Abstract
Objective: to study peculiarities of the pituitary-adrenal system reactivity during pregnancy and delivery in women suffering from rheumatism depending on the rheumatoid process activity and heart failure (HF) degree.Materials and methods: the level of adrenocorticotropic hormone (ACTH) and cortisol before delivery and in the dynamics of delivery among women suffering from rheumatism and healthy ones.Results. The functional state of the pituitary-adrenal system in pregnant women and women in childbirth suffering from rheumatism was found to be disturbed. Delivery in patients with inactive phase of rheumatic process with CHF stage I occurs with more tension of the pituitary gland and adrenal cortex functional activity which is evidenced by higher content of ACTH and cortisol in the peripheral blood. Stressful situations during delivery in patients with active phase of rheumatic process result in marked tension of the pituitary-adrenal system of the maternal organism. Associated severe insufficiency of blood circulation leads to the exhaustion of the reserved adrenal cortex capabilities which is manifested by a decreased cortisol level in the blood of women in childbirth.Conclusions. Pathologic decrease in ACTH and cortisol levels in the blood of women in childbirth suffering from rheumatism is indicative of disturbed processes of adaptation to stressful childbirth-related effect and chronic hypoxia.
Highlights
Objective: to study peculiarities of the pituitary-adrenal system reactivity during pregnancy and delivery in women suffering from rheumatism depending on the rheumatoid process activity and heart failure (HF) degree
Delivery in patients with inactive phase of rheumatic process with CHF stage I occurs with more tension of the pituitary gland and adrenal cortex functional activity which is evidenced by higher content of adrenocorticotropic hormone (ACTH) and cortisol in the peripheral blood
Associated severe insufficiency of blood circulation leads to the exhaustion of the reserved adrenal cortex capabilities which is manifested by a decreased cortisol level in the blood of women in childbirth
Summary
Изучили уровень адренокортикотропина (АКТГ) и кортизола перед родами и в динамике родов у больных ревматизмом и у здоровых женщин. У беременных и рожениц, страдающих ревматизмом, нарушается функциональное состояние гипофизарно-надпочечниковой системы. Роды у больных неактивной фазой ревматического процесса при І стадии ХСН протекают с большим напряжением функциональной активности гипофиза и коры надпочечников, о чем свидетельствует более высокое содержание АКТГ и кортизола в периферической крови. У женщин с активной фазой ревматического процесса стрессовые ситуации в родах приводят к выраженному напряжению гипоталамо-гипофизарной системы. Присоединение тяжелой ХСН приводит к истощению резервных возможностей коры надпочечников, что проявляется снижением уровня кортизола в крови рожениц. Патологическое снижение уровня АКТГ и кортизола в крови рожениц с ревматизмом свидетельствует о нарушении процессов адаптации к стрессорному влиянию родов и хронической гипоксии. Вивчили рівень адренокортикотропіну (АКТГ) і кортизолу перед пологами та в динаміці пологів у хворих на ревматизм і у здорових жінок
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