Material and methods. The analysis was performed on 102 pregnant women, that underwent cesarean section. Group 1 (25) – pregnant women without comorbid pathology, group 2 (27) – women with 2nd degree of obesity; group 3 (22) – with 3rd degree of obesity; group 4 (28) – with moderate and severe preeclampsia. The healing process of laparotomy wound tissues was evaluated. The obtained digital data was pro cessed by the method of variation statistics. Results. In pregnant women with preeclampsia and obesity, especially with grade 3, the healing of abdominal wall tissues in the cesarean section area in the early postoperative period proceeds at a slow tempo. According to the assessment of the cytological material, the prolongation of the inflammatory phase and its delayed transition to the reparative phase have been established. This has been confirmed by clinical tests. In vitro studies have established the effect of plasma from pregnant women with preeclampsia on the metabolic activity and regenerative potential of dermal fibroblast cultures. Conclusion. In women in labor with moderate and severe preeclampsia, as well as with third-degree obesity who underwent cesarean delivery, the reparative regeneration of laparotomy wound tissues gone slowly and is manifested in the early stages by a significant decrease in the degenerative-degenerative index, slowing down the transformation of poly blasts into tissue forms. In vitro studies have established the effect of plasma from pregnant women with preeclampsia on the metabolic activity and regenerative potential of dermal fi broblast cultures; no significant differences were found in comorbid obesity.