DOI: https://doi.org/10.18370/2309-4117.2020.51.37-41

Features of the exchange of connective tissue and certain microelements in pregnant women with a risk of postterm pregnancy

І. А. Жабченко, І. С. Ліщенко, В. В. Буран

Abstract


Purpose of the study: to investigate the serum content of certain trace elements and synthesis markers (Total P1NP) and collagen resorption (β-CrossLaps) in pregnant women with a risk of postterm pregnancy and their role in this pathology.

Materials and methods. Main group included 80 pregnant women with a risk of postterm pregnancy. Control group consisted of 34 pregnant women without a risk of postterm pregnancy demostrating physiologic cervical maturation. Enzyme immunoassay was used for measurement of synthesis markers (Total P1NP - N-terminal propeptide of type I collagen), connective tissue resorption (ß-CrossLaps), and trace elements - Na, K, Mg, P, total and ionized Ca.

Results. Significant decrease in the concentration of Total P1NP was noted In pregnant women with a risk of postterm pregnancy compared with the control group (50.90 ± 4.27 ng/ml, p <0.05). The average value of connective tissue resorption marker β-CrossLaps in pregnant women of the main group was significantly higher than in the control ones (0.420 ± 0.02 ng/ml and 0.300 ± 0.02 ng/ml respectively). The total Ca was 1.98 ± 0.03 mmol/L that is 7.9% and 10.4% less than the lower limit of the physiological norm and in the control group (2.21 ± 0.04 mmol/l, p < 0.05) respectively. Mg in the main group was 0.68 ± 0.02 mmol/L, that is at the lower limit of the norm, and 20.9% less than in the control group (0.86 ± 0.03 mmol/L; < 0.05). The total serum vitamin D in pregnant women of the main group was 25.4% less than in the control group (23.62 ± 1.61 ng/ml, p <0.05).

Conclusions. An imbalance of the most microelements significant for the normal functioning of connective tissue and processes of transmission of nervous excitation in combination with a deficiency of vitamin D contributes to a cascade of reactions that inhibit the timely restructuring of the cervix structure before childbirth. Pregnant women with a risk of overexposure are characterized by a predominance of type I collagen resorption processes over its synthesis processes, which is probably one of the reasons for the insufficient maturation of the cervix on the eve of childbirth.


Keywords


postterm pregnancy; cervix; calcium; vitamin D; connective tissue

References


Benyuk, V.O., Golota V.Y., Wentzkivskyi, I.B., et al. Pathological obstetrics. Kyiv. Professional (2009): 51–4.

Vayssière, C., et al. “Prolonged and post-term pregnancies: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF).” Eur J Obstet Gynecol Reprod Biol 169 (2013): 10–6.

Vitale, S., et al. “Diagnosis, antenatal surveillance and management of prolonged pregnancy: current perspectives.” Minerva Ginecol 67.4 (2015): 365–73.

Měchurová. A. “Posterm pregnancy.” Čes Gynek 81.2 (2016): 98–103.

American College of Obstetricians and Gynecologists. “Practice Bulletin No. 146: Management of Late-Term and Postterm Pregnancies.” Obstet Gynecol 124.2 (2014): 390–6.

Markin, L.B., Smutok, S.R. “A differentiated approach to pregnancy after week 41.” Medical aspects of women's health 2 (2011): 5–9.

Shcherbina, A.M., Morgulian, O.V. “Peculiarities of the Influence of Pregnancy Transfer on the Formation of Perinatal Pathology of the Fetal Nervous System.” Tavricheskiy Mediko-Biologicheskiy Vestnik 15.2.2.58 (2012): 223–5.

Caughey, A.B., Sundaram, V., Kaimal, A.J., et al. “Maternal and neonatal outcomes of elective induction of labor.” Evid Rep Technol Assess 176 (2009): 241–57.

Caughey, A.B., Sundaram, V., Kaimal, A.J., et al. “Systematic review: elective induction of labor versus expectant management of pregnancy.” Ann Intern Med 151.4 (2009): 252–63.

Ailamazyan, E.K., Kulakov, V.I., Radzinskiy, V.E., Savelyeva, G.M. Obstetrics: a national guide. Moscow. GEOTAR-Media (2013): 1200 p.

Smolnova, T.Y., Adamyan, L.V. “Dynamics of phenotypic signs of connective tissue dysplasia syndrome at various age periods, the urgency of the problem in obstetrics and gynecology.” Obstetrics and gynecology 4 (2013): 74–9.

Savitsky, A.G., Gultyaeva, A.O., Kuzmina, D.N., et al. “’Cervical factor’ in the pathogenesis of hypertensive dysfunctions of the uterus.” Children's medicine of the North-West 2.3 (2012): 35–42.

Bakhmach, V.O., Chekhonatskaya, M.L., Yannayeva, N.E., et al. “Changes in the uterus and cervix during pregnancy and on the eve of childbirth (review).” Saratov Journal of Medical Scientific Research 7.2 (2011): 396–400.

Brekhman, G.I. “Cervix: transformations in connection with the birth process.” Female doctor 6.5 (2010): 5–11.

Shestopalov, A.V., Shulga, A.S., Alexandrova, A.A., et al. “Indicators of the metabolism of type I collagen in the blood of women with different pregnancy options.” Fundamental research: Scientific journal 2.2 (2012): 393–8.

Caranza-Manane, B., Havelock, J., Hemming, R., et al. “The management of uterine fibroids in women with otherwise unexplained infertility.” J Obstet Gynaecol Car 37 (2015): 277–85.

Lukina, T.S., Pavlov, O.G. “Therapy with magnesium preparations during pregnancy in women with undifferentiated connective tissue dysplasia.” Bulletin of new medical technologies: electron. journal 1.1 (2014): 1–5.

Khodzhaeva, Z.S., Gurbanova, S.R. “Magnesium deficiency, undifferentiated connective tissue dysplasia and isthmic-cervical insufficiency.” Problems of reproduction 2 (2009): 97–100.

Akhmedli, K.N. “Features of deficiency of macro and micronutrients in connective tissue dysplasia.” Modern pediatrics 84.4 (2017): 117–9.

Sudakov, D.S., Zazerskaya, I.E. “Features of bone metabolism during pregnancy and lactation.” Journal of Obstetrics and Women's Diseases 59.1 (2010): 57–65.

Gromova, O.A., Torshin, I.Y., Tomilova, I.K., et al. “Calcium and collagen biosynthesis: a systematic analysis of molecular mechanisms of action.” RMJ. Mother and Child 15 (2016): 1009–17.

Grigus, Y.I., Mikhailova, O.D., Gorbunov, A.Y., Vakhrushev, Y.M. “The Importance of Magnesium in the Physiology and Pathology of the Digestive System.” Experimental and Clinical Gastroenterology 6 (2015): 89–94.

Shurpiak, S.A., Zhemela, N.I. “The role of the balance of trace elements and vitamins in the provision of the gestational process.” Women's Health 5 (2014): 37–40.

Franasiak, J.M, Lara, E.E, Pellicer, A. “Vitamin D in human reproduction.” Curr Opin Obstet Gynecol 29.4 (2017): 189–94.

Zaft, V.B., Klimova, J.O., Zaft, A.A., et al. “Vitamin D deficiency and its modern laboratory diagnostics.” Medical Pharmacy News. Obstetrics and gynecology 587 (2016): 23–8.

Chernukha, E.A. Postterm and prolonged pregnancy. Moscow. GEOTAR-Media (2007): 208 p.


GOST Style Citations


1.            Бенюк, В.О. Патологічне акушерство / В.О. Бенюк, В.Я. Голота, І.Б. Венцківський та ін. – Київ: «Професіонал», 2009. – С. 51–54.

2.            Vayssière, C., et al. “Prolonged and post-term pregnancies: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF).” Eur J Obstet Gynecol Reprod Biol 169 (2013): 10–6.

3.            Vitale, S., et al. “Diagnosis, antenatal surveillance and management of prolonged pregnancy: current perspectives.” Minerva Ginecol 67.4 (2015): 365–73.

4.            Měchurová. A. “Posterm pregnancy.” Čes Gynek 81.2 (2016): 98–103.

5.            American College of Obstetricians and Gynecologists. “Practice Bulletin No. 146: Management of Late-Term and Postterm Pregnancies.” Obstet Gynecol 124.2 (2014): 390–6.

6.            Маркін, Л.Б. Диференційований підхід до ведення вагітності після 41-го тижня / Л.Б. Маркін, С.Р. Смуток // Медицинские аспекты здоровья женщины. – 2011. – №2. – C. 5–9.

7.            Щербина, А.М. Особливості впливу переношування вагітності на формування перинатальної патології нервової системи плода / А.М. Щербина, О.В. Моргулян та ін. // Таврический медико-биол. вестник. – 2012. – Т. 15, №2, Ч.2 (58). – С. 223–225.

8.            Caughey, A.B., Sundaram, V., Kaimal, A.J., et al. “Maternal and neonatal outcomes of elective induction of labor.” Evid Rep Technol Assess 176 (2009): 241–57.

9.            Caughey, A.B., Sundaram, V., Kaimal, A.J., et al. “Systematic review: elective induction of labor versus expectant management of pregnancy.” Ann Intern Med 151.4 (2009): 252–63.

10.          Айламазян, Э.К. Акушерство: национальное руководство / Э.К. Айламазян, В.И. Кулаков, В.Е. Радзинский, Г.М. Савельева, ред. – М.: ГЭОТАР-Медиа, 2013. – 1200 с.

11.          Смольнова, Т.Ю. Динамика фенотипических признаков синдрома дисплазии соединительной ткани в различные возрастные периоды, актуальность проблемы в акушерстве и гинекологии / Т.Ю. Смольнова, Л.В. Адамян // Акушерство и гинекология. – 2013. – № 4. – С. 74–79.

12.          Савицкий,  А.Г. «Шеечный фактор» в патогенезе гипертонических дисфункций матки / А.Г. Савицкий, А.О. Гультяева, Д.Н. Кузьмина и соавт.  // Детская  медицина  Северо-Запада. – 2012.  – Т. 2,№ 3. – С. 35–42.

13.          Бахмач, В.О. Изменения матки и шейки матки во время беременности и накануне родов (обзор) / В.О. Бахмач, М.Л. Чехонацкая, Н.Е. Яннаева  и др. // Саратовский научно-медицинский журнал. –2011. – Т. 7, № 2. – С. 396–400.

14.          Брехман, Г.И. Шейка матки: преобразования в связи с родовым процессом / Г.И. Брехман // Жіночий лікар. – 2010. – № 6. – С. 5–11.

15.          Шестопалов, А.В. Показатели метаболизма коллагена I типа в крови женщин при различных вариантах течения беременности / А.В. Шестопалов, А.С. Шульга, А.А. Александрова и др. // Фундамент. исслед.: науч. журн. – 2012. – № 2, Ч. 2. – С. 393–398.

16.          Caranza-Manane, B., Havelock, J., Hemming, R., et al. “The management of uterine fibroids in women with otherwise unexplained infertility.” J Obstet Gynaecol Car 37 (2015): 277–85.

17.          Лукина, Т.С. Терапия препаратами магния при беременности у женщин с недифференцированной дисплазией соединительной ткани / Т.С. Лукина, О.Г. Павлов // Вестник новых мед. технологий: электрон. журн. – 2014. – № 1. – С. 1–5.

18.          Ходжаева, З.С. Дефицит магния, недифференцированные дисплазии соединительной ткани и истмико-цервикальная недостаточность / З.С. Ходжаева, С.Р. Гурбанова // Проблемы репродукции. – 2009. – № 2. – С. 97–100.

19.          Ахмедли, К.Н. Особенности дефицита макро и микроэлементов при дисплазии соединительной ткани / К.Н. Ахмедли // Современная педиатрия. – 2017. – № 4 (84). – С. 117–119.

20.          Судаков, Д.С., Зазерская, И.Е. Особенности костного обмена при беременности и лактации / Д.С. Судаков, И.Е. Зазерская // Журнал акушерства и женских болезней. – 2010. – Т. LIX, №1. – С. 57–65.

21.          Громова, О.А. Кальций и биосинтез коллагена: систематический анализ молекулярных механизмов воздействия / О.А. Громова, И.Ю. Торшин, И.К. Томилова и соавт. // РМЖ. Мать и дитя. – 2016. –№15. – С. 1009–1017.

22.          Григус, Я.И. Значение магния в физиологии и патологии органов пищеварения / Я.И. Григус, О.Д. Михайлова, А.Ю. Горбунов, Я.М. Вахрушев // Экспериментальная и клиническая гастроэнтерология. – 2015. – № 6 (118). – С. 89–94.

23.          Шурпяк, С.А. Роль баланса микроэлементов и витаминов в обеспечении гестационного процесса / С.А. Шурпяк, Н.И. Жемела // Здоровье женщины. – 2014. – № 5. – С. 37–40.

24.          Franasiak, J.M, Lara, E.E, Pellicer, A. “Vitamin D in human reproduction.” Curr Opin Obstet Gynecol 29.4 (2017): 189–94.

25.          Зафт, В.Б. Дефіцит вітаміну D та його сучасна лабораторна діагностика / В.Б. Зафт, Ж.О. Клімова, А.А. Зафт та ін. // Новости мед. фармации. Акушерство и гинекология. – 2016. – № 587. – С. 23–28.

26.          Чернуха, Е.А. Переношенная и пролонгированная беременность / Е.А. Чернуха. – М.: ГЭОТАР-Медиа, 2007. – 208с.





Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)