Changes of maternal ACTH and oxytocinase plasma concentrations during the first trimester of spontaneous abortion.

INTRODUCTION: The labor at term finishes normal pregnancy. Both labor at term and first trimester spontaneous abortion are connected with increasing cytotoxic immune response within decidua. Th1 cytokines including IL-2 and INF-gamma are able to exert an effect on HPA axis and result in ACTH secretion. Oxytocinase serum level during pregnancy rises with the fetal development and arrest of oxytocinase serum growth might indicate the its development impairment, what might result in spontaneous abortion. MATERIAL AND METHODS: The study group consisted of 27 patients with clinical symptoms of missed abortion. A control group consisted of 89 pregnant women, who were successfully treated because of infertility. Immunoassay was used to measure ACTH plasma concentration. Oxytocinase plasma activity was established using l-cystine-di-beta-naphthylamide as a substrate. RESULTS: In the present study, significant increase in ACTH plasma concentration was observed during first trimester of spontaneous abortion. These patients were not characterized by significant increase of oxytocinase plasma level. CONCLUSIONS: The observed ACTH rise during spontaneous abortion might be also related to the alterations at the maternal-fetal interface and the response of HPA axis to the growing cytotoxic activity.

[Supplementary ultrasonometry of the fetus in evaluation of gestational age]. / Uzupelnienie ultrasonometrii plodu w ocenie wieku ciazowego.

The terminology quoted in the leaflet "Ultrasonometry of foetus in evaluation of gestational age" could change the diagnostic and therapeutic procedures in obstetrics from the point of view of only one out of many methods of imaging. The object of the study was to complement the "standards for eleven measurements pertinent to evaluation of pregnancy age and well-being of the foetus", in order to use them in compliance with the laws of auxology with recognize the priority of developmental age over the postmenstrual calendar age. Foetus is not a statistical patient, but an individual one, and it is not clinically important that, e.g. 15% of children are born at the foetal age of 38 or 41 weeks, but whether the examined foetus is born in either of the two weeks. Our complementation should be convincing about the great significance of ultrasonometry not of the foetus (as in the title of the publication in question), but of the foetuses in evaluation of their average gestational age, and about the necessity of reformulation of the published ultrasonomatric standarda, so as to render them clinically useful in regard of the foetuses of various gestational maturation rate.