Demir Çendek Büşra, Şahin Aker Seda, Dağdeviren Gülşah, Alışık Murat, Altay Mehmet Metin, Erel Özcan
Ankara Etlik City Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey.
University of Health Sciences Turkey, Kayseri City Hospital, Clinic of Gynecology and Obstetrics, Kayseri, Turkey.
Turk J Obstet Gynecol. 2024 Mar 4;21(1):15-21. doi: 10.4274/tjod.galenos.2024.96462.
The main aim of this study was to investigate the differences in maternal serum thiol/disulfide homeostasis among women with abortion imminens (AI), missed abortion (MA), and healthy pregnancies during the first trimester.
This was a prospective case-control study. This study was conducted on pregnant women who visited the Obstetrics Clinic at University of Health Sciences Turkey, Etlik Zübeyde Hanım Gynecology Training and Research Hospital and were diagnosed with either AI or MA during the 6 to 14 weeks of pregnancy. The participants had a normal pregnancy follow-up, no chronic illnesses, and did not take any multivitamin or antioxidant supplements except for folic acid. The study incorporated 33 pregnant women with AI, 36 with MA, and 40 with normal pregnancies. Age, and body mass index were matched across the three groups. This study used a recently developed automated spectrophotometric technique to quantify thiol/disulfide concentrations.
The AI group had considerably elevated levels of total thiol and native thiol (SH) compared with the MA group. Nevertheless, there was no notable disparity observed between the group of healthy pregnancies and the other two groups. Serum disulfide (SS) levels did not exhibit any significant variations among the three groups. Similarly, the ratios of SS/SH, SS/total thiol, and SH/total thiol did not show any significant differences between the groups (p>0.05).
Patients with MA had decreased levels of total thiol and SH, which possess antioxidant capabilities, compared to the AI group. A decrease in antioxidant levels in the body may contribute to the etiology of MA. When considering our findings alongside existing literature, it remains inconclusive whether the serum thiol-disulfide ratio can predict a healthy pregnancy or MA following AI. Therefore, it is not yet seen as a promising diagnostic tool for assessing pregnancy viability. Additional investigation is required to establish the influence of dynamic thiol/disulfide homeostasis on early pregnancy loss.
本研究的主要目的是调查孕早期即将流产（AI）、稽留流产（MA）和正常妊娠女性之间母体血清硫醇/二硫化物稳态的差异。
这是一项前瞻性病例对照研究。本研究针对在土耳其健康科学大学埃特利克·祖贝德·哈尼姆妇科培训与研究医院产科门诊就诊、在妊娠6至14周期间被诊断为AI或MA的孕妇进行。参与者妊娠随访正常，无慢性疾病，除叶酸外未服用任何多种维生素或抗氧化剂补充剂。该研究纳入了33例AI孕妇、36例MA孕妇和40例正常妊娠孕妇。三组在年龄和体重指数方面进行了匹配。本研究使用一种最近开发的自动分光光度技术来定量硫醇/二硫化物浓度。
与MA组相比，AI组的总硫醇和天然硫醇（SH）水平显著升高。然而，健康妊娠组与其他两组之间未观察到明显差异。三组之间血清二硫化物（SS）水平没有显著变化。同样，三组之间SS/SH、SS/总硫醇和SH/总硫醇的比率也没有显著差异（p>0.05）。
与AI组相比，MA患者具有抗氧化能力的总硫醇和SH水平降低。体内抗氧化水平的降低可能有助于MA的病因学。结合现有文献考虑我们的研究结果，血清硫醇 - 二硫化物比率是否能够预测AI后的健康妊娠或MA仍无定论。因此，它尚未被视为评估妊娠生存能力的有前景的诊断工具。需要进一步研究以确定动态硫醇/二硫化物稳态对早期妊娠丢失的影响。
