RU2495421C1 - Method for monitoring inducing action of cytomegaloviral infection on first-trimester gestation course with underlying peripheral blood lactogen decrease - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: pregnant woman's peripheral blood is examined for cytomegalovirus antibody titre and the placental lactogen content.

EFFECT: method enables estimating a risk of the spontaneous miscarriage accompanying the gain of the cytomegalovirus antibody titre and the lower placental lactogen content.

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Description

The purpose of the study is to show the nature of the violation in the peripheral blood of pregnant women in the first trimester of gestational placental lactogen gestation with an increase in the titer of antibodies to cytomegalovirus, which leads to the formation of a spontaneous miscarriage.

Placental lactogen is a glycoprotein, which is an active metabolic hormone with lactotropic and somatotropic activity. Its role in the embryonic gestation period is especially important, since it retains pregnancy due to its luteotropic effect (Afanasyeva N.V., Strizhakov A.N., 2004; Gavallo V.I., 1987). The placental lactogen is synthesized by the placenta syncytiotrophoblast starting from the 5th week of pregnancy. In uncomplicated pregnancy, its blood content increases in proportion to the development of the placenta and the fetus (Gunyeli I., Zeigeroglu S., 2009; Constant F., Canious S., Chavatte-Palmer P., 2011). The maximum concentration of placental lactogen is observed at 37-38 weeks of gestation.

Placental lactogen plays an important role in the maturation and development of the mammary glands during pregnancy and in preparing them for lactation. Placental lactogen actively affects the metabolism of the mother, promotes the consumption of glucose by the fetus, and mobilizes free fatty acids as a source of energy for the mother’s body (Handwerger S., Freemark M., 2000).

The placental lactogen enhances the production of progesterone, that is, it provides a metabolic function to the needs of the developing fetus.

A decrease in the level of placental lactogen in the first trimester of gestation leads to placental insufficiency. On the eve of the death of the fetus, there is a decrease in the content of placental lactogen by almost 50% one to three days before a miscarriage.

However, despite the information presented in the studies of Gavallo V.I. (1987), Afanasyeva N.V. and Strizhakova A.N. (2004), evidence that with insufficient production of placental lactogen in the early stages of gestation, spontaneous miscarriage may occur in these works there are no facts indicating under what conditions there is a suppression of production in the body of a pregnant placental lactogen.

In our application, there are fundamental differences from the above studies:

1. Studies were conducted in the early stages of pregnancy in the first trimester of gestation, when the presence in the body of a pregnant woman produced by a syncytiotrophoblast of placental lactogen is essential for the formation of the initial stages of embryo development.

2. Studies were carried out with exacerbation in the body of a pregnant cytomegalovirus infection.

3. It was studied whether cytomegalovirus infection affects the content of placental lactogen in the peripheral blood of pregnant women in the first trimester of gestation.

4. Particular attention was paid to the degree of aggressiveness of cytomegalovirus infection, the content of placental lactogen is most reduced and a miscarriage occurs.

The claimed method has the following techniques:

1. The studies were carried out on the basis of the hospital of the obstetric department of the clinic of the Federal State Budgetary Institution of the Far Eastern Scientific Center of Physiology and Respiratory Pathology SB RAMS. We examined 15 pregnant women who had an increase in the first trimester of gestation of the titer of antibodies to cytomegalovirus, as well as 15 pregnant women who did not have a reaction to the presence of cytomegalovirus infection in the peripheral blood. 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 the Participation of Man" 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 06.06.2003, No. 266 .

2. The titer of antibodies to cytomegalovirus was determined by enzyme immunoassay on a Stat Fax-2100 spectrophotometer (USA)

3. The content of placental lactogen was determined in the peripheral blood of pregnant women by enzyme immunoassay using test systems manufactured by DRG (USA) on a Stat Fax-2100 spectrophotometer (USA).

Studies have shown that in pregnant women with exacerbation of cytomegalovirus infection, the titer of antibodies to cytomegalovirus 1: 200 was already determined at the 6th week of gestation. In this condition, only traces of placental lactogen were detected in the peripheral blood. At further stages of pregnancy, the indicators were as follows: 8th week of pregnancy — the titer of antibodies to cytomegalovirus was determined as 1: 400, the content of placental lactogen — 0.05 mg / l with a control of 0.5 mg / l; 10th week of pregnancy - the titer of antibodies to cytomegalovirus increased to 1: 800, the content of placental lactogen was 0.5 mg / L with a control of 1.1 mg / L. In two pregnant women with such a low level of placental lactogen in the peripheral blood, a miscarriage occurred.

Thus, an exacerbation of cytomegalovirus infection in the early stages of pregnancy (6-10 weeks of gestation) with an increase in the titer of antibodies to cytomegalovirus to 1: 800 and a decrease in the content of placental lactogen in peripheral blood to 0.5 mg / l (almost 50%) poses a threat spontaneous miscarriage.

Example 1. Pregnant A. (10 weeks of pregnancy) was in the obstetric department of the clinic FGBU "Far Eastern Scientific Center for Physiology and Respiratory Pathology" SB RAMS. At 5 weeks of gestation, the pregnant woman exacerbated cytomegalovirus infection (antibody titer to 1: 200). By the 10th week of pregnancy, the titer of antibodies to cytomegalovirus reached 1: 800. In peripheral blood, the content of placental lactogen was 0.5 mg / l with a control of 1.1 mg / l, that is, 50% lower compared to normal. In the tenth week of gestation, a miscarriage occurred.

Example 2. Pregnant N. (10 weeks of pregnancy) was in the obstetric department of the FSBI "Far East Scientific Center for Physiology and Respiratory Pathology" SB RAMS. Type-specific antibodies to cytomegalovirus have not been identified. At 10 weeks of pregnancy, the content of placental lactogen in the blood was 1.1 mg / L. Pregnancy proceeded without complications and ended with delivery without complications.

LITERATURE

1. Afanasyeva N.V., Strizhakov A.N. Outcomes of pregnancy and childbirth with fetoplacental insufficiency of varying severity. Questions of gynecology, obstetrics and perinatology. 2004, vol. 3, No. 2, pp. 7-13.

2. Gavallo V. I. Immunology of reproduction. 1983. M :, Medicine. 303 s

3. Constant F., Canious S., Chavatte-Palmer P. Alteraed secretion of pregnancy associated glycoproteins during gestation in bovine sanatic clones // Theriogenology, 2011, t. 76, No. 6, p. 1006-1021.

4. Gunyeli I., Zeigeroglus S. Th diagnostic significance of hPG and hPL via immunohistochemistry of placental tissues in pregnancies diagnosed with IUGR and IUD. J. Obstet. Gynecol., 2009, 129, No. 6, p. 521-525.

5. Handwerger S., Freemark M. The roles of placental hormone and placental lactogen in the regulation of human fetal growth and development // J. Pediatr. Endocrinolog Metabol. 2000, 113, No. 4, p. 343-356.

Claims (1)

A method for assessing the inducing effect of cytomegalovirus infection on the nature of pregnancy in the first trimester of gestation against the background of a decrease in the peripheral blood of placental lactogen, characterized in that when the titer of antibodies to cytomegalovirus increases in peripheral blood to 1: 800 and the content of placental lactogep decreases to 0.5 mg / l with a control of 1.1 mg / l, a threat of spontaneous miscarriage is created.