[The regulatory transport proteins in diagnostic and prognosis of preeclampsia].

The article considers the results of analysis of content of regulative transport proteins in blood serum and urine of pregnant women (term III) in case of uncomplicated pregnancy and pregnancy complicated by preeclampsia and eclampsia for elaborating their pathogenic role and evaluating prognostic significance. It is established that the more severe eclampsia is the higher is the level of a2-macroglobulin and the lower is the content of lactoferrin in blood. At that, excretion of a2-macroglobulin and albumin with urine increases with aggravation of severity of processes and in urine is detected a1-antitrypsin previously undetected. The excretion of lactoferrin reaches its peak values in case of preeclampsia and decreases in case of eclampsia. The alteration of levels of a2-macroglobulin and lactoferrin are uncharacteristic for classic inflammatory reaction and testify their active involvement into pathogenesis of eclampsia. The decreasing of in blood of levels of a1-antitrypsin lesser than 5 g/l and lactoferrin lesser than 0.8 mg/l at concentration of a2-macroglobulin higher than 3.5 g/l against the background of decreased levels of albumin and crude protein in blood and also increasing in urine of concentrations of a2-macroglobulin up to 0.0005 g/l and higher and occurrence of a1-antitrypsin and increasing of content of albumin up to 10 times can be recommended as criteria of high risk of development of eclampsia in regnant women with moderately expressed preeclampsia in term III.

[The level of pregnancy-associated alpha2-glycoprotein and the hormonal background during different options of hormonal replacement therapy in the menopausal syndrome].

The authors studied the concentration of pregnancy-associated alpha2-glycoprotein (PA alpha2GP), a sensitive marker of estrogen-dependent tumors, and the association of its level with the serum content of a number of hormones: follicle-stimulating hormone, luteinizing hormone, estradiol (E-2), dehydroepiandrosterone sulfate (DEAS-S), and testosterone in females receiving the groups of drugs containing: 1) estradiol valerate; 2) 17beta-estradiol, and 3) tibolone. The type of the active ingredient of a drug and the duration of its administration were shown to differently affect both the concentration of hypothalamopituitary hormones and steroid sex hormones and the level of PA alpha2GP). The latter increased significantly in Group 1 and insignificantly in Group 2 and did not differ from the normal values in Group 3, at the same time the concentration of E-2 elevated in Groups 1 and 2, rather than in Group 3; the level of DEAS-S increased in Groups 2 and 3 irrespective of the duration of use. Moreover, there were elevated levels of testosterone in Group 3 and those of DEAS-S in Group 1 only when the drugs were administered for 3-6 months. A number of correlations were found in the levels of PA alpha2GP with those of steroid hormones. The authors consider that individual monitoring of the level of PA alpha2GP in the females who need hormonal therapy in menopause provides a useful guide to choosing a drug, monitoring its use efficiency, and preventing malignant proliferation in proper time.

[The prediction of the probability of the development of myocardial infarct by genetic and phenotypic markers]. / Prognozirovanie veroiatnosti razvitiia infarkta miokarda po geneticheskim i fenotipicheskim markeram.

The study was made of marker distribution of 17 hereditary polymorphism systems in 493 patients with myocardial infarction (MI) and 422 healthy subjects. The prognostic system for determination of predisposition or resistance to MI development has been designed in accordance with marker occurrence in the patients and healthy subjects basing on Bayer's method. When the sum of the prognostic ratios of all the markers is +5 scores and more there is a high risk of MI, when this sum is -6 scores and less the resistance to its genesis is predicted. The proposed prognostic system makes it possible to predict predisposition to myocardial infarction at an early age and, therefore, to take preventive measures.

[Experience with conducting programmed labor]. / Opyt provedeniia programmirovannykh rodov.

An analysis was made of programmed labours in 128 high-risk females having relative indications for cesarean section. Oxytocin or prostaglandin was used as a uterine-contracting agents. The dosage, rate and duration of drug administration were adjusted by the values of uterine activity and the rate of cervical dilatation. In the latent phase (up to 4-5 cm) the optimal dilatation rate was considered to be 1 cm/h in primiparas, 1.5 cm/h in multiparas; in the active period (over 5 cm), that was 1.5 and 2.0 cm/h, respectively. The optimal labour duration was at least 10-12 hours in primiparas and at least 8 hours in multiparas. One hundred and sixteen (90.6%) females delivered vaginally without any delivery operations. Twelve (9.4%) delivered via cesarean section. All 128 babies were liveborn. It has been concluded that programmed labour is a sparing tool of delivery in high-risk pregnant who have no indications for cesarean section.

PIP: Programmed labor defined as a planned natural delivery was carried out in 128 women. The group included 43 gravida I (average age 24.6 years) and 85 gravida II (average age 29.2 years). Indications for programmed labor included late toxemia (44), prolonged pregnancy (23), ABO and Rhesus isoimmunization (24) fetal hypotrophy (8), and extragenital diseases (29). All patients had relative indications for cesarean section. Planned labor was conducted at gestation age of 36-38 weeks in 24 women, at 39-41 weeks in 81, and at 42-43 weeks in 23. Predelivery management included administration of prostaglandin synthesis inducers, spasmolytics, estrogens (300-500 units/kg, intramuscularly). In the evening prior to labor induction, the patients received intracervical administration of prostaglandin gel. Labor was induced by oxytocin or prostaglandin administration. Oxytocin dose depended upon the body weight and ranged from 5 units (1 ml) for the body weight of 50-69 kg to 7,5 units (1.5 ml) for 70-89 kg, and 10 units (2 ml) for the body weight of over 90 kg. Oxytocin was given by an intravenous drip starting with 8-10 drops/min and gradually increasing to 30-40 drops/min. Prostaglandin (5 mg per 500 ml of solution) was given by an intravenous drip starting with 20 drops/min and gradually increasing to 40 drops/min. Effectiveness of oxytocin or prostaglandin dose was estimated by stability of uterine contractions and by the rate of cervix dilatation. Normal duration of labor was no more than 10-12 hr for gravida I and no more than 8 hr for gravida II. Of 128 women, 116 had normal vaginal delivery and 12 had to undergo emergency cesarean section. Delivery was complicated by cervix rupture in 9 patients. All 128 women gave birth to live babies. Agar score ranged from 8-9 in 108, to 7 in 15, and 6 in 5.