RU2472157C2 - Method for prediction of course of pregnancy with regard to intensity to formation of placental hormones estriol and progesterone varying with aggravation of herpes viral infection during gestation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: with underlying aggravation of herpes viral infection in the third trimester (titre 1:12800), pregnant woman's peripheral blood is examined for the content of estriol and progesterone by ELISA technique, and if the estriol content is less than 32.8±0.8 nmole/l, while the progesterone content is less than 126.2±0.7 nmole/l, threatened miscarriage is predicted. In these cases, the pregnant woman especially on her third trimester shall be clinically controlled to produce immunoglobulin and other symptomatic agents.

EFFECT: higher prediction accuracy.

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Description

The purpose of the study is to develop a method for predicting the nature of the course of pregnancy, based on the intensity of the formation of placental hormones, which changes under the influence of exacerbation of herpes virus infection, especially in the third trimester of gestation.

Placental hormonal insufficiency occurs either when pathological disorders in the placenta itself are exposed, or as a result of external action on the mother’s body (Savchenko ON, Stepanova NA, 1979; Kobozeva NV, Gurkin Yu.A., 1986; Andrievskaya I.A., 2004; Bystritskaya T.S., 2008, 2010; Kvitkina I.G., 2008).

Individual hormones are leading in the regulation of the gestational period: dehydroepiandrosterone sulfate, estradiol, estriol and progesterone (Gavallo V.I., 1987; Timoshenko L.V. et al., 1981).

Despite the fact that there is enough literature indicating a decrease in the content of estriol and progesterone during pregnancy complicated by various diseases: diabetes mellitus (Gryaznova I.M., 1985), surgical diseases (Stepanov E.A., Krasovskaya T.V., Kobozeva T.N., 1984), however, there is practically no literature in which the authors attempted to formulate a prognosis of the nature and course of pregnancy with hormonal placental insufficiency caused by an exacerbation during the gestation period of herpes virus infection. In this work, we rely on a violation of the synthesis in the placenta of the leading hormones of the placenta - estriol and progesterone, the content of which changes in the placenta if the pregnant woman suffered a herpes virus infection of high aggressiveness during gestation (antibody titer to the herpes virus - 1: 12800).

The claimed method has the following techniques:

1. During pregnancy, there were 40 women who underwent an exacerbation of herpes virus infection with an antibody titer of 1: 12800 in the third trimester. The control was 25 pregnant women who were not ill during the entire gestation period. The studies were carried out on the basis of the hospital of the obstetric department, the clinic of the Far Eastern Scientific Center of Physiology and Respiratory Pathology SB RAMS. All studies were carried out taking into account the requirements of the Helsinki Declaration of the World Association “Ethical Principles for the Conduct of Scientific Medical Research with Human Participation” as amended in 2000 and the “Rules of Clinical Practice in the Russian Federation”, approved by Order of the Ministry of Health of the Russian Federation dated June 19, 2003 No. 266.

2. HSV was verified by the dynamics of titers of IgG antibodies in peripheral blood using standard test systems from Vector-Best CJSC (Novosibirsk) using a Stat-Fax-2100 spectrophotometer (USA).

3. The content of estriol and progesterone was determined using reagents of NVO Immunotech CJSC (Moscow) using an enzyme immunoassay using a Stat-Fax-2100 spectrophotometer (USA).

4. Statistical processing of the material was carried out using t-student criterion.

Studies have shown that with a titer of antibodies to the herpes virus in the peripheral blood of a pregnant woman, estriol synthesis is suppressed to 32.8 ± 0.8 nmol / L (control - 53.06 ± 4.0 nmol / L), and progesterone to 126.2 ± 0.7 nmol / L (control - 226.43 ± 14.02 nmol / L; p <0.001). Thus, the content of the main placental hormones under the influence of herpes virus infection, if its outbreak occurs in the third trimester of gestation, decreases sharply, which creates a threat of termination of pregnancy.

Example 1. Pregnant K. Pregnancy 33 weeks. In the third trimester, the pregnant woman suffered an outbreak of herpes virus infection with a titer of antibodies to the herpes virus 1: 12800.

In the peripheral blood of pregnant K. after exacerbation of the herpes virus infection, the content of estriol decreased to 32.8 ± 0.8 nmol / L (control - 53.06 ± 4.0 nmol / L). At the same time, during exacerbation of herpes virus infection, there is a decrease in the third trimester of gestation and the content of progesterone in the peripheral blood to 126.2 ± 0.7 nmol / L (before exacerbation of the outbreak, its parameters were calculated as 226.43 ± 14.02 nmol / L; p <0.001). In this case, the threat of abortion is predicted.

Literature

1. Andrievskaya I.A. Morphofunctional characteristics of the placenta in violation of the metabolism of hormones and nutrients in pregnant women with herpes virus infection: abstract. dis. ... cand. biol. sciences. Irkutsk, - 2004, 20 p.

2. Baghramyan E.R. On hormonal regulation of the gestational process // Obstetrician. and gynecol. - 1984. - No. 4. S.8-12.

3. Bystritskaya TS Prediction of the implementation of intrauterine infection of newborns born to mothers with herpes virus infection. Mater. X anniversary of the All-Russian Scientific Forum "Mother and Child". M .: 2009, 457 p.

4. Govallo V.I. Immunology of reproduction. M .: Medicine. 1987, 303 p.

5. Kvitkina I.G. Prevention and early diagnosis of placental insufficiency in pregnant women with herpes virus infection: author. dis. ... cand. honey. sciences. Chelyabinsk. 2009, 19 p.

6. Kobozeva N.V., Gurkin Yu.A. Perinatal endocrinology. L .: Medicine, 1986, 310 p.

7. Savchenko O.N., Stepanova N.A. Placenta, - In the book: Physiology of the endocrine system: a Guide to physiology. L :. 1979, chap. 11, S.396-412.

8. Stepanov E.A., Krasovskaya T.V., Kobozeva T.N. Surgical diseases. - In the book: Reference book of a neonatologist / Ed. V.A. Tabolina, N.P. Shabalova. L .: 1984, S.241-262.

9. Timoshenko L.V., Travenko T.D., Glants M.R. Obstetric endocrinology. - Kiev: Health, 1981, 277 p.

Claims (1)

A method for predicting the course of pregnancy during exacerbation during gestation of herpes virus infection, characterized in that during exacerbation in the third trimester of herpes virus infection in the peripheral blood of pregnant women determine the content of estriol and progesterone by the enzyme immunoassay and when the content of estriol is less (32.8 ± 0, 8) nmol / l, and less progesterone (126.2 ± 0.7) nmol / l predict the threat of termination of pregnancy.