The aim of the study is to define the role of abnormalities in the formation of estriol hormones in the development of hormonal dysfunction of fetoplacental system. There were examined 39 placentas from women with exacerbation of chronic cytomegalovirus infection at the third trimester of pregnancy and IgG antibody titer 1:1600 and 30 placentas from women with latent CMV infection and titer 1:400. The activity of androstenedione dehydrogenase was found out with histochemical method on cryostat sections of freshly frozen tissues of placentas by Lloyd’s method. The assessment of intensiveness of histochemical reaction was done with cytophotometric method by Scion program. Estradiol in homogenate of placenta was measured with immune-enzyme method. The quantity of nuclei of placenta syncytiotrophoblast in the state of apoptosis was done with cytophotometric method on paraffin sections stained by ISEL method. By the results of the study the exacerbation of CMV infection at the third trimester of pregnancy leads to the decrease of intensiveness of histochemical reaction in placentas to androstenedione dehydrogenase till 32.1±2.88 pixel/mcm2 (at the latent course it is 54.2±4.31 pixel/mcm2, р<0.001), and in homogenate of placenta to the decrease of estradiol till 18443.2±117.53 pmole/l (at the latent course of the disease it is 28977.7±158.13 pmole/l, p<0.001), on paraffin sections in syncytiotrophoblast by the increase of nuclei number in the state of apoptosis till 5.0±0.03% (at latent course of the disease it is 1.2±0.001%, р<0.001) and vacuole formation, which leads to destructive damages of syncytiotrophoblast cytoplasm. The obtained results prove that the exacerbation of CMV infection at the third trimester of pregnancy causes the decrease of estriol hormones formation, which is accompanied by the damage of morphostructure and exchange processes in cell elements of placenta.
The contents of β-subunit of chorionic gonadotropin (β-CG), estriol, progesterone, dehydroepiandrosterone (DEAS), placental lactogen and cortisol were studied in 164 women of child-bearing age at the 7-9th weeks of pregnancy. The first group (control) consisted of 30 women with physiologic course of pregnancy. The second group (comparison) had 32 patients with the threat of premature delivery of non-infectious etiology. The third group included 36 patients with influenza virus А(Н3N2) (anti-virus antibody titers were 1:4-1:16); the fourth group had 34 women with influenza virus А(Н3N2) (antibody titers were 1:8-1:32); in the fifth group there were 32 patients with influenza virus А(Н3N2) (antibody titers were 1:32-1:128) and the threat of premature delivery in the period of reconvalescence. The patients of the fifth group had the decrease of the level of β-CG till 40.5±2.0 mМЕ/ml, of estriol till 3.4±0.21 nmole/l, of progesterone till 35.1±3.13 nmole/l, of DEAS till 7.3±0.68 nmole/l, of placental lactogen till 12.1±1.0 nmole/l, as well as the increase of cortisol till 738.7±22.08 nmole/l in comparison with 73.0±2.0 mМЕ/ml (р<0.001), 5.9±0.33 nmole/l (р<0.001), 70.6±4.14 nmole/l (р<0.001); 7.3±0.68 nmole/l (р<0.001), 12.1±1.0 nmole/l (р<0.001) and 567.8±24.02 nmole/l (р<0.001) in the first group, respectively. The differences of hormonal status in the fifth and third group consisted of the drop of concentration of β-CG by 22.8% (р<0.001), of estriol by 26.1% (р<0.01), of progesterone by 32.1% (р<0.001) and placental lactogen by 32.4% (р<0.001). At the same time there were no significant changes in the concentration of DEAS and there were registered higher indicators of cortisol, i.e. the increase by 11.5% (р<0.05), which suggested the significance of the growth of antivirus antibody titers in the suppression of synthesis of hormones in ovaries and in syncytiotrophoblast as a result of direct and indirect negative influence of influenza infection.
At full-term pregnancy the level of anti-influenza antibodies in 126 pairs “mother-child” at influenza A(H3N2) in the first trimester of gestation was studied. The first group (comparison) was made of 40 pairs “mother-child” at pregnancy not complicated with acute respiratory virus infection, but with exacerbation of somatic diseases as well as moderate and severe somatic and obstetric pathology. The second group consisted of 43 pairs “mother-child” with influenza infection with antibody titer 1:4-1:16; the third group had 41 pairs “mother-child” with influenza А(Н3N2) with antibody titer 1:8-1:32; the fourth group had 42 pairs “mother-child” with influenza infection (antibody titers were 1:32-1:128) associated with the threat of miscarriage at early stages of gestation. It was found out that in the second group in 80% of cases mothers had higher titers of anti-virus antibodies in comparison with the titers of their children; in 12.5% of cases there were equal titers of antibodies in maternal and umbilical blood. In the second and the third groups unlike the first one there was a tendency to the decrease of a number of pairs that had higher titers of antibodies in mothers and there was an increase of pairs with equal titers of anti-virus antibodies. In the fourth group the number of pairs with domination of titers of anti-influenza antibodies increased till 28.6% in children in comparison with the titers in their mothers (in the second group it was in 4.7%, р<0.05), which suggested antenatal infecting of full term newborns.
The aim is to analyze androstenediol converting in villous chorions at gestation against cytomegalovirus infection activation during the first trimester of pregnancy. 48 villous chorions samples taken during medical abortion at 8-10th weeks of gestation of women with chronic cytomegalovirus reactivation during pregnancy became the material for study, and 35 villous chorions samples were taken as the control. The results of pregnant women examination were analyzed from the point of cytomegalovirus infection activity with immune-enzyme method by the presence of IgM antibodies or by the value of 4-times and more growth of IgG antibodies titer in paired sera in dynamics in 10 days. IgG avidity index to cytomegalovirus was more than 75% in all women. Androstenediol converting was assessed with histochemical methods. Quantitative evaluation of the reaction products was carried out on sections under the microscope MT (Japan) associated with software-hardware complex «SCION Corporation» (USA). Histochemical reaction product of the androstenediol dehydrogenase was well detected in cyto- and syncytiotrophoblast of chorious villi. Reaction activity in the material from women with reactivation of cytomegalovirus infection during pregnancy was low, which indicated a reduction in the reserve for the synthesis of estrogen. The concentration of estriol and estradiol in villous chorions during reactivation of cytomegalovirus infection decreased till 24.9±2.01 nmol/l and 15765.1±107.77 pmol/l, respectively.
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