Effects of exposure to tobacco smoke in pregnancies complicted by oligohydramnios and premature rupture of the membranes. II. Activity of brush border enzymes in human amniotic fluid.

The aim of the present study was to assess the activity of membrane enzymes: alanine aminopeptidase (AAP), gamma-glutamyltransferase (GGT) and trehalase in amniotic fluid of women who smoke cigarettes during pregnancy complicated by idiopathic oligohydramnios or premature rupture of the membranes (PROM). The enzyme activity was measured between 22 and 31 (group A) and between 32 and 39 (group B) weeks of gestation. In the women of group A with idiopathic oligohydramnios, AAP activity was five times higher than in PROM women. AAP activity was declining with the progression of gestation, and in the B group women with oligohydramnios, it was over eight times lower than in group A. A threefold increase in GGT activity was found in women of group A with oligohydramnios as compared to women of group A with PROM. No statistically significant differences in trehalase activity were found in amniotic fluid of women with oligohydramnios and PROM, AAP, GGT and trehalase activity in women with idiopathic oligohydramnios correlated with the cadmium ion concentration, and AAP and GGT activity with the lead ion concentration in amniotic fluid which confirms toxical properties of these heavy metals present in cigarette smoke. It has already been confirmed that measurements of the brush border enzyme activity in amniotic fluid are very useful in prenatal diagnosis and detection of the placenta disorders.

[The usefulness of hysteroscopy and hysterosalpingography in diagnosis of tubal infertility]. / Przydatnosc badania histeroskopowego i histerosalpingograficznego w diagnostyce nieplodnosci jajowodowej.

OBJECTIVES: To estimate the usefulness of hysteroscopy (HSC) and hysterosalpingography (HSG) examination on a retrospective study. DESIGN: Canulisation and morphology of ovarian tube detected during HSG and reactivity of uterine tubal ostia observed in HSC were compared. MATERIAL AND METHODS: The results of HSG and HSC examination performed on 125 young infertile women whom the tubal uterine factor of infertility was suspected were analyzed 250 ovarian tubes, after previous selection were taken into consideration. The analysis had a retrospective character. RESULTS: The analyzed group of women were divided into 3 group which differed from each other in reactivate of uterine ostia of the ovarian tubes. The first group first with correct reactivity of tubal ostia was the largest. The authors observed canulisation, which was the best in the first group and morphologic changes in the internal structure of the ovarian tubes. The highest percentage of these changes were observed in group three with unreactive uterine ostia. CONCLUSIONS: The HSG and HSC examination are supplementary examinations. The use of both methods together increases their diagnostic value and gives a more correct estimation of tubal status.

Effects of exposure to tobacco smoke in pregnancies complicated by oligohydramnios and premature rupture of the membranes. I. Concentration of Cd and Pb in blood and Zn, Cu, Cd and Pb in amniotic fluid.

To assess the exposure to tobacco smoke in pregnant women with oligohydramnios, idiopathic or caused by premature rupture of the membranes (PROM), cotinine concentrations were measured, using enzyme-like immunosorbent assay (ELISA). In women with idiopathic oligohydramnios (22-31 weeks of gestation), serum cotinine concentration was 1010 +/- 445 micrograms/L which provides evidence that women of this group were heavy smokers. In these women, significantly higher Cd concentrations in blood and amniotic fluid were found as compared to other pregnant women. A positive correlation between Cd concentrations in blood and amniotic fluid was observed (PROM r = 0.784; p < 0.001; idiopathic oligohydramnios r = 0.7118; p < 0.02). In oligohydramnios cases of both types, Cd concentration in amniotic fluid was over two times and Pb concentration ten times lower than blood concentrations of these metals, whereas amniotic fluid Zn concentration was two times lower than that found earlier in women with normal pregnancy. In the group of women with idiopathic oligohydramnios who were mostly exposed to tobacco smoke, a considerably larger number of still births and new-borns with CNS disorders than in PROM cases, were observed. Zn deficiency at increased exposure to Cd and Pb could play a significant role in etiology of these abnormalities. A positive correlation was found between Zn and Cu concentrations (r = 0.862; p < 0.05) in PROM cases which indicates regular transport of trace metals to the fetal ovum. The condition of infants born to this group of women was much better, and prematurity was the only complication of pregnancy.

[The influence of computer supervision of deliveries on the medical procedures during labor and neonatal post-delivery status]. / Wplyw komputerowego nadzoru porodu na sposób postepowania medycznego w czasie porodu oraz stan pourodzeniowy noworodków.

OBJECTIVES: The aim of the study was estimation of the influence of computer supervision of delivery on the way of medical management during partus. MATERIALS AND METHODS: Authors analyzed 10,983 labours which took place in years 1990-1999 in University Clinic of Reproduction and Obstetrics of Medical Academy in Wroclaw. Cases of labours without computer monitoring was the first analyzed group, and the cases of computer monitoring deliveries was the second group. In both groups, the count of cesarean sections performed because of first symptoms of fetal asphyxia, and Apgar score gained by newborns, were taken into consideration. RESULTS AND CONCLUSIONS: The frequency of cesarean sections and neonatal Apgar score gained by newborns were compared in two characterized group in order to evaluation the influence of computer monitoring deliveries on the neonatal status. No impact of computer supervision on the way of delivery procedures, quality of work and neonatals state was observed.

[Evaluation of the neonatal status from pregnancies complicated by PROM or oligohydramnios in smoking women]. / Ocena stanu noworodków z ciaz powiklanych przedwczesnym odplywaniem plynu owodniowego lub malowodziem u kobiet palacych papierosy.

OBJECTIVES: The aim of the study was analysis of neonatal status from pregnancies complicated oligohydramnios and from pregnancies complicated premature rupture of the membranes (PROM). MATERIALS AND METHODS: Authors analyzed 15 newborns from pregnancies with oligohydramnios diagnosed and 15- from pregnancies complicated PROM. Mothers of these newborns smoked cigarettes or were exposed to tobacco smoke. The features taken into consideration was prematurity, hypotrophy, malformations, birth weight, Apgar scale gained by newborns in first minutes after delivery. RESULTS AND CONCLUSIONS: The higher perinatal mortality, more frequent occurrence of hypotrophy and malformations were shown in newborns from pregnancies complicated oligohydramnios. The most frequent developmental anomaly was defect of nervosal system. Status of newborns from PROM pregnancies was getting better in according to lengthening duration of gestation. It wasn't stated in case of pregnancies with oligohydramnios complications.

[Activity of N-b-D-acetylglucosaminidase molecular forms in amniotic fluid of tobacco smoking pregnant women with oligohydramnios or premature rupture of the membrane complications]. / Aktywnosc molekularnych form N-acetylo-beta-D-glukozaminidazy w plynie owodniowym kobiet palacych papierosy podczas ciazy powiklanej malowodziem lub przedwczesnym odplywaniem plynu owodniowego.

OBJECTIVES: Morphological lesions in placenta and changed metal distribution through placenta, which were observed in pregnancy exposed to tobacco smoke, could cause alternations in lysosomal enzymes secretion to amniotic fluid. DESIGN: Assessment of total activity and molecular forms of N-beta-D-acetylglucosaminidase in amniotic fluid in pregnancy with oligohydramnios or PROM. MATERIALS AND METHODS: The materials for studies were amniotic fluids collected from pregnancy with oligohydramnios and from pregnancy with PROM. Determination of N-beta-D-acetylglucosaminidase activity was performed with use of sodium salt of 3-crezolosulfthaleinyl-N-beta-D-acetylglucosamide as a substrate (test Boehringer, Niemcy). Creatinine was determined by kinetic method (test of Analco-GBG firm). Protein was determine by Bredford method. NAG-B was assessed after previous thermal NAG-A inactivation in 56 degrees C, for 2 hours and the difference between activity of total form and termostabile form of NAG were assessed. The microsomal and cytosol fractions were separated by ultracentrifugation. RESULTS AND CONCLUSIONS: The statistically significant growth of NAG activity in amniotic fluid in pregnant with oligohydramnios was observed. The cytosol form took over 90% of whole activity. The activity of NAG microsomal fraction was lower in amniotic fluid in women with PROM diagnosis. The positive coleration between NAG-A activity and the Pb level was observed in this group of women as well. In the second group of women with oligohydramnios, the positive coleration between NAG and Cd level, NAG-A and level, NAG-B and Pb level were demonstrated. Obtained results show on damage of placental and foetal membranes cell structure. It could be caused by metal ions cumulation and releasing of molecular N-beta-D-acetylglucosaminase form to amniotic fluid.

[Levels of Cd, Pb in blood and Zn, Cu, Cd, Pb in amniotic fluid of tobacco smoking women during pregnancy complicated oligohydramnios or premature rupture of membranes]. / Poziom metali Cd i Pb we krwi oraz Zn, Cu, Cd i Pb w wodach plodowych kobiet palacych papierosy podczas ciazy powiklanej malowodziem lub przedwczesnym odplywaniem wód plodowych.

OBJECTIVES: The ingredients of tobacco smoke have the impact on uterine blood vessels. They caused vascular insufficiency of placenta during development of gestation and changes in placental tissue and fetal membranes. It manifest changeable metal permeability and others symptoms. DESIGN: Assessment of metal contents in blood and amniotic fluid in pregnancies with oligohydramnios and PROM. MATERIALS AND METHODS: The materials for studies were blood and amniotic fluid of 30 pregnancies. All of them had made amino-punction between 20 and 38 week of pregnancy before procedure of amniotic fluid supplementation. 15 patients had diagnosed oligohydramnios and the next 15 women had diagnosed premature rupture of membranes. Metals were determined by method of electrothermal atomical absorbic spectrophotometry (ET-ASA). RESULTS AND CONCLUSIONS: Twice lower concentration of Zn and Cd and ten times lower concentration of Pb in amniotic fluids in examined women than women in normal pregnancy were observed. The women, with oligohydramnios in earlier period of gestation, smoked many more cigarettes and cotinine++ and Cd. were much higher. Both these facts had relevance with each other certainly. The stillborns were many more in this group. The different distribution of Cd, Pb, Zn in pregnant women with PROM and oligohydramnios, comparing with women in normal pregnancy was demonstrated. It is probable to be effect of placental tissue and fetal membranes disfunction.