The Effect of Light Deprivation on Functional Processes in the System “Mother – Placenta – Fetus” in Case of Threatening Preterm Birth and Its Clinical Significance

Abstract

Objective: to study the nature of uterine contractile activity, hormonal status, melatonin metabolism, blood flow in the uterine and fetal vessels, and the state of the fetus wellbeing before and after standard drug treatment and combination therapy involving the additional use of light deprivation. Materials and methods: a total of 547 women with threatening preterm birth were examined at 28 – 35 weeks of pregnancy. Among these, 198 pregnant women received standard therapy and 196 women received combined treatment, medical along with light deprivation. The control group consisted of 153 women with physiological pregnancy. We used cardiotocography to study the contractile activity of the uterus and the fetal cardiac rhythm, enzyme-linked immunosorbent assay methods to study the expression of hormones (ACTH, cortisol, progesterone, estriol, placental lactogen) in the blood and 6-sulfatoxymelatonin in the urine of pregnant women. Results: threatening preterm labor is accompanied by an increase in the level of generalized (bilateral) uterine activity, a decrease in the level of melatonin and an increase in the level of stress hormones. After using standard drug therapy, there is a suppression of any form of uterine activity, which leads to a deterioration of the fetus state in 30,2% of women, while combined therapy increases the level of melatonin, decreases the activity of stress-liberating subsystems of the mother’s body, and increases the level of right-sided uterine contractions that contribute to maintaining functional activity of the uteroplacental “pump”, contributing to the prevention of fetal distress. Conclusions: the studies indicate an improvement in the therapeutic effect with using light deprivation, as an additional method for tocolysis in women with the threat of premature birth.