RU2492815C1 - Method of determining fetoplacental insufficiency in pregnant women who had cytomegalovirus infection exacerbation in third trimester of pregnancy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine. In order to determine fetoplacental insufficiency in pregnant women, who had cytomegalovirus infection exacerbation in third trimester of pregnancy, measurement of titre of antibodies to cytomegalovirus in peripheral blood, and after that, content of leptin in parturient woman's placenta is carried out at the moment of exacerbation. If antibody titre is 1:1600 and leptin level 29.18±0.71 ng/ml, presence of fetoplacental insufficiency is determined.

EFFECT: method makes it possible to diagnose fetoplacental insufficiency in pregnant women who had cytomegalovirus infection exacerbation in the third trimester of pregnancy.

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Description

A method for determining placental insufficiency in pregnant women who underwent exacerbation of cytomegalovirus infection in the third trimester of gestation.

The invention relates to medicine, in particular to the problem of creating new methods for diagnosing placental insufficiency in especially dangerous viral infections during pregnancy, such as cytomegalovirus.

The development of fetoplacental insufficiency during pregnancy complicated by cytomegalovirus infection (CMVI) is the cause of pregnancy complications: miscarriage, preeclampsia, fetal growth retardation syndrome, which affect the condition of the woman, the viability and adaptation of the fetus and newborns [3]. The formation of fetoplacental insufficiency is a complex process in which dysfunction of metabolic and metabolic processes in the placenta and vascular endothelium develops, including lipid metabolism regulated by leptin, which leads to a progressive violation of the uteroplacental blood flow and pathological metabolism of the fetus against hypoxia [4 , 5, 6].

Problems associated with the diagnosis of placental insufficiency during exacerbation of cytomegalovirus infection during pregnancy can be solved by creating new approaches to the use of key factors that determine the state of metabolic and metabolic processes occurring in the placenta.

To date, the diagnosis of fetoplacental insufficiency during cytomegalivirus infection during pregnancy is solved by detecting virus-specific antibodies, antigens and cytomegalovirus DNA in peripheral blood and placental tissues, determining placental maturity by histological methods of investigation and the state of cellular immunity in pregnant women [1]. The authors note that in women with undifferentiated forms of connective tissue dysplasia, the risk of damage to the herpes group viruses (herpes simplex virus, cytomegalovirus) of the placenta increases, with the formation of an inflammatory process and subcompensated secondary placental insufficiency with a predominance of hypoplastic form.

A number of other authors showed that the risk of developing placental insufficiency in urogenital infections, including cytomegalovirus infection, during pregnancy was assessed using enzyme-linked immunosorbent (type-specific antibodies, class G and M immunoglobulins) and morphological methods (macroscopic (determining the state of the placenta, membranes, umbilical cord), morphometric (determination of the mass and size of the placenta, the specific volume of the placenta components), histological) [2]. The studies that followed allowed the authors to talk about the development of relative subcompensated chronic placental insufficiency with focal impairment of maturation of villi in women with mixed urogenital infections.

At the same time, the problem of determining the risk of developing placental insufficiency in pregnant women with exacerbation in the third trimester of gestation CMVI remains unresolved to date.

The present invention was the development of a method for the diagnosis of placental insufficiency in pregnant women who underwent exacerbation of CMVI in the third trimester of pregnancy, depending on the leptin content in the placenta homogenate.

Achievable technical result is the diagnosis of fetoplacental insufficiency in pregnant women who underwent exacerbation of CMVI in the third trimester of pregnancy.

The method is as follows:

An enzyme-linked immunosorbent assay for exacerbation of cytomegalovirus infection in the third trimester of gestation determines the titer of antibodies to cytomegalovirus and the placenta homogenate in the peripheral blood of pregnant women and the placenta homogenate. If the titer of antibodies to cytomegalovirus in the peripheral blood of pregnant women who underwent an exacerbation of cytomegalovirus infection in the third trimester of gestation was 1: 1600 (at the time of the exacerbation of the disease) and the leptin in the homogenate of the parturient women was determined at the level of 29.18 ± 0.71 ng / ml (control - 18.13 ± 0.55 ng / ml), then this indicates the presence of placental insufficiency.

To obtain diagnostic criteria, we examined the peripheral blood and placenta of 25 pregnant women who suffered an exacerbation of cytomegalovirus infection in the third trimester of gestation and 20 pregnant women who did not get sick throughout the gestation period. The studies were carried out on the basis of the hospital of the obstetric department of the clinic of the Federal State Budgetary Institution “Far Eastern Scientific Center of Physiology and Pathology of Respiration” of the Siberian Branch of the Russian Academy of Medical Sciences. All studies were carried out taking into account the requirements of the Helsinki Declaration of the World Association “Ethical Principles for 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 of June 19, 2003 No. 266 . The titer of antibodies to the herpes simplex virus was determined by enzyme-linked immunosorbent assay (ELISA) on an enzyme-linked immunosorbent analyzer "Stat-Fax-2100" (USA) using reagent kits CJSC "Vector-Best" (Novosibirsk). The leptin content in puerperal homogenate was studied by ELISA using an Stat-Fax-2100 immunoassay analyzer (USA) using the Diagnostics Biochem reagent kit (Canada). During the study, two diagnostic criteria were identified that made it possible to diagnose the presence of placental insufficiency, namely, the titer level of antibodies to cytomegalovirus in the peripheral blood of pregnant women who had an exacerbation of cytomegalovirus infection in the third trimester of gestation, amounting to 1: 1600 (at the time of the exacerbation of the disease) and leptin level in the homogenate, the placenta is parturient, amounting to 29.18 ± 0.71 ng / ml (control - 18.13 ± 0.55 ng / ml).

Clinical example 1. A woman, 34 g., The first pregnancy, suffered an exacerbation in the third trimester of gestation of cytomegalovirus infection. The titer of antibodies to cytomegalovirus was determined in the peripheral blood and the content of leptin in the placenta homogenate. The titer of antibodies to cytomegalovirus at the time of exacerbation of the disease was 1: 1600. The leptin content in the placenta homogenate was determined at the level of 29.44 ng / ml. Diagnosed with chronic placental insufficiency.

Clinical example 2. A woman, 27 years old, a second pregnancy, suffered an exacerbation in the third trimester of gestation of cytomegalovirus infection. The titer of antibodies to cytomegalovirus was determined in the peripheral blood and the content of leptin in the placenta homogenate. The titer of antibodies to cytomegalovirus at the time of exacerbation of the disease was 1: 1600. The leptin content in the placenta homogenate was determined at the level of 29.00 ng / ml. Diagnosed with chronic placental insufficiency.

Literature

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2. Dorokhova L.N., Shaboldin A.V., Narolenko L.N., Moses V.G. The status of the fetoplacental system in pregnant women with undifferentiated forms of connective tissue dysplasia, carriers of the herpes virus family // Saratov Journal of Medical Scientific Research. - 2010. - T. 6, No. 3. - S.531-535.

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4. Shestopalov A.V., Shulga A.S., Aleksandrova A.A., Rynashevsky A.N., Shkurat T.P. Adipokines and indicators of carbohydrate metabolism during pregnancy complicated by gestosis. - Rostov State Medical University of the Ministry of Health and Social Development of the Russian Federation, 2012. - P.2-5.

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Claims (1)

A method for determining fetoplacental insufficiency in pregnant women who underwent an exacerbation of cytomegalovirus infection in the third trimester of gestation, including measuring the titer of antibodies to cytomegalovirus in the peripheral blood of the pregnant woman and then in the parturient placenta homogenate — leptin content, and at a titer of 1: 1600 and leptin level 29.18 ± 0.71 ng / ml determine the presence of placental insufficiency.