Blood Serum Of Pregnant Women Research Articles

The role of corticoliberin concentration levels and placental CRH receptors 1 and 2 in the prolongation of pregnancy.

Objective To examine the changes in CRH concentrations in the blood serum of pregnant women and in the placenta of patients after the 41st week of gestation, and to determine its influence on the effectiveness of inducing labor and its progress. Materials and Methods The study group comprised pregnant patients who did not deliver until the 41 week of gestation (n = 114). The control group was divided into two subgroups: patients in whom delivery started spontaneously before the 41st week of gestation (n = 24) and pregnant patients in whom delivery started spontaneously after the 41st week of gestation (n = 23). Blood serum and placenta were obtained from the patients. Corticoliberin originating from blood serum was assessed with the use of ELISA Kit. Parts of the placenta were stained with monoclonal antibodies for the presence of corticoliberin, corticoliberin receptors 1 and 2. Results No statistically significant differences were found with regard to corticoliberin concentrations in the blood or during a qualitative assessment of the number of CRH R1 in the placenta between the research groups. However, corticoliberin receptor 2 had a statistically higher expression rate in the control group in which the delivery started spontaneously before the 41st week of gestation. Conclusion In post-term pregnancy, the up-regulation of CRH R2 receptor is disturbed with no change in CRH R1 expression, which complicates the initiation of labor despite correct corticoliberin levels in both blood serum and the placenta. Pregnancy duration over 41 weeks and the effectiveness of preinducing or inducing labor do not depend on corticoliberin concentrations.

Psychoemotional state and filaggrin level in pregnant women with atopic dermatitis

Purpose of the study: to assess the psycho-emotional state and the level of filaggrin in the blood serum of pregnant women with exacerbation of atopic dermatitis (AtD). Materials and methods. The study included 70 pregnant women with AtD, 20 non-pregnant women with AtD, 20 healthy pregnant women. A survey was conducted on the Beck Depression and Anxiety Scale. The filaggrin level in the blood serum was assessed by ELISA. Research results. Serum filaggrin levels in pregnant women with AtD were significantly higher than in non-pregnant women with AD (p=0.007) and healthy pregnant women (p=0.001). The level of anxiety was increased in the groups with AtD compared with the group of healthy pregnant women (p=0.001). The level of depression in pregnant women with AtD was higher than in healthy pregnant women (p=0.002) and non-pregnant women with AtD (p=0.021). Conclusions. It was found that pregnant women with AtD have more pronounced disorders of the psycho-emotional state and a higher level of filaggrin in the blood serum than non-pregnant women with AtD and healthy pregnant women.

Blood serum of pregnant women for feeding premature babies. Siegmund (Zbl. F. Gyn., 1933, "No. 3)

Blood serum of pregnant women for feeding premature babies. Siеgmund (Zbl. F. Gyn., 1933, "No. 3) used the serum of pregnant women when feeding premature babies with good results.

Evaluation of sFlt-1 and PlGF for predicting preeclampsia in pregnant women with diabetes mellitus

AIM: The aim of this study was to evaluate soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) levels in the blood of women with various types of diabetes mellitus, depending on the correction method applied, and to determine the prognostic significance of the sFlt-1 / PlGF ratio for predicting the development of preeclampsia in this patient population.
 MATERIALS AND METHODS: We examined 140 pregnant women who were included in six main study groups: type 1 diabetes mellitus (with or without pregravid preparation), type 2 diabetes mellitus (diet therapy or insulin therapy), and gestational diabetes mellitus (diet therapy or insulin therapy). The comparison groups consisted of pregnant women with preeclampsia and patients without complications of pregnancy. Using electrochemiluminescence analysis, PlGF and sFlt-1 levels in the blood serum were determined twice, at 11+013+6 and 30+033+6 weeks of gestation. Statistical data processing was performed using the IBM SPSS Statistics version 23 and GraphPad Prism version 8.0 software packages.
 RESULTS: In the blood serum of pregnant women with diabetes mellitus in the first and third trimesters of pregnancy, we found an increase in sFlt-1 level and a decrease in PlGF level, as well as an increase in the sFlt-1 / PlGF ratio. These changes were most pronounced in individuals with type 1 diabetes mellitus without pregravid preparation and with type 2 diabetes mellitus on insulin therapy. In patients with pregestational types of diabetes mellitus, the sFlt-1 / PlGF ratio was a predictor of preeclampsia already in the early stages of pregnancy. Analysis of the ROC curve showed that the threshold sFlt-1 / PlGF ratio for predicting preeclampsia in pregnant women with diabetes mellitus in the first trimester was 32.5 (sensitivity 92.9%, specificity 50.0%) and in the third trimester 71.8 (sensitivity 85.7%, specificity 82.3%) with AUC 0.78 (95% CI 0.680.88) and 0.89 (95% CI 0.830.95), respectively. In the first trimester, the positive and negative predictive values of the sFlt-1 / PlGF ratio as a predictor of preeclampsia in pregnant women with diabetes mellitus were 63.3% and 97.6%, respectively; in the third trimester, 38.9% and 93.6%, respectively.
 CONCLUSIONS: Blood level alterations of PlGF and sFlt-1 are characteristic of patients with diabetes mellitus in the first and third trimesters of pregnancy. An increase in the sFlt-1 / PlGF ratio is associated with a higher incidence of unfavorable perinatal outcomes in women with impaired carbohydrate metabolism. Determination of the sFlt-1 / PlGF ratio is a valid method for predicting the development or absence of preeclampsia in women with diabetes mellitus.

Features of the functional state of the fetoplacental complex in pregnant women with a history of sexually transmitted infections

The objective: a study of the features for the formation and functioning of the fetoplacental complex in pregnant women with a history of sexually transmitted infections.Materials and methods. We examined 50 pregnant women with a history of sexually transmitted infections (I group – the main group). The control group consisted of 30 pregnant women without somatic and gynecological pathology, who had vaginal delivery. All pregnant women underwent a comprehensive clinical examination, taking into account complaints, medical history, objective and additional methods of examination. The levels of estriol, cortisol, placental lactogen and progesterone in the blood serum of pregnant women and the state of fetoplacental complex in terms of 18–20th, 28–30th and 38–40th weeks were determined.Results. In the pregnant women in I group, starting from the 18th weeks there was a significant decrease in the secretion of progesterone (160,8±15,9 nmol/L versus 202,4±5,5 nmol/L, respectively; p<0,05), placental lactogen (77,5±13,2 nmol/L versus 91,3±23,8 nmol/L)/ This means that already in these stages of pregnancy there are signs of placental dysfunction in pregnant women with a history of sexually transmitted infections. The changes in the functional state of the fetoplacental complex at the 28–30th weeks are more pronounced, as evidenced by an increase in the frequency of early intrauterine growth restriction (12.0 %), disorders of fetal breathing (11.0 %) and fetal movements (18.0 %) (according to the biophysical profile score assessment); premature of the placenta, increased hormonal insufficiency of the fetoplacental complex and the first signs of hemodynamic disorders (an increased blood flow in the umbilical artery and uterine arteries and a slight decrease in blood circulation in the middle cerebral artery of the fetus). At the final assessment of the condition of the fetoplacental complex at the 38–40th weeks in pregnant women with a history of sexually transmitted infections, a satisfactory condition was observed in 24 % of cases, compensated ultrasound changes occurred in 46.0 % of cases; subcompensated – in 20.0 % and decompensated – in 10.0 % of cases, respectively, which causes a high frequency of obstetric and perinatal complications in this group of pregnant women.Conclusions. The formation and functional state of the fetoplacental complex in pregnant women with a history of sexually transmitted infections, from early pregnancy is characterized by a significant level of functional disorders of the fetus, placenta and the amount of amniotic fluid on the background of pronounced hemodynamic and endocrinological disorders, which requires prevention in the pre-pregnancy period.

Immunoregulatory potential of pregnancy-specific β1-glycoprotein

The embryo, being half an antigenically “foreign” organism, should elicit a maternal immune response. During evolution, however, the mechanisms ensuring successful development of pregnancy have been formed. In particular, among factors providing immune tolerance during pregnancy are some proteins associated with pregnancy. The pregnancy-specific β 1-glycoprotein (PSG, PSG1; SP1; PSβG1) is a dominant fetoplacental protein produced by cyto- and syncytiotrophoblast cells, and it exhibits immunosuppressive properties. Our team of authors possesses a patented method for obtaining native human PSG preparation from blood serum of pregnant women, a mixture of PSG1, PSG3, PSG7, PSG9, and their isoforms and precursors. This review presents an analysis of our results for the period from 2015 to 2020. We studied the immunoregu-latory effects of the obtained PSG preparation at concentrations comparable to those observed in pregnancy (1, 10, 100 |ag/mL). The study was performed with peripheral blood cells obtained from non-pregnant women. It was found that PSG significantly increased the percentage of adaptive Tregs in vitro, as well as expression of CTLA-4, GITR, and production of IL-10 by these cells. It has been shown that PSG has a stimulating effect upon indoleamine-2,3-dioxygenase (IDO) activity of peripheral blood monocytes. For Th17 cells, we have demonstrated that PSG can suppress differentiation and proliferation of these cells, along with reduced production of critical proinflammatory cytokines (IL-8, IL-10, IL-17, IFNγ, MCP-1, TNF α). As for the memory T cells, PSG suppressed CD25 expression and IL-2 production by them, along with simultaneous decreased expression of Gfi1, hnRNPLL genes, thus preventing the formation of the “mature” CD45R0 isoform. PSG has been shown to inhibit naive T cells’ conversion to the terminally differentiated effector subpopulation of helper T cells. When analyzing PSG effects upon cytokine profile of immunocompetent cells, it was found that the protein predominantly suppresses the Th1 cytokine production by the studied cell types, and regulates the Th2 cytokine production in divergent manner. The results obtained are consistent with general concept of immunosuppression during pregnancy. Thus, PSG could be one of the factors preventing formation and implementation of immune response to placental antigens.

Cytokine profile in women with threatened miscarriage and intestinal dysbiosis

Hypothesis/Aims of study: Systemic endotoxinemia resulting from intestinal dysbiosis activates the Th1 immune response and excessive production of proinflammatory cytokines, which can cause abortion. This study was aimed at assessing interleukin levels in women with the threat of miscarriage and exploring their dependence on intestinal microbiocenosis and the level of endotoxinemia.
 Study design, materials and methods: The study involved 87 women aged 18 to 43 years in pregnancy from six to 22 weeks. The main group consisted of 50 women with a threatened miscarriage. The control group included 37 women with normal pregnancy. A qualitative and quantitative analysis of intestinal microbiocenosis was performed by real-time PCR, with endotoxin and interleukin levels evaluated using conventional methods.
 Results: In patients of the main group, intestinal dysbiosis of grade I was detected in 30 % (n = 15), of grade II in 46 % (n = 23), and of grade III in 24 % (n = 12) of cases. In the control group, intestinal microflora disorders corresponded to grade I dysbiosis in 67.6 % (n = 25) and grade II dysbiosis in 32.4 % (n = 12) of cases, there being no cases of severe dysbiosis revealed. The level of endotoxin in pregnant women of the main group was 0.57 0.02 nmol / ml and was classified as increased. The endotoxin level in the blood serum of pregnant women of the control group was 0.34 0.02 nmol / ml and was characterized as low (p 0.001). A strong correlation was found (r = 0.8, p 0.001) between the grade of intestinal dysbiosis and the level of endotoxinemia. The cytokine profile in patients of the main group was characterized by increased concentrations of pro-inflammatory cytokines (IL-1 4.9 1.6 pg / ml, IL-6 4.8 1.5 pg / ml) and a decreased concentration of anti-inflammatory cytokine (IL-10 18.0 4.5 pg / ml), when compared to the control group (IL-1 1.8 0.2 pg / ml, IL-6 2.1 0.2 pg / ml, IL-10 30.3 4.4 pg/ml). There were a statistically significant moderate positive correlation between the level of endotoxinemia and the concentration of pro-inflammatory cytokines and a weak negative correlation between the endotoxin level and the concentration of anti-inflammatory IL-10.
 Conclusion: Endotoxinemia, which occurs as a result of intestinal microflora dysbiosis and activates pro-inflammatory pathways, can really be as a triggering factor in the pathogenesis of miscarriage in pregnant women.

The Relationship Between Pregnancy-Induced Hypertension And Calcium Levels

<p>Hypertension in pregnancy often progresses to pre-eclampsia as one of the biggest contributors to maternal mortality. Mineral and nutritional factors have an important role in the etiology of hypertension in pregnancy, especially pre-eclampsia. Mineral factors associated with hypertension are calcium. The purpose of this study was to analyze the relationship of calcium levels with the incidence of hypertension in pregnancy. This study uses a cross-sectional study design that measures / observes independent variables (calcium levels) with dependent variables (hypertension in pregnancy). The number of samples was 43 trimester II pregnant women taken by consecutive sampling technique. This study uses primary data by examining blood pressure and calcium levels in the blood serum of pregnant women. Univariate analysis results showed 30% of pregnant women experience hypertension in pregnancy, and 44% of pregnant women have insufficient calcium levels. The results of calcium levels and the incidence of hypertension in second trimester pregnant women (p value 0,000).the bivariate analysis prove that there is a significant correlation between maternal blood</p>

The experience of L-arginine using in placental insufficiency

Objective. To evaluate the effectiveness of the use of L-arginine in the treatment of placental insufficiency (PI) in pregnant women.
 Materials and methods. We examined 49 pregnant women with PI at 22-34 weeks of gestation. The women were divided into two groups. The 1st group included 27 patients who, as part of the standard complex treatment, were injected intravenously with L-arginine (Tivortin®, “Yuria-Pharm”, Ukraine) 4.2 % solution for infusion at a dose of 100 ml a day for 5 days. The 2nd group included 22 women in which standard basic therapy was used for PI treatment. To study the state of the fetoplacental complex in the blood serum of pregnant women, the level of human placental lactogen (hPL) and free estriol (E3) was determined by direct competitive enzyme immunoassay (ELISA).
 Results and discussion. All patients included in the study were comparable in somatic and obstetric status. The age of pregnant women in both groups ranged from 22 to 39 years, averaging 26±3.2 years in the 1st and 31±2.4 years in the 2nd group. The level of hPL before therapy was reduced in 10 (37.03 %) patients in the 1st group and in 8 (29.62 %) patients in the 2nd group. The concentration of free E3 was reduced in 12 (44.44 %) patients of the 1st group and in 9 (40.9 %) patients of the 2nd group. In the main group, the average concentration of free E3 was 18.8±13.3 ng/ml, and the hPL was 7.1±2.6 mg/L. In the comparison group, the level of free E3 averaged 19.1±10.2 ng/ml and hPL was 6.9±3.9 mg/L. After adjustment of PI in all patients of the 1st group, and in 19 (86.36 %) of the 2nd group, the concentration of hPL and free E3 corresponded to the norm. Thus, in the main group, the average concentration of free E3 was 22.7±14.1 ng/ml, and the hPL was 8.1±2.9 mg/L. In the comparison group, the level of free E3 averaged 22.1±14.6 ng/ml and hPL – 8.3±3.9 mg/L. Only in 3 (13.63 %) patients of the comparison group, the level of hormones was still reduced.
 Conclusions. The inclusion of L-arginine (Tivortin) in therapeutic regimens in order to correct placental dysfunction leads to a regression of fetoplacental circulatory disorders and reduces the risk of unfavorable perinatal outcomes.

Seroprevalence of hepatitis E virus (Hepeviridae: Orthohepevirus: Orthohepevirus A) among pregnant women in the highly endemic region of Kyrgyzstan

Hepatitis E (HE) is an important public health problem worldwide and is especially significant for pregnant women, among whom the associated mortality rate reaches 25%. The distribution of HE serological markers in this cohort in the endemic regions of Central Asia is poorly understood. The aim of the study was to assess the seroprevalence of HEV among pregnant women in the region of Kyrgyzstan where an increased incidence of HE is reported. Blood serum of pregnant women, obtained from medical institutions in Bishkek, city of Osh and Osh region in the period from September 2016 to October 2019, and the control group of clinically healthy women were tested using the test systems "DS-IFA-ANTI-HEV-G" and "DS-IFA-ANTI-HEV-M" (NPO "Diagnostic Systems", Russia). IgG antibodies to HEV were detected in 87 (5.9%) of 1472 examined pregnant women, IgM antibodies -in 64 (4.8%) of 1378, while 5 (0.34%) samples were simultaneously positive for IgG and IgM antibodies. The rates of detection of antibodies to HEV in women of three age categories from 17 to 36 years old in the studied and control groups were similar. The analysis of the seasonal dynamics of HEV seroprevalence in pregnant women in the period from February to September 2019 showed a tendency towards an increase in the values of the positivity coefficient of specific IgM antibodies by the beginning of the autumn. Antibodies to HEV were detected with highest frequency in women from Osh region. A high risk of HEV infection for pregnant women in the surveyed region had been shown.

Pathogenesis of anemia in pregnant women with gestational diabetes mellitus

The aim of the research was to establish the role of inflammation mediators and iron metabolism in the pathogenesis of various types of anemic syndrome in pregnant women with gestational diabetes mellitus (GDM). Materials and methods. 32 pregnant patients with GDM were examined; 14 of them had iron deficiency anemia, 18 – anemia of chronic diseases. The enzyme-linked immunosorbent assay was used to determine the concentration of IL-6, hepcidin and a soluble receptor for transferrin in the blood serum of pregnant women, the concentrations of C-reactive protein and transferrin were determined with the method of turbidimetry. Results. It was shown that women with GDM had higher IL-6 level compared to healthy pregnant women, and the concentration of IL-6 did not depend on the type of anemic syndrome. The C-reactive protein concentration was higher in patients with GDM and anemia of chronic diseases than in healthy pregnant women or in pregnant women with iron deficiency anemia. An analysis of iron metabolism markers in pregnant women with GDM established that patients with anemia of chronic diseases had higher hepcidin levels than women with iron deficiency anemia or healthy pregnant women. Conclusions. We established the heterogeneity of the anemic syndrome in pregnancy complicated by GDM. It was confirmed that GDM was accompanied by subclinical inflammation, which was more pronounced in anemia of chronic diseases. The research showed that the mechanism of development of anemia of chronic diseases involving the hepcidin protein was also realized in GDM, characterized by subclinical inflammation. The results indicate the importance of establishing the type of the anemic syndrome in pregnant women with GDM for effective therapeutic follow-up.

EVALUATION OF HORMONAL ASPECTS BY CERVICAL INSUFFICIENCY IN WOMEN WITH HISTORY OF INFERTILITY

Introduction. Today, the frequency of infertility is increasing worldwide. Infertility, associated with anovulation, is especially challenging for the medical correction especially. The leading aspect of this problem is hormonal disorders in the body of a woman. The aim of this study was to assess the level of estradiol and progesterone in the blood serum of pregnant women with cervical insufficiency and infertility associated with anovulation in the history. Materials and methods. The main group included 30 pregnant women with the II trimester of pregnancy, who had cervical insufficiency and infertility associated with anovulation in the past medical history. They got pregnant after assisted reproductive technologies. The control group included 30 pregnant women without cervical insufficiency and with physiological gestation. Estradiol and progesterone levels in blood serum were determined at 20-22 and 30-32 weeks of gestation. Results. The average age of the women in the basic group was statistically higher relative to the control one – 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. In the main group, 73.33% of the persons were primagravida, 10.00 % of patients had two pregnancies, and 16.67 % - three pregnancies. 56.67 % of the women in the control group were primagravida, 26.67 % had two pregnancies, 16.66 % - three pregnancies. Although primaparas predominated in both groups, the number of such women was in 1.47 times higher in the main group (93.33 %) than in control (63.33 % of patients; χ2=6.28, p=0.01); 6.67 % and 26.67 % women had two labors respectively and 10.00 % of healthy patients - three labors. The concentration of estradiol at the 20-22 and 30-32 weeks of pregnancy in women of the main group almost corresponded to physiological parameters. However, the progesterone level in women with cervical insufficiency and a history of infertility was by 13.44 % lower than in healthy pregnant women at 20-22 weeks, and by 17.02% at 30-32 weeks (p=0.003). Conclusions. In pregnant women with cervical insufficiency and infertility associated with anovulation, the level of estradiol in the II and III trimesters of gestation mainly corresponds to the level of physiological pregnancy. However, they have the decrease in progesterone concentration in the III trimester of pregnancy relative to healthy pregnant women (p<0.003).

VASCULAR ENDOTHELIAL GROWTH FACTOR AS A MARKER OF ENDOTHELIAL DYSFUNCTION IN THE PREGNANT WOMEN WITH OBESITY

Today, obesity is one of the most common diseases worldwide and is a risk factor for obstetric and perinatal complications. Therefore, the purpose of the study is to determine the vascular endothelial growth factor in the blood serum of pregnant women with physiological body weight and obesity of varying degrees in the first and third trimesters of gestation. Materials and methods. The subjects were divided into 6 groups. The first group (control) consisted of pregnant women with physiological body weight in the first trimester; the second group included pregnant women with physiological body weight in the third trimester; the third group involved pregnant women with obesity Class I in the first trimester (20 women in each group); the fourth group - pregnant women with obesity of Class I in the third trimester (15 women); the fifth group - pregnant women with obesity of Classes II – III in 1st trimester (20 women); the sixth group – pregnant women with obesity of Classes II – III in the third trimester (15 women). Results and discussion. The article presents the evaluation of angiogenesis in pregnant women with physiological body weight and in pregnant women with concomitant obesity. The analysis of the results obtained has demonstrated the following pattern: the blood serum angiogenic factor decreases as obesity increases over I and III trimesters. Conclusions: 1. The endothelial growth factor of blood vessels in pregnant women with physiological body weight increases as pregnancy progresses. 2. Сoncentration of vascular endothelial growth factor in the serum of pregnant women with concomitant obesity in the 1st and 3rd trimesters of pregnancy naturally decreases with increasing severity of obesity, and its indicators in pregnant women with obesity in the 1st trimester can be used to predict the occurrence of obstetric complications associated with obesity.

ИММУНОГИСТОХИМИЧЕСКИЕ МАРКЁРЫ И ГИСТОЛОГИЧЕСКИЕ И МОРФОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ В ПЛАЦЕНТЕ ЖЕНЩИН, РОДИВШИХ ДЕТЕЙ С АНЭНЦЕФАЛИЕЙ

Objective: To study immunohystochemical markers and features of histological and morphological changes in the placenta of women who have given birth to children with anencephaly. Methods: 15 women with anencephaly in the fetus (the main group) and 20 women, who gave birth to practically healthy children (control group), were examined. All women were tested for tumor marker alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG), morphological examination of placenta and levels of apoptosis, definition expression Nkx-2.2 in vascular endothelial cells of the villous chorion of the placenta of women in norm, and with congenital malformation (CM) of the central nervous system (CNS), in particular – anencephaly in the fetus. Results: A feature of the histochemical characteristics of placenta in women who have given birth to children with anencephaly is the predominance of chronic compensated deficiency with manifestations of dyscirculatory disorders. Statistically significant reduction of Nkx-2.2 expression levels in the vascular endothelial cells of the villous chorion placenta of women who gave birth to children with anencephaly, confirms the role of this factor in the differentiation of nervous structures. An inverse correlation between the level of Nkx-2.2 expression in the placenta and the level of AFP in the blood serum of pregnant women at the beginning of the second trimester of pregnancy determines the level of AFP as the most significant marker of the development of anencephaly in the fetus. Conclusions: Based on the conducted studies it is possible to assume the participation of the placenta in the formation of abnormalities of the CNS of fetuses and newborns. Consequently, properly organized antenatal surveillance with mandatory definition of AFP level at 14 weeks of pregnancy will improve the quality of care for women at risk development of CM of the CNS of the fetus, in particular – anencephaly. Keywords: Immunohistochemical markers, diagnostics of anencephaly, expression of Nkx-2.2 in the placenta, degree of apoptosis in the placenta

PECULIARITIES OF CHANGES IN INDICES OF CALCIUM AND ZINC TRACE ELEMENTS AND MATRIX METALLOPROTEINASE-2 IN PREGNANT WOMEN WITH PERINATAL INFECTIONS

Introduction: The role of calcium and zinc in the body is very high and diverse. Calcium performs a structural and important regulatory function, participates in key physiological and biochemical processes. One such regulation is its coordinated action with zinc, occurring in matrix metalloproteinases (MMP), which play an important role in reproductive processes. The aim: To study the peculiarities of changes in the levels of calcium, zinc indices in serum of pregnant and umbilical cord blood of newborns and MMP-2 indices in serum of pregnant, depending on the etiology of perinatal infection. Materials and methods: The study involved 230 pregnant and their newborns, who were divided into clinical groups depending on the pathogen of perinatal infection (PI): Group I - 60 women with viral PI; Group II - 60 women with bacterial PI; Group ІІІ - 60 women with combined PI; Group IV (control) - 50 women with a physiological course of pregnancy. The presence of PI is confirmed by the high titre of anti-infective M antibodies and low-avidity Ig G in serum and other biological fluids in pregnant women and their newborns. The study implied determination of the level of calcium and zinc in serum of peripheral blood in pregnant and cord blood of newborns, the level of MMP-2 in serum of peripheral blood in pregnant. The received data was statistically processed using STATISTICA software. Results: The presence of PIs leads to the development of moderate but consistent hypocalcemia. Bacterial infection has a more pronounced negative effect than a viral infection, whereas the combined infection is most likely to affect the reduction of calcium in the blood serum of pregnant women. In the groups of patients with PI, the average zinc content in serum of pregnant and umbilical cord blood of newborns was reduced in comparison with the control group (1 μmol / l, Kruskall-Wallis test, p <0.05). In all groups of pregnant with PIs, MMP-2 level in blood was elevated with respect to Group IV parameters by about 3-4 times (Kruskall-Wallis test, p <0.05). Assessment of the decrease in the level of trace elements studied in pregnant with PIs showed a statistically significant relationship between the level of MMP-2 and the level of serum calcium in pregnant and PI in newborn (Kruskall-Wallis test, p 0.001). Conclusions: Taking into account the fact that MMPs belong to Zn- and Ca-dependent proteolytic enzymes, it can be assumed that microelementosis and changes in the level of MMP-2 found in women are interrelated, they are complex and contribute to the creation of favorable conditions for the risk of development of PIs and other complications of the fetus.

Functional condition of the thyroid gland of newborns from methers with a diffuse toxic goiter

Objective: to study the functional state of the thyroid gland in newborns from mothers with diffuse toxic goiter, depending on the level of antibodies to thyroid stimulating hormone receptors (AB-rTSH).Materials and methods: 68 newborns from 67 mothers with diffuse toxic goiter were examined. The control group included 49 newborns from 49 mothers without thyroid pathology. To assess the functional state of the thyroid gland of newborns, we determined the levels of thyroid stimulating hormone, free thyroxine (fT4), and AB-rTSH in cord blood and calculated the TSH/fT4 coefficient, which allows us to differentiate congenital hypothyroidism from neonatal thyrotoxicosis. On the 4-7th day of life, all newborns underwent ultrasound examination (ultrasound) of the thyroid gland.Results: newborns from mothers with diffuse toxic goiter had lower growth-weight indices in comparison with the same indices of the control group and they often showed thyroid hyperplasia. It was shown that the increased content of AB-rTSH in the blood serum of pregnant women with diffuse toxic goiter and in the umbilical cord blood of newborns can contribute to the development of neonatal thyrotoxicosis, detected in 16.2 % of newborns.Conclusions: increased levels of AB-rTSH in the blood serum of mothers with DTG, especially in the second half of pregnancy, and in the umbilical cord blood of newborns affect the formation of thyroid hyperplasia in newborns and contribute to the development of neonatal thyrotoxicosis.

GENETIC ASPECTS OF PREGNANCY MISCARRIAGE

Pregnancy miscarriage is a consequence of many factors. The aim of the study was to analyze the effect of miscarriage gene on embryometric, ultrasound, hormonal, immunological parameters in pregnant women, and to evaluate its prognostic value. The main group includes 31 pregnant women who had clinical signs of miscarriage in current or previous pregnancy. The control group consists of 32 healthy pregnant women whose clinical-paraclinical parameters served as a control to compare the data of the pregnancy survey of the main surveillance group. A general clinical examination and a special obstetrical examination (complaints, anamnesis, general medical examination, obstetric examination), biochemical studies (determination of hormones of the fetoplacental complex in blood serum of pregnant women), ultrasound, immunological studies, histological studies of the placenta, molecular genetic study A1166C polymorphism of the AGTR1 gene were made. In the course of the research, the genetic determinism of miscarriage was discovered. The polymorphism of the A1166C of the AGTR1 gene was considered as a prognostic marker of miscarriage in early gestational term and preeclampsia in the second half of pregnancy. A reliable marker of abortion was the maternal genotype 1166AC for the genome AGTR1. The risk of occurrence of clinical manifestations of abortion increased five times. At simultaneous influence of all prognostic factors the risk of abortion increased 6,25 times. Detection of genetic markers of pregnancy miscarriage will allow early correction of this pathology and prevent perinatal loss.

Antimicrobial peptides in pregnant women with TORCH infections

Introduction. Analysis for TORCH infections is ordered to simultaneously detect several common infections: Toxoplasmosis, Other infections (syphilis, hepatitis B, chickenpox, Epstein-Barr virus, parvovirus and some others), Rubella, Cytomegalovirus and Herpes simplex virus. Contracting a TORCH infection in pregnancy triggers the synthesis of immune factors including antimicrobial peptides (AMPs).Aim: to determine the levels of AMPs – lactoferrin, defensin, endotoxin, BPI (bactericidal/permeability-increasing protein) and hepcidin – in the blood serum of pregnant women with TORCH infections.Materials and methods. The main group included 40 pregnant women with TORCH infections; in 33 of those, pregnancy continued until full-term delivery, and 7 women had miscarriages at the end of the first trimester. The comparison group consisted of 29 pregnant women free of TORCH infections. Blood for AMP measurement was taken in all pregnant women in the first trimester and in women with an ongoing pregnancy also in the III trimester. The control group consisted of 19 healthy non-pregnant women. Serum AMP was determined by enzyme-linked immunosorbent assay (ELISA).Results. In pregnant women with TORCH infections, there was an increase in the serum levels of lactoferrin, defensin, hepcidin, BPI, and endotoxin; the increase was most pronounced in the first trimester of pregnancy. The decrease in AMP levels observed in the III trimester could be due to the antiviral treatment given to the patients in order to prevent the immunological rejection of the embryo and maintain the normal course of pregnancy.Conclusion. The increased level of AMPs reflects the enhanced activity of the immune system and represents one of the pathogenetic links of spontaneous abortion.

THE ROLE OF E-SELECTIVE IN THE DEVELOPMENT OF PREVENTION OF MISCARRIAGE

Introduction. The article presents the results of enzyme-linked immunosorbent assay of E-selectinin blood serum of pregnant women with physiological pregnancy and miscarriage.Miscarriage, especially in the early stages, continues to be a topical both medical and socio-demographic problem. Reducing the healthy potential of the population leads to an increase in the percentage of women whose pregnancy goes through complications or is generally interrupted prematurely.According to many scientists, the success in solving the problem of the early perinatal loss lies in a deeper study of the etiopathogenesis of this problem. Therefore, the priority is to search for markers that will detect pre-clinical forms of the threat of abortion, which will allow prolongation of pregnancy and reduce perinatal losses.At the present stage, the theory of endothelial dysfunction and its role in the development and pathogenesis of obstetric complications is of great importance intending to clarify the anatomical and functional disorders of the reproductive system.Objective. To determine the role of E-selectin in the development of miscarriage.Materials and methods. In order to study E-selectin in women with miscarriage 153 pregnant women with the physiological course and miscarriage have been examined, who were registered in the Women's consultation №1, Chernivtsi, and were in inpatient treatment at the gynecological department of MHCF "City clinical maternity hospital №1". They have been divided into three groups, 30 women were with uncomplicated pregnancy for 6-12 weeks (Group I - Control), 60 women were with the threat of miscarriage (Group II), 34 women were with spontaneous abortion (Group III) and 29 women were with a blighted ovum (Group IV).The average age of the examined women was 18-45 years. Artificial abortions and reproductive loss occurred in the history of most patients. Gynecological and extragenital diseases in the acute and subacute stages were absent in patients of all groups. Pregnant women with antiphospholipid syndrome have not been included in the study.E-selectin has been determined by the method of immunoassay analysis using a test system manufactured by the company Diaclone (France). The human CD62E ELISA kit is designed to quantify the "in vitro" soluble adhesive molecule of endothelial leukocytes ELAM-1 (CD62E) in plasma, human serum, buffer solution, or cell culture. It defines both natural and recombinant CD62E.Results. The conducted research showed that in women at 6-12 weeks of uncomplicated pregnancy, the level of E-selectin was 69.04 ± 4.30 μg/l, and with the threat of abortion, it dropped to 52.43 ± 3.91 μg/l. In case of spontaneous abortion, this index was characterized by a tendency to further decrease – 43.06 ± 5.95 μg/l, and in the case of blighted ovum – up to 47.14 ± 6.04 μg/l. Analysis of the level of E-selectin within the II, III and IV groups of the studied women has not revealed a significant difference.Taking into account the important role of E-selectin in the processes of trophoblast invasion, the development of chorion, its vascular system, it can be assumed that the reduction of its level in the blood of pregnant women indicates the development of endothelial dysfunction in women with a pathology of pregnancy.Conclusions. Studies have shown that women with a risk of miscarriage, with spontaneous abortion and non-developing pregnancy, tend to decrease the concentration of E-selectin compared with the indicators in physiological pregnancy. Since the above reduction of this indicator is a reflection of endothelium work, it can be considered that one of the reasons for not pregnancy in the examined women was endothelial dysfunction.

SIGNIFICANCE OF INFLAMMATION MARKERS DETERMINED IN PREGNANT WOMEN WITH ANEMIC SYNDROME AND OBESITY

The purpose of the present study was to specify a role of inflammatory mediators in pathogenesis of various types of anemia in pregnant obese women. We determined IL-1, IL-6, TNFα, C-reactive protein and hepcidin concentrations in blood serum of pregnant women with obesity depending on the type of anemic syndrome, either iron-deficiency anemia, or anemia of chronic diseases. We showed that the content of IL-6 in blood of the obese women exceeds the value of this index in healthy pregnant women (p &lt; 0.05), and it does not depend on the presence and type of anemic syndrome. We found that the C-reactive protein concentration in pregnant women with obesity is higher than reference values (p &lt; 0.05). Moreover, the contents of C-reactive protein in blood serum of pregnant women with anemia of chronic diseases is significantly higher (p &lt; 0.05) than in women with iron deficiency anemia. Hepcidin concentration in blood of pregnant women with obesity and anemia of chronic disease was a specific feature: its content was significantly higher than in healthy pregnant women (p &lt; 0.05), or in pregnant women with anemia-free obesity (p &lt; 0.05). Hepcidin levels also exceeded 2-fold its contents in serum from pregnant women with obesity and iron deficiency anemia (p &lt; 0.05). We have found that only pregnant women with obesity and anemia of chronic diseases have shown a positive correlation between the concentrations of C-reactive protein and blood levels of hepcidin (r = 0.733, p &lt; 0.05), or IL-6 (r = 0.679, p &lt; 0.05).The discussion concerns potential mechanisms of evolving anemia of chronic disease combined with subclinical inflammation in pregnant women with metabolic disorders. We conclude that a combination of obesity with gestational diabetes is a risk factor of anemia of chronic diseases in pregnant women. Development of an algorithm for differential diagnosis of iron deficiency anemia and anemia of chronic diseases in this cohort of patients is advisable for future studies in the area.