Changes in regulation of oxidase activity of peripheral blood granulocytes in women with habitual abortions.

Generation of active oxygen forms by blood granulocytes was studied in women with a history of habitual abortions (2-3 spontaneous abortions in the first trimester, undeveloped pregnancies). The level of spontaneous luminol-dependent chemiluminescence of nonfractionated peripheral blood was increased in this patient population (study group) in comparison with women with normal reproductive function (reference group). The two groups differed by the level of activation of respiratory burst induced by opsonized zymosan and by activity of isolated granulocytes in response to chemotactic peptide N-formyl-methionyl-leucyl-phenylalanine (1-50 microM). Differences in the effects of inhibitor of tyrosine protein kinases and protein phosphatases and inhibitor of mitogen-activated proteinkinase p38 MAPK were detected. The results attest to predisposition to oxidative stress and poor cytotoxic functions of granulocytes in women with habitual abortions, which can be due to specific features of regulation of oxidase activity by tyrosine protein kinases and protein phosphatases and by p38 MAPK.

[Ultrasonic study of the fetal heart in a pregnant woman with antiphospholipid antibodies]. / Ul'trazvukovoe issledovanie serdtsa ploda u beremennoi s nalichiem antitel k fosfolipidam.

Analysis of the findings of ultrasonic examinations of the fetal heart in pregnant women with antibodies to phospholipids has shown changes in this parameter in 42% of the examinees, in 3 cases antenatal fetal death was revealed. The detected changes were of different nature, but in the majority of cases they were of a compensatory type. Marked hypertrophy of the right ventricular myocardium, whose work in the antenatal period is largely responsible for the viability of the fetus, was found.

[Acid-base equilibrium and blood gases in pregnant women with habitual abortion after metabolic therapy]. / Kislotno-osnovnoe sostoianie i gazy krovi u beremennykh s privychnym nevynashivaniem na fone metabolicheskoi terapii.

Blood oxygen transport, pH, acid-base status, urinary ketone level and urobilinogen were studied in 52 pregnant women in whom pregnancy ran a normal course and in 56 ones with a history of habitual abortions, treated for metabolic disorders. Signs of metabolic acidosis in the presence of respiratory alkalosis at the expense of pulmonary hyperventilation were detected in women with normal pregnancy. Follow-up of acid-base status and gases of blood, aciduria and ketonuria in pregnant women with a history of habitual abortions has revealed in them respiratory alkalosis signs presenting in hypoxemia and reduced oxygen saturation and ketonuria. Metabolic therapy included in combined therapeutic schemes for such patients actively influenced the processes of metabolic acidosis and ketonuria compensation, probably at the expense of its normalizing effect on intracellular metabolism. Metabolic therapy of pregnant women liable to spontaneous abortions, due to ovarian hypofunction had a marked antihypoxic effect, normalized the bicarbonate system status and was therefore conducive to improvement of oxygen transport to maternal tissues and the fetus.

[A clinico-experimental study of the tocolytic properties of salbupart in treating threatened abortion]. / Kliniko-éksperimental'noe izuchenie tokoliticheskikh svoistv sal'buparta pri lechenii ugrozhaiushchikh prezhdevremennykh rodov.

Clinical and experimental studies have revealed that salbupart, a beta-mimetic agent, administered in a dose of 0.14 mg/kg (the maximal therapeutic dose) markedly inhibited the spontaneous and oxytocin-induced uterine contractility, caused no embryotoxic or teratogenic effects, and did not influence fetal growth and development. The efficacy of salbupart tocolytic therapy was estimated as 75%. Blood plasma cAMP levels normalized in the pregnant women over the course of therapy. Clinical and experimental results recommend salbupart for pregnancy protecting therapy in cases with threatened spontaneous abortions.

[Diagnostic and prognostic value of specific immune response to Cytomegaloviruses in pregnant women with a history of habitual abortion]. / Diagnosticheskaia i prognosticheskaia tsennost' spetsificheskogo immunnogo otveta k virusu tsitomegalii u beremennykh zhenshchin s privychnym nevynashivaniem beremennosti.

The authors analyze the usefulness of specific serologic tests for anti-CMV antibodies of the IgG and IgM classes for the prediction of the course of pregnancy and choice of immunocorrective therapy of women suffering from habitual abortions. Detection of specific IgM antibodies to cytomegalovirus with the use of Abbott diagnostic system was found highly informative, for it permitted a differential diagnosis of the cause of habitual abortions and monitoring of the treatment efficacy. Enzyme immunoassay of TBH in blood serum samples of pregnant women helped monitor the course of pregnancy.

[Characteristics of enzyme activity of leukocytes in women with history of habitual abortion]. / Osobennosti fermentativnoi aktivnosti leikotsitov u zhenshchin s privychnym nevynashivaniem v anamnese.

Leukocytic dehydrogenases (succinate and alpha-glucose phosphate dehydrogenases) and acid and alkaline phosphatase hydrolases activities were cytochemically assayed in 20 healthy women with normal menstrual cycles (controls) and 34 ones with habitual abortions. Ovulation in health was associated with a significant elevation of SDH, alpha-GPDH, and alkaline phosphatase activities. The second peak of enzymic activation, less marked, was recorded on days 20-24 of the cycle. Acid phosphatase activity was reduced by the second phase of the cycle. In women with habitual abortions the activities of redox enzymes (SDH and alpha-GPDH) reduced as against the controls (p less than 0.05, less than 0.01, less than 0.001), and no ovulatory peak of enzymic activation was detectable. The curves of enzymic activities were in good correlation with rectal temperature curves of the examinees. Elevated enzymic activities during ovulation and in the second phase of a normal cycle evidenced a sufficiently high energy supply of these processes. The detected reduction of leukocytic enzymic activities in women with habitual abortions may be used for the early diagnosis of an unfavorable pregnancy course and, possibly, for the prediction of placental insufficiency.

[The importance of determining trophoblastic beta 1-glycoprotein (TBG) for the early diagnosis and prognosis of placental insufficiency in pregnant women with habitual abortion]. / Znachenie opredeleniia TBG dlia rannei diagnostiki i prognozirovaniia platsentarnoi nedostatochnosti u beremennykh s privychnym nevynashivaniem.

Blood serum TBH levels were measured by enzyme immunoassay over the course of pregnancy in 40 women with normal pregnancy (controls) and 80 with a history of habitual abortions. Weekly measurements of TBH concentrations have revealed a significant reduction of its secretion over the entire pregnancy course in women with a history of habitual abortions vs. the controls (p less than 0.05; 0.01). A reduced TBH level starting from the first pregnancy trimester (4-7-fold reduction) and no manifest elevation of its concentration were the signs predicting the formation of primary placental insufficiency; the risk of its development was particularly high if these signs were associated with low placentation, detachment of the chorion, and recurring threatened abortions. A 10-fold and lower decrease of TBH level, its gradual or drastic reduction are the unfavorable signs preceding a spontaneous abortion. Therefore TBH measurements may be regarded as a screening test for the prediction and early diagnosis of developing placental insufficiency in pregnant women with a history of habitual abortions.

[Diagnosis of the causes and prevention of intrauterine fetal death in the second trimester of pregnancy in women with hyperandrogenism]. / Diagnostika prichin i profilaktika vnutriutrobnoi gibeli ploda vo II trimestre beremennosti u zhenshchin s giperandrogeniei.

Differential diagnosis of the causes of intrauterine fetal death was carried out in 84 women; in 57 of them it was due to hyperandrogenism of various origins. 63.2% of patients suffered from mixed (combined ++ovario-adrenal) androgen hypersecretion, 33.3% from the adrenal and only 3.5% of women from the ovarian form of hyperandrogenism. Relationship between the frequency of intrauterine fetal death, the pregnancy term and the form of hyperandrogenism was revealed. Differential diagnosis of hyperandrogenism forms and preparatory pathogenetic therapy helped preserve the pregnancy and resulted in delivery of a viable healthy child in 77.4% of the examined women.

[Contents of prostaglandins E2 and F2alpha and cAMP in the endometrium of women with habitual abortion during late pregnancy terms]. / Soderzhanie prostaglandinov E2 i F2 alfa i tsAMF v éndometrii zhenshchin, stradaiushchikh privychnym nevynashivaniem beremenosti pozdnikh srokov.

Measurements of prostaglandins E2 and F2 alpha in the endometrium of 35 women of a reproductive age, suffering from habitual abortions in late pregnancy terms, have shown elevation of these prostaglandin levels in the secretory phase as against the reference group and their normal values during the proliferative phase. It is possible, that disordered prostaglandin synthesis in the endometrium, manifesting in pregnancy, is one of the causes of habitual abortions. cAMP levels were somewhat decreased in the secretory phase in this patient population; this permits a hypothesis on disorders in the adenylate cyclase system.

[Status of the feto-placental system in pregnant women with a history of habitual abortion during complex therapy including metabolic correction]. / Sostoianie feto-platsentarnoi sistemy u beremennykh, stradaiushchikh privychnym nevynashivaniem, na fone kompleksnoi terapii s primeneniem metabolicheskoi korrektsii.

Fifty-two women suffering from habitual abortions, referred to high-risk group in respect of placental insufficiency development, were followed up over the course of pregnancy. Metabolic correction was added to the complex of therapy of some of these patients, the rest were administered basic therapy alone. The examinations revealed placental insufficiency signs in 78.8% of these women. Placental insufficiency in the examined group was characterized by enlarged intervillous space and a longer period necessary for filling this space, reduced linear rate of the blood stream in this space, as well as by reduced levels of the fetoplacental hormones and activation of lipid peroxidation. Addition of metabolic therapy to the complex of therapeutic measures helped reduce the incidence of placental insufficiency by 17.4% and reduce more than twofold the incidence of fetal hypoxia and hypotrophy .

[Endometrial steroid receptor levels in habitual abortion in advanced pregnancy]. / Soderzhanie steroidnykh retseptorov v éndometrii pri privychnom nevynashivanii beremennosti pozdnikh srokov.

Estrogen and progesterone reception was examined in the endometrial cytoplasmic and nuclear fraction from apparently healthy subjects and patients with habitual late incompetent pregnancy in the early proliferative and late secretory periods of a menstrual cycle. The reception of the two reproductive hormones in the nuclei and the binding of estrogens in the endometrial cytosol were demonstrated to be significantly higher in the female patients than in healthy subjects. The cytosol estrogen to progesterone reception ratio was increased in the patients in the secretory phase of a menstrual cycle than in normal females. There was a complete normalization of endometrial reproductive hormone receptor levels in the patients undergoing hyperbaric oxygenation.

[State of the sex hormone receptor in the endometrium of women with late habitual abortion]. / Sostoianie retseptornogo apparata polovykh gormonov v éndometrii zhenshchin pri privychnom nevynashivanii beremennosti pozdnikh srokov.

A study was made of estrogen and progesterone reception of the endometrial cytoplasmatic and nuclear fractions of healthy women and women suffering from late habitual abortion in the early proliferative and late secretory phases of the menstrual cycle. Reception of both sex hormones in the nuclei and estrogen binding in the endometrial cytosol of women with late habitual abortion was significantly higher than that in healthy women. The estrogen receptors/progesterone receptors ratio in the cytosol in the pathological endometrium at the secretory phase of the menstrual cycle was higher than in the normal one. Hyperbaric therapy given to such patients resulted in complete normalization of endometrial sex hormones reception.

[Status of the problem of spontaneous abortion]. / Sostoianie problemy nevynashivaniia beremennosti.

Findings of research into the problem of recurrent spontaneous abortion that has been conducted in major obstetric-gynecological clinics of this country in the recent five-year period are analysed. Risk factors of spontaneous abortion and preterm labour are specified, and the influences of environmental effects, pathogenesis, diagnosis, management, and prognosis are evaluated. Prospects of research in this field are outlined.

[Abortion as a high risk factor in perinatal pathology]. / Nevynashivanie beremennosti--faktor vysokogo riska perinatal'noi patologii.

Analysis of the pregnancy course and neonatal outcomes in 896 women with a history of recurrent spontaneous abortion showed a high rate of perinatal disease and neonatal problems. This is underlain by hormonal, immunological, and some other disorders, and also by a high infection level both during pregnancy and without it. To reduce the perinatal morbidity rate, a system of the reproductive function check-up and rehabilitation for the non-pregnant and a stage-by-stage control over the pregnancy course and the status of the fetoplacental unit was suggested.

[Multifactorial evaluation of miscarriage risk]. / Mnogofaktornaia otsenka riska nevynashivaniia beremennosti.

Presented in the paper are the results of epidemiological survey of pregnancy miscarriage in the Moscow population. Computer-assisted prognosis for pregnancy outcomes is discussed.

[Epidemiological study of conditions causing miscarriage]. / Epidemiologicheskoe izuchenie uslovii vozniknoveniia nevynashivaniia beremennosti.

The results of a population survey of the causes of spontaneous abortion are reported. A total of 328 female residents of the Cheremushki district in Moscow were investigated, using a retrospective epidemiologic method and 2 kinds of specifically-elaborated questionnaires. Mathematical analysis of the data has identified meaningful risk factors of spontaneous abortion.