FEATURES OF CONNECTIVE TISSUE METABOLISM AND MICROELEMENTS IN BLOOD SERUM OF PREGNANT WOMEN WITH CERVICAL INSUFFICIENCY
Abstract
The preterm deliveries are the leading cause of the perinatal morbidity and represent important mortality indicators. Functional cervical insufficiency, which is a phenotypic manifestation of undifferentiated connective tissue dysplasia, plays the main role in the development of pregnancy complications in primigravidas (women pregnant for the first time) and primiparas (women giving birth for the first time).
Aim of the research: to study the indicators of connective tissue metabolism and basic microelements in order to determine the role of undifferentiated connective tissue dysplasia in the pathogenesis of functional cervical insufficiency during pregnancy.
Methods. The 101 pregnant women (the main group) at the 22–32 week gestation period which were diagnosed with “Functional cervical insufficiency” were examined, as well as 34 pregnant women with the physiological obstructive function of the cervix (the control group). Utilizing immunoenzyme analysis we measured in blood serum the concentration of Total P1NP the amino-terminal propeptide of procollagen type I a marker of synthesis, and β-CrossLaps resorptions marker of the connective tissue. Utilizing the automatic analyzer of electrolytes and a set of reagents for their determination we estimated the content of microelements Na+, K+, Mg2+, Ca2+ and total Ca and P.
Results. The functional cervical insufficiency in pregnant women was indicated by cervical shortening up to 22.88±1.02 mm, and the majority of women (76.2 %) had phenotypical manifestations of undifferentiated connective tissue dysplasia. We found a significant increase in the concentration of marker of synthesis Total P1NP, whereas the concentration of resorption marker β-CrossLaps remains normal, and strong reverse correlation (r=–0.7362) between the index of cervix length and concentration of marker of connective tissue synthesis Total P1NP. We detected a significant increase in the concentration of total and ionized calcium, total phosphorus, deficiency of ionized magnesium, potassium and sodium that lead to changes in the structure of connective tissue and reduction of cervical obstructive function.
Downloads
References
Cavalcante, M. B., Costa, F. da S., Araujo Junior, E., Barini, R. (2014). Risk factors associated with a new pregnancy loss and perinatal outcomes in cases of recurrent miscarriage treated with lymphocyte immunotherapy. The Journal of Maternal-Fetal & Neonatal Medicine, 28 (9), 1082–1086. doi: http://doi.org/10.3109/14767058.2014.943175
Alzahrani, D. A. (2016). Progestrone uses in obstetrics and gynecology, MedCrave Online Journal of Women’s Health, 2 (5), 127–128. doi: http://doi.org/10.15406/mojwh.2016.02.00046
Pasek, R. C., Dunn, J. C., Elsakr, J. M., Aramandla, M., Matta, A. R., Gannon, M. (2017). Vascular-derived connective tissue growth factor (Ctgf) is critical for pregnancy-induced β cell hyperplasia in adult mice. Islets, 9 (6), 150–158. doi: http://doi.org/10.1080/19382014.2017.1356963
Aleman, A., Althabe, F., Belizan, J., Bergel, E. (2002). Bed rest during pregnancy for preventing miscarriage. Cochrane Database Systematic Reviews, 2. doi: http://doi.org/10.1002/14651858.cd003576
Balogun, O. O., da Silva Lopes, K., Ota, E., Takemoto, Y., Rumbold, A., Takegata, M., Mori, R. (2016). Vitamin supplementation for preventing miscarriage. Cochrane Database of Systematic Reviews, 5. doi: http://doi.org/10.1002/14651858.cd004073.pub4
Lee, H. J., Park, T. C., Norwitz, E. R. (2009). Management of pregnancies with cervical shortening: a very short cervix is a very big problem. Reviews in Obstetrics and Gynecology, 2 (2), 107–115.
De-Regil, L. M. (2012). Vitamin D supplementation for women during pregnancy. Cochrane Database of Systematic Reviews, 2. doi: http://doi.org/10.1002/14651858.cd008873.pub2
Norman, J. E., Marlow, N., Messow, C.-M., Shennan, A., Bennett, P. R., Thornton, S. et. al. (2016). Vaginal progesterone prophylaxis for preterm birth (the OPPTIMUM study): a multicentre, randomised, double-blind trial. The Lancet, 387 (10033), 2106–2116. doi: http://doi.org/10.1016/s0140-6736(16)00350-0
Marder, W., Littlejohn, E. A., Somers, E. C. (2016). Pregnancy and autoimmune connective tissue diseases. Best Practice & Research Clinical Rheumatology, 30 (1), 63–80. doi: http://doi.org/10.1016/j.berh.2016.05.002
Saar, P., Hermann, W., Müller-Ladner U. (2006). Connective tissue diseases and pregnancy. Rheumatology (Oxford), 45 (3), 30–32.
Vengetesh, P. M., Hebbar, S., Rai, L. (2015). Autoimmune diseases in pregnancy: maternal and fetal outcomes. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 4 (1), 9–14. doi: http://doi.org/10.5455/2320-1770.ijrcog20150202
Dodd, J. M., Crowther, C. A. (2009). The role of progesterone in prevention of preterm birth. International Journal of Women’s Health, 1, 73–84.
Bloomfield, S. A., Martinez, D. A., Boudreaux, R. D., Mantri, A. V. (2016). Microgravity stress: bone and connective tissue. Comprehensive Physiology, 6 (2), 645–686. doi: http://doi.org/10.1002/cphy.c130027
Balc, A. K., Koksal, O., Kose, A., Armagan, E. (2013). General characteristics of patients with electrolyte imbalance admitted to emergency department. World Journal of Emergency Medicine, 4 (2), 113–116. doi: http://doi.org/10.5847/wjem.j.issn.1920-8642.2013.02.005
LaRusso, J., Li, Q., Jiang, Q., Uitto, J. (2009). Elevated dietary magnesium prevents connective tissue mineralization in a mouse model of pseudoxanthoma elasticum (Abcc6(-/-). Journal Investigative Dermatology, 129 (6), 1388–1394. doi: http://doi.org/10.1038/jid.2008.391
Koshel, M. V., Chebotarev, V. V. (2014). Acne treatment in patients with connective tissue dysplasia. Medical news of North Caucasus, 9 (2), 170–172. doi: http://doi.org/10.14300/mnnc.2014.09048
Fujita, Y., Goto, S., Ichikawa, M., Hamaguchi, A., Maki, K. (2016). Effect of dietary calcium deficiency and altered diet hardness on the jawbone growth: A micro-CT and bone histomorphometric study in rats. Archives of Oral Biology, 72, 200–210. doi: http://doi.org/10.1016/j.archoralbio.2016.08.036
Clinical guideline for obstetric care (2008). Ministry of public health of Ukraine from 03.11.2008. No. 624. «Miscarriage».
Quinn, J.-A., Munoz, F. M., Gonik, B., Frau, L. (2016). Preterm birth: Case definition & guidelines for data collection, analysis, and presentation of immunisation safety data. Vaccine, 34 (49), 6047–6056. doi: http://doi.org/10.1016/j.vaccine.2016.03.045
Dakhale, G. N., Hiware, S. K., Shinde, A. T. (2012). Basic biostatistics for post-graduate students. Indian Journal of Pharmacology, 44 (4), 435–442. doi: http://doi.org/10.4103/0253-7613.99297
Oxlund, B. S., Ortoft, G., Brüel, A., Danielsen, C. C., Oxlund, H., Uldbjerg, N. (2010). Cervical collagen and biomechanical strength in non-pregnant women with a history of cervical insufficiency. Reproductive Biology and Endocrinology, 8, 92. doi: http://doi.org/10.1186/1477-7827-8-92
Bohiltea, R. E., Munteanu, O., Turcan, N., Baros, A., Bodean, O., Voicu, D., Cirstoiu, M. M. (2016). A debate about ultrasound and anatomic aspects of the cervix in spontaneous preterm birth. Journal of Medicine and Life, 9 (4), 342–347.
Copyright (c) 2018 Sadrudin Magomedov, Iryna Zhabchenko, Viktor Oleshko, Larysa Polishchuk, Nellia Korniets
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
