Features of hormonal function in pregnant women - displaced persons.

Zhabchenko, I.A.; Korniets, N.G.; Tertychna-Telyuk, S.V.

doi:10.26641/2307-0404.2019.2.170146

Cited by 3 publications

(5 citation statements)

References 3 publications

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“…Estradiol also contributes to the formation of blood vessels in the chorionic villi -angiogenesis and vasculogenesis, supports the steroid production, increases the uterine artery blood flow velocity, induces mammary gland for lactation, and increases the uterine activity [16]. The level of estradiol during pregnancy may indicate the development of placental dysfunction [17].…”

Section: Resultsmentioning

confidence: 99%

“…We have not found the scientific publications about the detailed mechanisms of vaginal progesterone adjunctive action on the other hormone levels in pregnant women. Nevertheless, it was studied that, for example, placental disorders were associated with deficiency of placental lactogen, which may be an indicator of placental insufficiency [17]. One of the explanations of progesterone significance during pregnancy is related to its anxiolytic and sedative effects resulting in a decrease in stress and anxiety levels in a woman, thus reducing a concentration of stress-associated hormones, including prolactin and cortisol.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the hormonal levels in different management strategies for women with cervical insufficiency and a history of anovulatory infertility

Pakharenko¹

2021

ZMJ

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Cervical insufficiency (CI) is one of the causes of preterm birth. The rate of CI is higher in women after in vitro fertilization treatment for infertility compared to the general population. The aim. To assess the hormonal level in women with CI and a history of anovulatory infertility in the second and third trimesters of pregnancy in different management strategies for CI. Materials and methods. 60 pregnant women with CI who conceived through in vitro fertilization treatment for anovulatory infertility were divided into two groups: in the I group (30 women), CI was corrected only with cervical cerclage / pessary in the II trimester of pregnancy, in the II group (30 persons), cervical cerclage / pessary was combined with vaginal progesterone 200 mg ones a day until 34 full weeks of gestation. 30 pregnant women without СІ or infertility with the physiological course of pregnancy were controls. The concentrations of estradiol, progesterone, placental lactogen, prolactin and cortisol were determined in the terms of 19–22 and 30–32 weeks of gestation in the maternal blood serum. Results. In the patients with CI at 19–22 gestational weeks, the estradiol and placental lactogen concentrations were slightly lower in the I and II groups than those in the control women, the level of progesterone was less in the I group by 13.44 %, in the II group – by 17.30 % (P < 0.05) compared to the controls; the levels of prolactin and cortisol in the I and II groups were increased significantly (P < 0.001). At 30–32 gestational weeks, the levels of estradiol (P < 0.05), progesterone (a decrease of 23.10 %, P < 0.001) and placental lactogen (a decrease of 10.74 %, P < 0.05) were significantly less as compared to the physiological ranges, while these parameters in the II group patients were on the lower limit of normal. In the I group, the concentrations of prolactin and cortisol were higher by 41.70 % (P < 0.001) and 27.36 % (P < 0.001), respectively, than the controls, in the II group – only by 24.10 % (P < 0.05) and 13.70 % (P < 0.05), respectively. Conclusions. In the women with cervical insufficiency after in vitro fertilization treatment for anovulatory infertility, the levels of estradiol, progesterone and placental lactogen are not significantly different from physiological indices, but the prolactin and cortisol concentrations are much higher. Adjunctive vaginal progesterone treatment to cervical cerclage/pessary in the third trimester of pregnancy promotes the normalization of progesterone, estradiol and placental lactogen levels, the decrease in prolactin and cortisol indices at 30–32 gestational weeks compared to the women with cervical cerclage/pessary alone.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of the hormonal levels in different management strategies for women with cervical insufficiency and a history of anovulatory infertility

Pakharenko¹

2021

ZMJ

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“…Саме він блокує α-адренергічну стимуляцію, зменшує кількість рецепторів до окситоцину, прямо впливає на внутрішньоклітинну концентрацію кальцію, синтез простагландину F2α та рецепторів до нього, посилює β-адренергічний токолітичний ефект під час вагітності. Регулюючи активність ферментів D-3βгідроксистероїддегідрогенази та 3β-стероїдсульфатази, що беруть участь у метаболізмі стероїдів, прогестерон контролює рівень естрогенів у міометрії [6].…”

Section: а к у ш е р с т в оunclassified

“…Наявність у цих вагітних різнонаправлених концентрацій гормонів (збільшення рівня естрадіолу та зменшення рівнів прогестерону і ХГЛ) за даними літератури свідчить про гормональну дисфункцію плаценти [5,6,16]. У зв'язку із цим була проведена корекція лікування вагітних для пролонгування та зниження вірогідності розвитку передчасних пологів згідно з попередньо проведеним ретроспективним аналізом [25] .…”

Section: результати досліджень та їх обговоренняunclassified

Assessment of placental complex function and miscarriage prevention in pregnant women with uterine fibroid

Golyanovskiy

Supruniuk

Frolov

2022

RHW

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The objective: to reduce the frequency of the threat of pregnancy interruption and loss in women with uterine fibroid through treatment prediction and improvement.Materials and methods. A complex examination of 70 pregnant women with uterine fibroid at 15-16 weeks of pregnancy (main group) and 50 pregnant women without uterine fibroid at the same gestational term (control group) was carried out at 4 clinical bases of the Department of Obstetrics and Gynecology N1 of the Shupyk National Healthcare University of Ukraine in the time period of 2020-2022. Pregnant women in the main group were divided into 2 subgroups depending on the type of the nodes: Ia – 39 pregnant women with subserous type of fibroid nodes (type 5-6 according to FIGO) and Ib – 31 pregnant women with intramural fibroid (type 3-4 according to FIGO). The pregnant women in the main group received the complex of developed therapy for pregnancy interruption (micronized progesterone, magnesium preparations, vitamin B6, acetylsalicylic acid), in the control one – the common therapy (bed rest, abstinence from sexual life, micronized progesterone preparations, tranexamic acid).The concentrations of estradiol, progesterone, human chorionic gonadotropin (hCG) were determined in the blood plasma of all persons at 15–16 weeks and 24 weeks of pregnancy.Results. In the II trimester the concentration of estradiol in the blood of pregnant women with intramural uterine fibroid, especially with multiple forms, was significantly higher than in the control group (p<0.05). At the same time, in pregnant women with intramural fibroid node(s) the mean concentration of estradiol exceeded the similar indicator in the group with the subserosal type (p<0.05). These changes indicated the stress of the hormonal function of the placenta and were considered by us as one of the signs of the initial stage of placental dysfunction.With an increase in estradiol concentration, a significant decrease in progesterone amount was noted. Progesterone deficiency was significantly more common in the subgroup of pregnant women with multiple intramural uterine fibroid and nodes in contact with the uterine cavity, especially at the place of placenta attachment (type 3) – 165.24±14.71nmol/l compared to the control group – 219.96±16.63 nmol/l, and with pregnant women with subserosal node(s) – 210.61±18.57 nmol/l (р<0.01), which confirms the threat of abortion and indicates the development of placental dysfunction. In the II trimester of pregnancy the concentration of hCG in women with uterine fibroid was significantly lower than in women without uterine fibroid and especially lower in multiple uterine fibroid. In the women of the main group progesterone and hCG concentrations in the blood plasma normalized (p>0.05) after the treatment, but the level of estradiol in the group of pregnant women with multiple intramural uterine leiomyoma remained significantly higher (p<0.05).Conclusions. Pregnant women with uterine fibroid have an increased risk of placental dysfunction with a disbalance of the main placental hormones: an increase in estradiol concentration and a relative decrease in progesterone and human chorionic gonadotropin, a shift in the estrogen-progesterone balance towards relative hyperestrogenia.The use of medical measures with long-term support with progesterone, magnesium and low doses of acetylsalicylic acid for the prevention of miscarriage in persons with the clinical manifestations of the threat of gestation is quite effective.

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“…Despite the long-standing concern of researchers on the problem of pre-eclampsia (PE), this pathology continues to occupy a prominent position in the structure of perinatal and maternal morbidity and mortality, and its pathogenesis is not fully understood [1][2][3][4]. Therefore, obstetrics still lacks an eff ective treatment and prevention scheme for this disease [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Possibilities of Correcting Cellular-Humoral Immune Disorders and Cytokine Status in High-Risk Pregnant Women for the Development of Preeclampsia

Vashchenko

2023

Neonatol. hìr. perinat. med.

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The development of pre-eclampsia is associated with immunological interactions between the foreign maternal and fetaltissues, which are characterized by a predominance of the infl uence of type 1 T-helper cells, leading to increased production of highly aggressive pro-infl ammatory cytokines. However, the mechanism of cellular- humoral immune and cytokine changes leading to the manifestation of pre-eclampsia is not fully understood and no corrective measures have been developed.Purpose. To investigate the changes in the cellular- humoral immunity and cytokine profi le in a cervical mucus of pregnantwomen at high risk for developing PE and to fi nd out the eff ectiveness of the proposed secondary prevention of PE in thenormalization of these indicators.Method and Materials. The main group (MG) consisted of 91 pregnant women with risk factors for pre-eclampsia whohad impaired blood fl ow in the uterine spiral arteries at 18-20 weeks of pregnancy. Among them, 59 patients (MG-II) received secondary prevention of pre-eclampsia from 18-20 weeks until delivery using metformin, vitamin D3, and corvitin, while the remaining 32 patients (MG-I) declined preventive measures. The control group (CG) consisted of 30 healthy pregnant women. The research was regulated by the rules of humane treatment of patients in accordance with the requirements of the Tokyo Declaration of the World Medical Association, the international recommendations of the Helsinki Declaration on Human Rights, the Convention of the Council of Europe on Human Rights and Biomedicine, and the laws of Ukraine. TNF-α, INFγ and IL-10 levels were determined in cervical mucus by enzyme- linked immunosorbent assay (ELISA); peripheral blood lymphocyte CD3+, CD4+, CD8+, CD16+, CD22+ levels were assessed by indirect immunofl uorescence. The CD4/CD8 ratio was calculated as an immunoregulatory index. Blood serum immunoglobulin (Ig) levels were determined by competitive enzyme- linked immunosorbent assay (A, M, and G). The concentration of circulating immune complexes (CIC) in blood serum was measured by the immunoturbidimetric assay. The data were analyzed by mathematical- statistical methods, calculating the mean (M), variance (σ), and standard error (m), applying Student’s t-test, and performing correlation analysis using the statistical program «STATISTICA» (StatSoft Inc., USA). The paper is an excerpt from the initiative scientifi c research project of the Department of Obstetrics and Gynecology № 2 of the Poltava State Medical University entitled «Optimization of approaches to management of pregnancy in women at high risk of obstetric and perinatal pathology» (state registration number 0122U201228, duration: 10.2022-09.2027).Results. In women at high risk of developing pre-eclampsia (MG-I), a signifi cant decrease in the concentration of T helpercells (CD4+), an increase in T suppressor/killer cells (CD8+), a decrease in the immunoregulatory index, a decrease in B cells(CD22+) and an increase in CIC were observed. In addition, CIC greater than 100 IU/ml strongly correlated with the development of pre-eclampsia. IgM levels were signifi cantly elevated in women with pre-eclampsia, indicating possible trophoblastic stimulation of their immune system, while IgG levels were signifi cantly reduced. Women with pre-eclampsia had a signifi cant predominance of pro-infl ammatory cytokines and a defi ciency of anti-infl ammatory cytokines. In women of the MG-II group who received the proposed complex of secondary prevention of pre-eclampsia, the content of T-helper cells (CD4+) and T-suppressor/killer cells (CD8+) was normalized. The immunoregulatory index increased signifi cantly, and the number of CD22+ cells was about the level observed in healthy pregnant women. The concentrations of IgA and IgG increased to the levels observed in the control group, while the level of IgM decreased. The level of CIC decreased in pregnant women with MG-II, in contrast to the levels observed in women with MG-I. The levels of pro-infl ammatory cytokines INF-γ and TNF-α decreased after preventive treatment. However, the levels of the antiinfl ammatory cytokine IL-10 increased signifi cantly in MG-II, leading to a signifi cant reduction in the TNF-α/IL-10 ratio (p<0.001).Conclusions. Pregnant wo men with a history of increased risk factors for PE and a decrease in the intensity of bloodfl ow in the spiral arteries of the uterus at 18-20 weeks of gestation have a pronounced imbalance of the T-cell subpopulation, which is accompanied by a decrease in the production of T-helpers (CD4+) and an increase in the synthesis of T-suppressors/ killers (CD8+), which causes a decrease in the immunoregulatory index. This is accompanied by the development of a cytokine imbalance with a predominance of pro-infl ammatory cytokines and a defi ciency of anti-infl ammatory cytokines, and is also associated with a signifi cant decrease in the concentration of IgG and a decrease in the number of B cells. Such changes are a consequence of the exhaustion of the reactivity of the humoral link of the general immunity, creating the conditions for the frequent manifestation of PE, which occurs in almost half of such women. The application of our proposed improved method of secondary prevention of pulmonary embolism in pregnant women with a high risk of developing this disease leads to signifi cant positive changes in the work of the immune system and a corresponding improvement in clinical results. It makes it possible to reduce the frequency of PE development by 1.4 times and to prevent the occurrence of its severe forms by 2.6 times.

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Features of hormonal function in pregnant women - displaced persons.

Cited by 3 publications

References 3 publications

Assessment of the hormonal levels in different management strategies for women with cervical insufficiency and a history of anovulatory infertility

Assessment of the hormonal levels in different management strategies for women with cervical insufficiency and a history of anovulatory infertility

Assessment of placental complex function and miscarriage prevention in pregnant women with uterine fibroid

Possibilities of Correcting Cellular-Humoral Immune Disorders and Cytokine Status in High-Risk Pregnant Women for the Development of Preeclampsia

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