Diagnostic aspects of laboratory research of amniotic fluid are at premature births

Abstract

The objective: to learn a diagnostic value clinical-and-laboratory research of amniotic fluid atpremature births. Materials and methods. Under our supervision in clinical terms was 142 puerpera which actedon births to maternity establishments of different level. All the inspected acted with beginning ofchildbirth. From an incurrence there were eliminated puerpera with a multifetation, pelvic fetal presentation, anomalies of development of fetus and antenatal fetal death. Most inspected was inactive reproductive age. Middle age of inspected made 24,9±0,3 year.A complex clinical inspection was conducted all pregnant at a receipt in permanentestablishment. The clinical inspection of women was included by the study of anamnesisof life, including also to anamnesis of disease, the features of motion of pregnancy werestudied, the generally accepted laboratory and functional methods of research wereconducted. To the complex of additional methods researches were included echographic,cardiotocographic and Doppler. Results. The study of hormonal status of amniotic fluid rotined in births, that content ofestradiol during a childbirth had hesitated within the limits of 30–180 ng/ml. Found out areliable difference between maintenance of this hormone in a amniotic fluid at birth of boysand girls. So at birth of girls the index of estradiol arrived at 21,4±2,3 ng/ml, while at birthof boys a middle index of estradiol was at the level of 16,5±2,3 ng/ml. Although found out adifference and did not carry reliable character (р>0,05), this fact specifies on participating offetus in making a amniotic fluid.Meantime, level of estradiol in a amniotic fluid at birth of boys and girls identically for certainrose at presence of obstetric pathology, such as a weakness of childbirth in combination withfetal distress (p<0,05). An analogical picture is marked in maintenance of cortisol in a amnioticfluid. Indexes of cortisol in a amniotic fluid in births were within the limits of 200–450 nmol/ml.Thus at birth of girls the middle level of cortisol made 180,4±8,4 nmol/ml and at birth of boys –265,4±10,2 nmol/ml, that also testifies to participating of fetus in making of amniotic fluid.Between two hormones found out direct cross-correlation connection (r=0,64; p<0,05). Atpathological motion of births index of estradiol, as well as to the cortisol, rose for certain, thathad testified to the intrauterine fetal distress (p<0,01). The found out intercommunication oflevels of estradiol and cortisol is with other parameters of amniotic fluid and state of fetus inbirths. An index of estradiol was in direct dependence on the indexes of resistance of bloodstream at dopplerometry, namely – systolic-diastolic ratio and index of resistance (r=0,64).The indexes of estradiol and cortisol appropriately rose at the decline of pH in a amnioticfluid (r=-0,71; p<0,01) and at the decline of basale rhythm of cardiac activity of fetus oncardiotocogram (r=-0,69). Conclusion. The results of the conducted researches rotined that the physical and chemicaland biochemical parameters of amniotic fluid are inclined statistically to the reliable changesdepending on the term of births and intrauterine fetal distress in births. A most model are changesof concentration of kreatinine and urea in a amniotic fluid at births which were late, that canhave a diagnostic value. Combination of the indicated signs with the decline of acidity by theincrease of closeness of amniotic fluid at births which were late, and also a presence in it ofmeconium specifies on violation of metabolism of fetus and necessity of timely correction of foundout violations.The clinical use of the transferred parameters of amniotic fluid in births has an important diagnosticvalue at physiology and pathological motion of pregnancy and births.