CHANGESINIMMUNOLOGY STATUS IN PREGNANT WOMEN WITH EARLY GESTOSES

Abstract

One of the frequent complications of early terms of pregnancy is vomiting in pregnant women, which causes have not been studied sufficiently. The signs of early gestosis usually appear from the 4-9th week of pregnancy and decrease up to the 16th week. At the moment, there is no tendency for early gestoses to decrease their frequency. In the last years, huge significance for early gestosis lies in the disordered immune system in a pregnant woman. On the 4-5th week of pregnancy, the mother’s body gets antigens from the fetus that contributes to early gestosis.
 Aim of the research. Study features of immune-mediated inflammatory disorders during the early gestoses of different severity degrees.
 Materials and methods. We examined 120 females. The control group consisted of 30 women with the physiologic course of pregnancy. The main group had 90 pregnant females with present early gestoses of different severity degrees: the 1st one had 30 pregnant patients with present vomiting of a mild degree, the 2nd one – 30 females with early gestoses of moderate degree, the 3rd one – 30 women with early gestoses with the severe course. Inclusion criteria to the main group were considered the age of the patients from 18 to 40 years, present vomiting, present intrauterine singleton pregnancy, patient’s consent to the research, pregnancy term of 4-12 weeks. Exclusion criteria were gastrointestinal and hepatic diseases of different etiology in anamnesis, the patients younger than 18 years old and older than 40 years old, present oncologic diseases, ectopic pregnancy, patients with surgical intervention on the pelvic organs in anamnesis, pregnant women with IVF, present multiple pregnancy, present neuropsychiatric pathology, absent patient’s consent to the research, pregnancy term more than 12 weeks. In blood serum, the examinees had tested cytokine level, which regulated immune-mediated inflammatory response (IL-10, IL-6) on the STAT FAX 303/PLUS Microstrip Reader in the private certified laboratory PrimaMED (Ivano-Frankivsk).
 Results of the research. We tested levels of pro- and anti-inflammatory cytokines, vascular endothelial growth factors in blood serum in pregnant women with present early gestosis dependently on severity degree. Pregnant females with vomiting of several degrees have distorted humoral immune responses. This is seen provably by misbalanced pro- and anti-inflammatory cytokine levels in blood serum. The pro- and anti-inflammatory cytokine levels in pregnant patients with early gestoses depend on the severity of early gestoses. In the group of pregnant women with the mild course, we observed the lowest average values of IL-6 and the highest IL-10 level in blood serum. The females with moderate degree presented a probable decrease of IL-10 levels in 7.3 % and a significant increase of IL-6 levels in 5.5 % compared to the indices in females of the 1st group. The clearest misbalance in pro- and anti-inflammatory cytokines was registered in pregnant women of the 3rd group (severe degree). The women from this group presented a probable decrease of IL-10 level in 22.0% and a significant increase of IL-6 level in 14.8% compared to the indices in females from the 2nd group.
 Conclusions:
 
 The signs of early gestosis are associated with induction of inflammation.
 There are close direct correlations between severity degrees of early gestosis and IL-10 levels and inverse correlations with IL-6 levels. In females with signs of severe early gestosis in blood serum, we recorded a probable decrease of IL-10 levels and a probable increase of IL-6 levels compared to the values in females with mild and moderate early gestosis.