RU2502072C1 - METHOD FOR MONITORING INDUCING ACTION OF CYTOMEGALOVIRAL INFECTION ON FIRST-TRIMESTER OESTRIOL WITH UNDERLYING PERIPHERAL BLOOD TNFα INCREASE - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: if observing the aggravated cytomegaloviral infection to titre 1:1600 in the first trimester of gestation, pregnant woman's blood is examined for oestriol (nmole/l) and TNFα (pg/ml) by immunoenzyme method; a discriminant equation is derived: D_f=-7.539×Oestriol+(+8.071×TNFα). If D_f exceeds the limit value 153.33, a threatening miscarriage is stated.

EFFECT: higher accuracy of the threatening miscarriage assessment in a pregnant woman.

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Description

The purpose of the study was to show the inducing effect of cytomegalovirus infection in the first trimester of gestation on the blood estriol content against TNFα. A decrease in estriol is a threat to termination of pregnancy.

Estriol is a female sex hormone related to estrogen. It is produced by the placenta (Serov V.N., Prilepskaya V.N., Ovsyannikova T.V., 2006). Since the placenta and the fetus are involved in the formation of estriol, the level of this hormone is an ideal indicator of the placental system. Analysis of estriol allows you to determine possible violations in the development of the fetus.

Such violations can be: the threat of miscarriage and the threat of preterm birth (Kobozeva N.V., Gurkin Yu.A., 1986), Down syndrome, fetal adrenal hypoplasia, fetal anencephaly, fetoplacental insufficiency (Laricheva I.P., Chulkova V.I. ., 1983; Savolyev G.M., Serov V.N., Starostina T.A., 1984). Thus, a decrease in estriol levels indicates a likely fetal pathology. The lack of synthesis of estriol causes the threat of interruption in the first half of gestational pregnancy and the threat of premature birth in the second half of gestation.

The more the level of estriol is reduced, the higher the likelihood of a pathological condition. A decrease in the level of free estriol by more than 40% is considered to be threatening (Kobozeva N.V., Gurkin Yu.A., 1986).

Considering all the above studies, we did not find an explanation of the reasons that lead to an early decrease in the production of placenta estriol in the first half of pregnancy.

In our studies, we pay attention, in contrast to the above information on the role of estriol during pregnancy, to the following points:

1. The synthesis of estriol in the first half of gestation may be exacerbated by a persistent pregnant viral infection in the body, such as a cytomegalovirus infection.

2. At the same time, the production of interleukin TNFα is induced, which aggressively acts as a damaging factor on tissue systems.

The claimed method has the following techniques:

1. Studies were conducted on the basis of the obstetric department of the Federal State Budgetary Institution Far Eastern Scientific Center for Physiology and Respiratory Pathology SB RAMS.

2. We examined 30 pregnant women in whom, from the moment of gestation, an increase in the titer of antibodies to cytomegalovirus was noted, as well as 15 pregnant women who were not sick throughout the gestation period.

3. All studies were carried out taking into account the requirements of the Helsinki Declaration of the World Association “Ethical Principles for Conducting 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”.

4. The titer of antibodies to cytomegalovirus was determined by the enzyme immunoassay in the peripheral blood of pregnant women using a Stat Fax - 2100 spectrophotometer (USA) with Vector - Best reagents (Novosibirsk).

5. The content of TNFα was determined using test systems of LLC “Tsitokin” (St. Petersburg) on a microplacental reader “Stat Fax-2100” (USA).

6. The content of estriol was carried out by the enzyme immunoassay with sets of ZAO NVO IMMUNOTECH (Moscow).

7. Composed discriminant equation.

Studies have shown that during exacerbation of a cytomegalovirus infection during pregnancy to an antibody titer of 1: 1600, a decrease in the content of estriol in peripheral blood to 17.0 nmol / L was observed, with a control of 34, 48 nmol / L. At the same time, an increase in the peripheral blood of pregnant women showed a TNFα content of up to 53.0 pg / ml. The compiled discriminant equation showed that

Therefore, if D _{f is} greater than the boundary value of 153.33, the pregnant woman’s peripheral blood decreases, the estriol content decreases, and with an exacerbation of the cytomegalovirus infection to a titer of 1: 1600 with a simultaneous increase in TNFα to 53.0 pg / ml, a threat of miscarriage is created.

Literature

1. Kobozeva N.V., Gurkin Yu.A. Perinatal endocrinology. - L .: “Medicine”, 1986, 305 p.

2. Laricheva I.P., Chulkova V.I. // The state of hormonal adaptation of newborns according to radioimmunological studies. - In kN: Radioimmunological diagnosis of fetoplacental insufficiency and hormonal adaptation of newborns: Collection of scientific papers MDNIIAG., M., 1983, p. 62-67.

3. Savolyeva G.M., Serov V.N., Starostina T.A. Obstetric hospital. - M.: “Medicine”, 1984, 208 p.

4. Serov V.N., Prilepskaya V.N., Ovsyannikova T.V. Gynecological endocrinology. - M .: Medpress-inform, 2006, 520 p.

Claims (1)

A method for assessing the threat of miscarriage in a pregnant woman, characterized in that in the first trimester of gestation with exacerbation of a cytomegalovirus infection to a titer of 1: 1600, the estriol content (nmol / L) and the TNFα content (PG / ml) are determined by the enzyme-linked immunosorbent assay, discriminant equation: D _f = -7.539 × Estriol + (+8.071 × TNFα), and when D _{f is} greater than the boundary value of 153.33, the threat of miscarriage is revealed.