666 The role of relaxin in the regulation of the biological readiness of the body of pregnant women for childbirth

Abstract

Objective“The hormone of childbirth” - relaxin, has a wide range of biological effects for the pathophysiological basis of the prenatal cervical remodeling process. We tried to clarify the mechanisms involved in preparing the cervix for childbirth, to identify predictors of the readiness of the birth canal for timely rational pre-induction and the possibility of spontaneous onset of labor by studying the interrelation of the regulatory capabilities of relaxin. Study Design: We examined 115 primary pregnant women with a gestational age of 38-40 weeks. The degree of maturity of the cervix was assessed using the E.H. Bishop. Group I included 40 (34.8%) pregnant women with a “mature” cervix (9-13 points). Group II included 75 (65.2%) pregnant women with “immature” cervix (0-5 points). Immunological studies such as the level of relaxin, the concentration of cytokines (IL-1β, IL-6, TNF, TGF-β), MMP-1, MMP-9. Results: The level of relaxin in the blood serum of primary pregnant women with a “mature” cervix is 1.7 higher (361.8 ± 38.4 pg / ml) than in women with an “immature” cervix (208.9 ± 27.6 pg / ml) (p <0.05). The data obtained confirm the role of relaxin in the pathogenesis of cervical readiness for childbirth. In pregnant women with a “mature” cervix, there was an increase (p <0.05) in the concentration of MMP-1, MMP-9, IL-1β, IL-6, TNF and TGF-β. A direct correlation was found between the level of relaxin and matrix metalloproteinases (r = 0.78), along with a tendency towards a positive correlation with the studied cytokines. Conclusions: Relaxin and immune factors are reliable immunobiological predictors of the onset of labor, and the effectiveness of complex therapeutic approaches to induce labor.