Changes in the level of fetoplacental complex hormones in pregnant women with miscarriage

The purpose of the study was TO analyze the fetoplacental complex hormone levels and changes in their dynamics in pregnant women with miscarriage and the impact of these features on the subsequent course of pregnancy. Hormone levels were determined at different stages of gestation in 50 healthy women with a physiological course of pregnancy (control group) and 50 pregnant women with a history of miscarriage (main group). The women of the main group had a significantly slower rate of increase in hormones and a lag in quantitative indicators than the control group. The estradiol level indicators were 4.1 times (76.0%) and 2.89 times (65.5%) lower in women with miscarriage in the embryonic and late fetal period, respectively, compared to healthy women. Indicators of the level of placental lactogen and chorionic gonadotropin in the embryonic period in women with miscarriage were lower by 39.1% and 50.9%, respectively, compared to healthy women. In the late fetal period, the level of these hormones was lower by 72.9% and 35.4%, respectively. In the embryonic and late fetal periods, progesterone levels were lower by 67.4% and 68.4%, respectively, compared to the control group. The data obtained are evidence of a pronounced hormonal abnormality of the placenta, and hence a marker of fetoplacental dysfunction, which on the background of miscarriage develops at the early stages and continues to progress with the course of pregnancy.

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CHANGES OF HORMONAL STATUS IN PREGNANT WOMEN WITH MISCARRIAGE IN EARLY GESTATION TERMS

Neonatology surgery and perinatal medicine ◽

10.24061/2413-4260.x.4.38.2020.3 ◽

2020 ◽

Vol 10 (4(38)) ◽

pp. 35-40

Author(s):

K. Lisova ◽

I. Kalinovska ◽

P. Tokar

Keyword(s):

Pregnant Women ◽

Chorionic Gonadotropin ◽

Main Group ◽

Placental Lactogen ◽

Control Group ◽

Hormonal Status ◽

Early Stages ◽

Fetoplacental Complex ◽

Arterial Blood ◽

The Impact

Introduction. The article represents the results of the study of the placental hormone level during the early stages of gestation (5-20 weeks). The aim of the study. To analyze the level of hormones of the fetoplacental complex in pregnant women with miscarriage, along with the dynamics of changes in these indicators. To evaluate the features of the hormonal status of women during law-risk pregnancy and miscarriage in history and the impact of these features on the functional state of the fetoplacental complex and the subsequent course of pregnancy. Material and methods. We examined 30 somatically healthy women with a physiological course of pregnancy (the control group) and 30 pregnant women with a miscarriage in history (the main group). Research results. It was found that the content of estradiol, chorionic gonadotropin and placental lactogen in the blood plasma of pregnant women of the main group was significantly lower during the entire gestational period compared to the control group. Estradiol levels in pregnant women with miscarriage were 4.2 times lower than in healthy pregnant women. Placental lactogen levels in the main group of pregnant women were 6.1 times lower, and chorionic gonadotropin - 3.7 times lower compared with the control group. There was also a significant backlog in the growth of hormone levels as the pregnancy progressed. In its turn it indicates the development of placental dysfunction in women with a miscarriage in history in the early stages of gestation. Conclusions. As a result of the described changes there is a violation of the first wave of cytotrophoblast invasion and, as a consequence, incomplete gestational remodeling of segments of spiral arteries. The walls of blood vessels are not completely replaced by fibrinoid and the formed placental vessels do not provide a constant flow of arterial blood into the intervillous space. As a result, the uterine-placental area and the formed placenta are not ready to meet the needs of the developing fetus. In the future, this can lead to perinatal losses.

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Features of endocrinological status and fetoplacental complex in pregnant women with adenomyosis

HEALTH OF WOMAN ◽

10.15574/hw.2018.129.104 ◽

2018 ◽

pp. 104

Author(s):

N.Y. Skripchenko ◽

◽

O.M. Pavlova ◽

T.M. Mazur ◽

◽

...

Keyword(s):

Pregnant Women ◽

Comparison Group ◽

Diet Therapy ◽

Main Group ◽

Placental Lactogen ◽

Control Group ◽

Metabolic Therapy ◽

Pregnancy And Childbirth ◽

Fetoplacental Complex ◽

Treatment And Prevention

The objective: to study the features of the endocrinological status and the fetoplacental complex in pregnant women with adenomyosis, the course of pregnancy and childbirth in these women, to develop new, systematize and improve the existing methods of diagnosis, treatment and prevention of complications and reproductive losses. Materials and methods. We examined 90 pregnant women who were divided into groups: 30 healthy women – control group, a comparison group of 30 women with adenomyosis receiving classic progesterone therapy and the main group of 30 women with adenomatosis who received advanced preserving, metabolic therapy and diet therapy. The condition of the feto-placental complex, the frequency of IUGR, hemodynamic disturbances on the part of the fetus, and the level of estriol, progesterone, cortisol, chronic gonadotropin (CGL), placental lactogen were evaluated. Results. The main complication in pregnant women with adenomyosis was placental dysfunction (the comparison group was 60.0% and the main group was 33.3%), whose structure was performed by compensated (58.2%) and subcompensated forms (35.8%). The frequency of preterm labor threat was 20.0% in comparison group and 13.3% in main one, while in the control group – 1 case, which is 3.3%. Frequency of SCR was in the comparison group – 20.0% and in the main – 3.3%. Low levels of estriol, progesterone, HHG, placental lactogen, increased cortisol levels in comparison and main groups were determined, and after treatment the indicators of the main group significantly improved. Conclusions. With timely correction of violations, prevention of fetoplacental insufficiency and complex treatment with the use of advanced classical progesterone therapy in combination with metabolic and diet therapy we can significantly reduce the frequency of various complications in pregnant women with adenomyosis. Key words: adenomyosis, pregnancy, non-pregnancy, diet therapy, metabolic therapy, preservation therapy, preventive care.

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Features hormonal status in pregnant women with benign cervical pathology in anamnesis

HEALTH OF WOMAN ◽

10.15574/hw.2017.124.71 ◽

2017 ◽

pp. 71-73

Author(s):

N.Yu. Bysaha ◽

Keyword(s):

Statistical Analysis ◽

Pregnant Women ◽

Placental Lactogen ◽

Control Group ◽

Hormonal Status ◽

Hormonal Changes ◽

Fetoplacental Complex ◽

History Of ◽

Objective Study ◽

Stimulation Of

The objective: study of hormonal status in pregnant women with benign cervical pathology (CP) in anamnesis. Patients and methods. Clinical and statistical analysis of the hormonal status of 100 women with a history of benign CP pathology has been performed. According to the revealed symptoms of CP during colposcopic examination, women were divided into two groups: 100 pregnant women, in whom colposcopic and cytologically signs of CP pathology were not detected, were included in the control group; and 100 women who had a pathology of CP, entered the main group. Results. The study examined hormonal relationships in the system mother–placenta–fetus, namely the level of hormones such as estriol, progesterone, human chorionic gonadotropin, placental lactogen. Hormonal changes in pregnant women and contribute to reducing the immunoreactivity unwanted stimulation of existing benign hyperplastic background processes in the cervix. Conclusion. Determining functional state placenta is an important factor in the timely diagnosis of disorders in the functioning of the system mother–placenta–fetus. Key words: hormonal status, placenta, uterine cervix, fetoplacental complex.

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The experience of L-arginine using in placental insufficiency

Infusion & Chemotherapy ◽

10.32902/2663-0338-2020-3.1-56 ◽

2020 ◽

pp. 67-68

Author(s):

S.S. Safarova ◽

E.M. Aliyeva ◽

F.Yu. Abbasova ◽

Kh.M. Mirzoyeva

Keyword(s):

Pregnant Women ◽

Comparison Group ◽

Perinatal Outcomes ◽

Average Concentration ◽

Main Group ◽

Placental Insufficiency ◽

Placental Lactogen ◽

Placental Dysfunction ◽

Fetoplacental Complex ◽

Circulatory Disorders

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.

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

Reproductive health of woman ◽

10.30841/2708-8731.5.2021.240025 ◽

2021 ◽

Vol 5 ◽

pp. 43-47

Author(s):

E.I. Krotik

Keyword(s):

Pregnant Women ◽

Sexually Transmitted Infections ◽

Functional State ◽

Placental Lactogen ◽

Control Group ◽

Perinatal Complications ◽

Sexually Transmitted ◽

Fetoplacental Complex ◽

Biophysical Profile ◽

History Of

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.

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Peculiarities of Psychoemotional State in Pregnant Women with Oligohydramnios

Galician Medical Journal ◽

10.21802/gmj.2016.4.12 ◽

2016 ◽

Vol 23 (4) ◽

pp. 2016412

Author(s):

Irina Basiuga

Keyword(s):

Pregnant Women ◽

Trait Anxiety ◽

State Anxiety ◽

Main Group ◽

Control Group ◽

Low Level ◽

Average Value ◽

Healthy Women ◽

Psychoemotional State ◽

High Level

Oligohydramnios is an obstetric pathology being one of the most common perinatal diseases. In 70% of cases, its causes are unclear which requires further improvement of diagnostics and treatment tactics. The objective of the research was to examine psychoemotional state in pregnant women with oligohydramnios.Materials and methods. 120 pregnant women with oligohydramnios diagnosed at 27-29 weeks of gestation were examined. The control group included 30 somatically healthy women with physiological course of pregnancy. Psychoemotional state of women was evaluated using the survey and the scale proposed by S.D. Spilberg and adapted by Yu.A. Khanin. Results. When studying psychological peculiarities, we did not reveal realiable differences in the level of trait anxiety between women with oligohydramnios and pregnant women without it. Moreover, there was observed a similar division of patients by the low, medium and high levels of this indicator among patients of both groups. However, the analysis of the obtained data showed the increase in the level of state anxiety in the main group (43.28±1.36 points) compared to the control one (35.30±2.22 points, p<0.01). Among women with oligohydramnios, an increase in the proportion of individuals with a high level of this parameter (p<0.01) as well as a decrease in the proportion of individuals with a low level of this parameter was observed.Conclusions. The level of trait anxiety in pregnant women with oligohydramnios did not differfrom that in healthy women and corresponded to the average value, while the level of state anxiety which corresponded to the average values as well, significantly increased compared to pregnant women with physiological gestation (p<0.01). Among this category of patients, a statistically significant increase in the proportion of individuals with a high level of this parameter was observed (p<0.01).

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Modern view on the problem of optimization of therapy in pregnant women with functional cervical insufficiency

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(1)-33 ◽

2018 ◽

Vol 22 (1) ◽

pp. 173-177

Author(s):

V. F. Oleshko

Keyword(s):

Blood Serum ◽

Pregnant Women ◽

Main Group ◽

Control Group ◽

Cervical Insufficiency ◽

Progesterone Concentration ◽

Therapeutic Dosage ◽

Hormonal Balance ◽

Magnesium Orotate ◽

Micronized Progesterone

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.

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GENETIC ASPECTS OF PREGNANCY MISCARRIAGE

Likarska sprava ◽

10.31640/jvd.5-6.2019(8) ◽

2019 ◽

pp. 71-76

Author(s):

K. M. Lisova ◽

I. V. Kalinovska ◽

O. M. Yuzko

Keyword(s):

Pregnant Women ◽

Molecular Genetic ◽

Clinical Signs ◽

Clinical Manifestations ◽

Control Group ◽

Molecular Genetic Study ◽

Immunological Parameters ◽

Fetoplacental Complex ◽

Maternal Genotype ◽

A1166c Polymorphism

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.

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ПОРУШЕННЯ ВАРІАБЕЛЬНОСТІ СЕРЦЕВОГО РИТМУ ЯК МЕТОД ОЦІНЮВАННЯ АДАПТАЦІЙНИХ РЕАКЦІЙ ОРГАНІЗМУ ВАГІТНИХ ПРИ НАЯВНОСТІ ШКІДЛИВИХ ЗВИЧОК

Вісник наукових досліджень ◽

10.11603/2415-8798.2018.2.8951 ◽

2018 ◽

Author(s):

V. H. Korniienko ◽

A. S. Fitkalo

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Nervous System ◽

Pregnant Women ◽

Cardiac Rhythm ◽

Main Group ◽

Reproductive Age ◽

Control Group ◽

Cardiac Rhythm Variability ◽

Adaptive Reactions

According to modern data, the cardiovascular system is a kind of indicator of the organism's adaptive activity, and the structure of the heart rhythm carries information about the development of adaptive reactions in response to irritating factors of the external and internal environment.The aim of the study – to investigate the functional state of the autonomic nervous system in pregnant women who have harmful habits by evaluating and analyzing the parameters of heart rate variability in order to prevent complications of non-delivery of gestational process.Materials and Methods. The study involved 73 pregnant women, 53 of them were pregnant (the main group) who had malignant habits in history. Before studying adaptive reactions in pregnant women, a study of cardiac rhythm variability was performed in practically healthy non-pregnant women of reproductive age (25.3±2.2) years). The control group consisted of 20 pregnant women without any harmful habits. Determination of heart rate variability was performed on the basis of peripheral heart rate recording, which included measuring the sequence of RR intervals for 5 minutes, followed by mathematical analysis using the PlsMntr software product.Results and Discussion. It was established that in the main group, in the complicated failure to pass the gestational process, violations of cardiac rhythm variability were detected in 59.7 % of cases. There is an increase in the frequency of very low frequency (VL F) waves (43.5 % relative to control, p<0.05), indicating a predominance of humoral and metabolic rate of regulation of the cardiac rhythm. At the threat of premature births, a decrease in the particle (LF) is observed at 36.6 %, a decrease in the share of high-frequency waves (НF) by 30.8 %. Taking into account the results of the study, one can speak of a decrease in the tone of the sympathetic and parasympathetic nervous system, reducing the influence of the reflexive vegetative level of regulation, which, in turn, indicates the depletion of regulatory mechanisms and the lack of an adaptive protective effect of n.vagus on the heart.Conclusions. Our innovative low-invasive method of evaluating the adaptive reactions of the organism through the determination and analysis of indicators of cardiac rhythm variability in pregnant women with the existing harmful habits offers us the opportunity to observe manifestations of functional stress of regulatory systems of pregnant women, preceding the development of complication of non-delivery of gestational process.

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

Bulletin physiology and pathology of respiration ◽

10.12737/article_59acba4a9aebc9.37532870 ◽

2017 ◽

Vol 1 (65) ◽

pp. 50-53

Author(s):

Инна Довжикова ◽

Inna Dovzhikova ◽

Михаил Луценко ◽

Mikhail Lutsenko ◽

Ксения Петрова ◽

...

Keyword(s):

Pregnant Women ◽

Dehydrogenase Activity ◽

Cytomegalovirus Infection ◽

Hydroxysteroid Dehydrogenase ◽

First Trimester ◽

Main Group ◽

Control Group ◽

Reaction Products ◽

Igg Antibody ◽

Antibody Titers

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.

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