Korovay S, Stetsenko S, Bondareva A
Kharkiv Regional Perinatal Center, Department of Obstetrics, Perinatology and Gynecology, KhMAPO.
Kharkiv National Medical University, Ukraine.
Georgian Med News. 2019 Feb(287):20-25.
The purpose of the study is examination the dynamics of antioxidant defense indicators and lipoperoxidation processes in women with pregnancy termination different periods. 227 pregnant women were examined, 190 of them had clinical signs of premature birth in the gestation period of 23-36 weeks. Formation of clinical groups was carried out depending on the term of pregnancy in the form of premature and timely birth. 48 women with early pregnancy termination were included in group I, which ended in childbirth in the period from 23 to 27 weeks. All pregnant women with risk of early pregnancy termination had the following distribution depending on the gestational period: 23-25 weeks - 23 pregnant women (Ia subgroup); 26-27 weeks - 25 pregnant women (Ib subgroup). 142 women were included in group II with late term pregnancy termination in the period from 28 to 36 weeks, which depending on the term of premature birth were divided into subgroups: IIa - 38 people, 28-30 weeks; IIb - 48 people, 31-33 weeks; IIс - 56 people, 34-36 weeks. The III (control) group included 37 women with a physiological course of pregnancy, which ended in childbirth without complications at the time of 38-41 weeks. The criteria for including women into groups were: young reproductive age, single-pregnancy, absence of gestosis, acute and chronic gynecological and somatic diseases. Diagnosis of preterm labor was carried out in the presence of abdominal pain syndrome and structural changes in the cervix. The research was carried out in compliance with the bioethics principles. In women with pregnancy termination in the period of 23-36 weeks in relation to women with the physiological course of pregnancy, which ended with childbirth without complications in the period of 38-41 weeks, there is an imbalance in the work of first and second lines antioxidants of antioxidant defense, which provokes the generation of oxygen excessive amounts active forms, initiating processes of lipoperoxidation with the essential malonic dialdehyde formation. In women with termination of pregnancy in the early stages of 23-27 weeks in relation to women with the physiological course of pregnancy there is a tension in antioxidant defense with a significant increase in lipoperoxidation, which is confirmed by a decrease in the activity of superoxide dismutase (34%), an increase in the level of ceruloplasmin (87%), diene (30%), malonic dialdehyde (by 178%), Schiff bases (by 28%) with an ambiguous change in the activity of catalase - an increase of 28% in the period of 23-25 weeks, a decrease by 16% in the period of 26-27 weeks. In women with termination of pregnancy in late periods of 28-36 weeks in relation to women with the physiological course of pregnancy, the inclusion of compensatory reactions of antioxidant defense against the background of lipoproxidation increase is observed, which is confirmed by an increase in the activity of SOD (17%), glutathione peroxidase (24% ), CP (117%), diethine (by 55%), MDA (by 106%), and SBs (by 18%) with a decrease in catalase activity (by 45%). The antioxidant protection imbalance of the body and the intensification of lipoperoxidation processes is one of the components of pregnancy termination pathogenesis and may contribute in combination with other complications.
本研究的目的是检测不同时期终止妊娠女性抗氧化防御指标和脂质过氧化过程的动态变化。对227名孕妇进行了检查,其中190名在妊娠23 - 36周时有早产的临床症状。根据早产和足月产的妊娠期限形式进行临床分组。第一组纳入48名早期终止妊娠的女性,她们在23至27周期间分娩。所有有早期终止妊娠风险的孕妇根据妊娠期有以下分布:23 - 25周 - 23名孕妇(Ia亚组);26 - 27周 - 25名孕妇(Ib亚组)。第二组纳入142名晚期终止妊娠的女性,她们在28至36周期间分娩,根据早产期限分为亚组:IIa - 38人,28 - 30周;IIb - 48人,31 - 33周;IIc - 56人,34 - 36周。第三(对照)组包括37名妊娠生理过程正常的女性,她们在38 - 41周时顺利分娩且无并发症。纳入女性分组的标准为:年轻育龄、单胎妊娠、无妊娠中毒症、无急慢性妇科和躯体疾病。早产的诊断依据腹痛综合征和宫颈结构变化。研究遵循生物伦理原则进行。与在38 - 41周时顺利分娩且无并发症的妊娠生理过程正常的女性相比,在23 - 36周期间终止妊娠的女性,抗氧化防御的一线和二线抗氧化剂工作存在失衡,这会引发过量活性氧形式的产生,启动脂质过氧化过程并形成大量丙二醛。与妊娠生理过程正常的女性相比,在23 - 27周早期终止妊娠的女性抗氧化防御存在紧张状态,脂质过氧化显著增加,这通过超氧化物歧化酶活性降低(34%)、铜蓝蛋白水平升高(87%)、二烯(30%)、丙二醛(升高178%)、席夫碱(升高28%)以及过氧化氢酶活性变化不明确(23 - 25周期间升高28%,26 - 27周期间降低16%)得以证实。与妊娠生理过程正常的女性相比,在28 - 36周晚期终止妊娠的女性,在脂质过氧化增加的背景下观察到抗氧化防御的代偿反应,这通过超氧化物歧化酶活性增加(17%)、谷胱甘肽过氧化物酶(24%)、铜蓝蛋白(117%)、二乙胺(升高55%)、丙二醛(升高106%)和席夫碱(升高18%)以及过氧化氢酶活性降低(45%)得以证实。机体抗氧化保护失衡和脂质过氧化过程加剧是终止妊娠发病机制的组成部分之一,可能与其他并发症共同起作用。