scholarly journals DISTURBANCE OF 20α-HYDROXYSTEROID DEHYDROGENASE ACTIVITY IN VILLOUS CHORION SYNCIOTHYTHROPHOBLAST AT REACTIVATION OF CYTOMEGALOVIRUS INFECTION DURING PREGNANCY

Author(s):  
Инна Довжикова ◽  
Inna Dovzhikova ◽  
Михаил Луценко ◽  
Mikhail Lutsenko ◽  
Ксения Петрова ◽  
...  

The aim of the work is to assess the effects of cytomegalovirus infection on the 20α-hydroxysteroid dehydrogenase activity in the villous chorion syncytiotrophoblast in the first trimester of pregnancy. The materials for the study included 48 villous chorions samples taken during spontaneous abortions at 8th–10th weeks of gestation from women with reactivation of cytomegalovirus infection (the main group). The control group included 35 villous chorions samples from pregnant women with chronic cytomegalovirus infection in the latent stage taken at medical abortions at the same stage of gestation. The results of women’s examination were studied taken into account the activity of cytomegalovirus infection by immunoassay by detection of IgM antibodies or by 4 times and more increase of IgG antibody titers in the paired serums in dynamics in 10 days. The activity of 20α-hydroxysteroid dehydrogenase was assessed by the histochemical method. Quantitative evaluation of the reaction products was carried out on sections under the microscope MT (Japan) connected to software-hardware complex «SCION Corporation» (USA). At histochemical specimen of villous chorion of pregnant women who had a reactivation of cytomegalovirus infection during pregnancy (main group), there was a decrease of cytophotometric parameter of 20α-hydroxysteroid dehydrogenase activity till 30.1±2.12 pixels/μm2 (p<0.001) compared with the control group. The decrease in the reaction activity in syncytiotrophoblast indicated a decrease in the contents of 20α-dihydroprogesterone in placenta, which contributed, in our opinion, to spontaneous abortion.

Author(s):  
Инна Довжикова ◽  
Inna Dovzhikova ◽  
Ирина Андриевская ◽  
Irina Andrievskaya ◽  
Ксения Петрова ◽  
...  

The aim was to study the activity of progesterone and 5α-pregnan-3.20-dione conversion in the placenta at the exacerbation of cytomegalovirus infection (CMVI) during the first trimester of pregnancy. The study material included 50 villous chorions taken during medical abortions in the period of 8-10 weeks from women with exacerbation of chronic CMVI during pregnancy. The control group had 35 villous chorions of pregnant women of the same gestation period with chronic CMVI in the latent stage. Diagnosis of CMVI was performed taking into account the activity of CMVI with the immune-enzyme method by the level of antibodies of IgM and antibody titers of IgG in the paired serums in dynamics in 10 days. The progesterone content was determined at the “Stat Fax-2100ˮ spectrophotometer. The activity of 4-pregnene-3.20-dione dehydrogenase and 5α-pregnane-3.20-dione dehydrogenase was assessed by the histochemical method. Quantitative evaluation of the reaction products was carried out on sections under the microscope “Meiji Technoˮ connected to the software-hardware complex “SCION Corporationˮ. It was found out that progesterone content in villous chorions of women with reactivation of CMVI during pregnancy was reduced to 21.5±2.73 nmol/L in comparison with the control group (53.4±3.70 nmol/L, p<0.001). The disturbance of progesterone inversion intensiveness in placenta was proved by the decrease of enzyme activity: of 4-pregnene-3.20-dione dehydrogenase till 15.9±0.47 standard units (in control it was 28.6±0.58 standard units, p<0.001) and of 5α-pregnan-3.20-dione till 16.2±1.11 standard units (in control it was 25.0±1.91 standard units, p<0.001). Reduction in the intensity of progesterone conversion into 5α-dihydroprogesterone (5α-pregnan-3.20-dione) in the placenta with the exacerbation of CMVI can negatively affect the formation and functioning of the fetal nervous system.


Author(s):  
N. A. Ishutina ◽  
I. А. Andrievskaya ◽  
I. V. Dovzhikova ◽  
N. N. Dorofienko

Introduction. It is now generally acknowledged that cytomegalovirus infection (CMVI) is one of the main causes of miscarriage. However, the mechanism of this effect has not been sufficiently studied. At the same time, the influence of acids of the ɷ-3 family and α-tocopherol (αTP) on the placentation process through a pro-angiogenic action is shown.Aim. To study the concentration of αTP and ɷ-3 family acids in the peripheral blood and establish their role in miscarriage in CMV-seropositive women with CMVI reactivation.Materials and methods. A case-control study included 64 women in the first trimester of pregnancy (7-10 weeks), of which 36 were CMV-seropositive with CMVI reactivation (main group) and 28 were CMV-seronegative (control group). CMVI was diagnosed by the determination of class M and G antibodies by ELISA, as well as CMV DNA detected by PCR. The concentration of ɷ-3 acids of the family (eicosapentaenoic – EPA, docosahexaenoic – DHA) in blood serum was studied by capillary gas-liquid chromatography (J.P.Carreau, J.P.Dubacq). The αTP concentration was determined by the fluorometric method (L.G.Hansen, W.I.Warwich).Results. In women of the main group, a significant (p<0.001) decrease in the concentration of αTP to 1.32±0.025 μg/mL was observed in the peripheral blood compared to the same indicator in the control group (1.49±0.029 μg/mL). At the same time, the levels of EPA and DHA were also statistically significant (p<0.001) lower than the same indicator in the control group and amounted to 1.09±0.012 and 6.09±0.015%, respectively (in the control, 1.29±0.071 and 8.80±0.071%, respectively). Conclusion. The obtained results of the study allow us to establish the important role of disorders in the content of α-TF, EPA and DHA in the pathogenesis of miscarriage during reactivation of CMVI in the early periods of gestation, which can serve as a basis for expanding diagnostic and therapeutic measures in this pathology of pregnant women.


2017 ◽  
pp. 22-24
Author(s):  
E.V. Kravchenko ◽  

The objective: the study of the status of the embryo and extraembryonic structures for bleeding that is not associated with the detachment of the chorion in the first trimester of gestation. Patients and methods. Were examined 34 patients in the gestational age 6-9 weeks (main group) with bleeding from the genital tract, in which, at the primary ultrasonic inspection revealed no detachment of the chorion. The control group included 30 women with uncomplicated course And trimester of gestation. The average age of the pregnant women of the main group was 25.3±3.1 years in the control group 26.4±4.3 years. All women underwent standard clinical and laboratory examination. Results. Studies have shown that prognostic markers of unfavorable development of the embryo in the early stages of pregnancy bleeding not related to chorion detachment was not detected. For the purpose of hemostasis in pregnant of the main group of prescribed drugs traneksamic acid 0.25 mg 3-4 times a day for 3 days. Traneksam – antifbrinolytic tool is able to block not only plasminogen, and plasmin that has already formed. It also stimulates the synthesis of collagen, through which increases the elasticity of the fibrin clot. Pregnant women in both groups received vitamin E 1 capsule per day magnesium products, Magnicum 1 tablet 3 times a day, folic acid 400 micrograms per day. Assessing clinical signs of disease in dynamics of treatment, it should be noted that the hemostasis in the main group was achieved in an average of 2.3±0.7 days. Conclusion. Bleeding in early gestation, not connected with the detachment of the chorion, the use of Traneksam provides fast absolute hemostasis, which in turn contributes to the normalization of tone of the uterus and the physiological course of placentation. Key words: bleeding in early pregnancy, the chorion detachment, hemostasis, hemostatic therapy, Traneksam.


2019 ◽  
Vol 68 (5) ◽  
pp. 63-74
Author(s):  
Anna A. Siniakova ◽  
Elena V. Shipitsyna ◽  
Olga V. Budilovskaya ◽  
Vyacheslav M. Bolotskikh ◽  
Alevtina M. Savicheva

Hypothesis/aims of study. The problem of vaginal infections during pregnancy is of high importance in obstetric practice. To predict the risks and reduce the frequency of pregnancy and childbirth complications, it is necessary to dynamically assess the vaginal microflora and treat its disorders. The aim of the study was to investigate the vaginal microflora and evaluate the effectiveness of treating vaginal infections in pregnant women with a history of miscarriage. Study design, materials and methods. The study included 153 pregnant women in the first trimester. The main group (group I) consisted of 99 women with a history of miscarriage, 35 of whom had signs of threatened abortion (subgroup IA) and 64 did not (subgroup IB). The control group (group II) comprised 54 women without a history of miscarriage and signs of threatened abortion. The vaginal microflora was examined using microscopic, bacteriological and quantitative real-time PCR methods. All patients with an established vaginal infection (bacterial vaginosis, aerobic vaginitis, and vulvovaginal candidiasis) received etiotropic therapy, depending on the microorganisms identified and their sensitivity to antimicrobial drugs. After treatment, in order to assess the effectiveness of the therapy, the vaginal microflora was examined in the second trimester and the outcomes and complications of present pregnancy were evaluated. Results. In women of subgroup IA, vulvovaginitis and bacterial vaginosis were detected 3.5 times more often compared to the control group, and 1.6 times more often compared to subgroup IB (66% and 19%, respectively, p 0.001; 66% and 42%, respectively, p 0.05). Aerobic vaginitis was the most frequent vaginal infection in the first trimester of pregnancy in women of the main group (p 0.05). After treatment, the frequency of the vaginal infections in the second trimester in women of the main group significantly decreased: by 1.9 times in subgroup IA and by 1.5 times in subgroup IB (p 0.05). There were no significant differences in the frequency of adverse pregnancy outcomes in women with bacterial vaginosis or vulvovaginitis as compared to women with normal vaginal microflora. Nevertheless, pregnancy and childbirth complications were diagnosed 4 times more frequently in the main group (23% and 6%, respectively, p 0.05), with the complications occurring significantly more often in the cases of vulvovaginitis or bacterial vaginosis and signs of threatened abortion in the first trimester (p 0.05). Conclusion. Etiotropic therapy of vaginal infections diagnosed in the first trimester of pregnancy in women with a history of miscarriage was highly effective. In 40% of women, vaginal microbiocenosis normalized, and the clinical symptoms of vaginosis/vaginitis disappeared. Differences in the frequency of adverse pregnancy outcomes in women with vulvovaginitis or bacterial vaginosis in the first trimester and in women with normal vaginal microbiocenosis were not significant. However, the treatment of vaginal infections in the group of pregnant women with a history of miscarriage did not significantly affect the frequency of pregnancy and childbirth complications.


2019 ◽  
Vol 18 (3) ◽  
pp. 15-20
Author(s):  
I. A. Andrievskaya ◽  
N. A. Ishutina

The goal is to study the mechanisms of linoleic acid-dependent oxidative damage to hemoglobin in blood erythrocytes of pregnant women with cytomegalovirus (CMV) infection during the first trimester.Materials and methods. The study included 55 CMV-seropositive pregnant women at 8–11 weeks pregnant, aged 24,7 ± 0,18 years. 20 women had exacerbated cytomegalovirus infection and in 35 women a latent course of the disease was observed. The control group consisted of 20 CMV-seronegative pregnant women, comparable in age and gestational age with the group of pregnant women with cytomegalovirus infection. The levels of linoleic acid, superoxide dismutase, glutathione peroxidase and methemoglobin in the blood were studied by the spectrophotometry. Glutathione was determined by histochemical methods, the total amount of hemoglobin was measured using the automatic hematological analyzer, and hydrogen peroxide level was calculated by enzyme immunoassay.Results. In cytomegalovirus infection, an increase in the indices of exogenous hydrogen peroxide and linoleic acid in blood erythrocytes of pregnant women is observed. During the period of acute disease in the first trimester of pregnancy it causes oxidative modification and a decrease in the level of not only superoxide dismutase, glutathione peroxidase and glutathione, the processes involved in the redox regulation of thiol-disulfide exchange of erythrocytes, but also hemoglobin with formation of large amount of methemoglobin, which contributes to reduction of oxygen metabolism and development of hemic hypoxia. In the latent course of the disease, the oxidative damage to hemoglobin in the erythrocytes of pregnant women is mitigated by the increase in the activity of redox enzymes, which maintains oxygen homeostasis at the level necessary for the development of pregnancy. 


2020 ◽  
pp. 61-66
Author(s):  
S.P. Posokhova ◽  
◽  
S.V. Nikolaeva ◽  
K.O. Nitoсhko ◽  
◽  
...  

The objective: evaluation of the effectiveness of the prevention of preeclampsia in pregnant women with obesity using L-arginine during pregnancy Materials and methods. Materials and methods. The main group consisted of 38 obese women (1st century – 15th, 2nd century – 12th, 3rd century – 11), who were prescribed complex prevention of preeclampsia: from 12 weeks of pregnancy 150 mg of aspirin once a day, and from 16 weeks the solution L-arginine (Тivortin aspartate) 5 ml (1 g) 4 times a day for 2 months. The comparison group included 30 pregnant women with obesity of the II-III stage who did not receive preventive treatment. The control group consisted of 30 healthy pregnant women. By the beginning of prophylactic treatment and in the dynamics of all obese pregnant women, the level of pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PlGF), arginine and leptin was determined in blood serum. Results. In pregnant women with obesity, already in the first trimester a significantly higher level of leptin is observed compared to the main group and the level of placental growth factor is significantly lower, which are significant triggers for the development of preeclampsia and other gestational complications. After the prophylactic treatment of pregnant women of the main group with L-arginine for 2 months (at 16–24 weeks), the following trends were observed: the level of L-arginine did not change, was constant. Leptin levels differed depending on the degree of obesity, but did not have a high critical value. A positive trend was the growth of placental growth factor in women of the main group, which indicated normal placentation and the prevention of early preeclampsia. Conclusions. Thus, in pregnant women of the main group, after comprehensive prevention of the development of preeclampsia with aspirin and L-arginine (Тivortin) for 2 months, the incidence of severe severe preeclampsia decreased by 4.4 times, which is a favorable factor in maintaining a woman’s health and reducing perinatal losses. Additional L-arginine in the diet reduced the frequency of preeclampsia in pregnant women with obesity, contributing to vasodilation due to increased production of nitric oxide, may be one of the positive factors of pathogenetic treatment. Keywords: pregnancy, obesity, preeclampsia, leptin, nitric oxide, L-arginine.


2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.


2018 ◽  
Vol 22 (1) ◽  
pp. 173-177
Author(s):  
V. F. Oleshko

A functional cervical insufficiency plays an important role in the etiology of miscarriage and premature birth. The aim of research was to estimate the hormonal balance indexes during the course of pregnancy in pregnant women with functional cervical insufficiency and to correct the revealed violations in order to prevent obstetric complications. 101 pregnant women with confirmed diagnosis of a functional cervical insufficiency in term of gestation 22–32 weeks of pregnancy (the main group) and 34 pregnant women and women in labor with physiological condition of the cervix (the control group) were examined. The content of estradiol, progesterone, cortisol and prolactin was examined in the blood serum. On the second stage of examination 63 pregnant women obtained general basic therapy (I main group) and 38 pregnant women (II main group) received a developed treatment complex which included progesterone support by the micronized progesterone 200–400 mg twice a day up to 34–35 weeks of pregnancy, magnesium support by the magnesium orotate dehydrate in the therapeutic dosage and arginine glutamate in the therapeutic dosage. The correction of cervical insufficiency was performed with the help of a cervical pessary (according to indications). The examination of hormonal balance revealed an accurate decease of progesterone concentration on the background of high concentration of estradiol and increased levels of stress-associated hormones. Propitious influence of the developed therapy is proved by increase of progesterone concentration in the blood serum, normalization in stress-associated hormones balance according to gestational age. All this provideded the decrease of specific weight of threatened preterm labors, placental dysfunction, vaginitis, bacterial vaginosis and delay the labors up to 38–39 weeks of gestation in 97,4% of pregnant women (82,5% in the I main group). Prescription of micronized progesterone, magnesium orotate dehydrate, arginine glutamate to pregnant women with a cervical insufficiency is reasonable and effective one comparing with general and traditional therapy.


Author(s):  
Ümit Görkem ◽  
Özgür Kan ◽  
Mehmet Ömer Bostancı ◽  
Deniz Taşkıran ◽  
Hasan Ali İnal

Objective: Spontaneous abortion is the most common complication of early pregnancy, affecting up to 20% of recognized pregnancies. Kisspeptin is predominantly released by placental syncytiotrophoblasts, and regulates their placental invasion into the uterine matrices. We aimed to establish an association of serum kisspeptin levels with pregnancy outcomes during the early gestational stage of the first trimester. Method: In this prospective study, 90 pregnant women in their 7 to 8 6/7 gestational weeks were classified into three groups: (i) The control group, consisting of healthy pregnant women (n=30), (ii) the threatened abortion group (n=30), and (iii) the spontaneous abortion group (n=30). The maternal serum samples were analyzed for complete blood count parameters and kisspeptin levels. Results: There was no statistical difference regarding body mass index (BMI) and gestational age (p=0.370). Regarding detailed obstetric notations, including gravida, parity, abortion, and living children, socioeconomic levels, and employment rates, all study groups were comparable (p>0.05, for all). No significant association was found regarding the biochemical parameters of complete blood count, including neutrophil, lymphocyte, and platelet concentrations, as well as neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) (p>0.05, for all). The median serum kisspeptin levels of the study groups did not differ between the groups (p=0.153). Correlation analysis revealed no significant relationship between serum kisspeptin levels and other study parameters in any study groups (p>0.05, for all) Conclusions: We found no statistically significant relationship between serum kisspeptin concentrations and pregnancy outcomes in the early gestational stage of the first trimester, and serum kisspeptin concentrations did not seem to be a reliable marker to distinguish abortion status from viable pregnancy


2021 ◽  
Vol 9 (A) ◽  
pp. 1019-1023
Author(s):  
Salma Salma ◽  
Veni Hadju ◽  
Jamaluddin Jompa ◽  
Stang Stang ◽  
Sundari Sundari ◽  
...  

BACKGROUND: The prevalence of anemic pregnant women is still reasonably high, especially in low-middleincome countries. AIM: This study was aimed to assess the effect of giving red seaweed (Kappaphycus alvarezii) biscuits on changes in hemoglobin (Hb) levels and body weight of pregnant women in the first trimester. METHODS: The study used a quasi-experiment pretest-posttest study design. The study was conducted from April to June 2021 involving pregnant women in the first trimester who living in the working area of the Wapunto Community Health Center, Muna Regency, Indonesia. A total of 45 pregnant women were selected purposively and assigned to three different groups. The first group was given two pieces of red seaweed biscuits per day. The second group was given two pieces of red seaweed biscuits plus Fe tablets (60 mg/day), and the last group was given Fe tablet only (60 mg/day). Chi-square, paired sample t-test, Wilcoxon, and Kruskal–Wallis tests were performed using SPSS. RESULTS: The intervention group of red seaweed biscuits plus Fe tablets had the highest increase in Hb levels after 8 weeks of intervention, followed by the red seaweed biscuit group and the control group (0.97, 0.78, and 0.60 g/dL, respectively, p-value < 0.05). The red seaweed biscuit intervention group had the highest changes for body weight compared to the red seaweed biscuit plus Fe tablet group and the control group (1.07, 0.43, and 0.04 kg, respectively). CONCLUSION: The provision of red seaweed biscuits could increase maternal Hb level and weight during the first trimester of their pregnancy.


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