Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications
Objectives. To determine the features of the synthetic function of the placenta in intrahepatic cholestasis of pregnancy (ICP) and its obstetric and perinatal complications. Material and methods. The study involved 80 pregnant women. The main group included 54 patients with ICP, and the comparison...
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| Format: | Article |
| Language: | English |
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Vitebsk State Order of Peoples’ Friendship Medical University
2022-08-01
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| Series: | Вестник Витебского государственного медицинского университета |
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| Online Access: | https://vestnik.vsmu.by/downloads/2022/4/2022_21_4_52-58.pdf |
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| author | Ya.I. Bik-Mukhametova T.N. Zakharenkova N.M. Golubykh I.I. Ageeva |
| author_facet | Ya.I. Bik-Mukhametova T.N. Zakharenkova N.M. Golubykh I.I. Ageeva |
| author_sort | Ya.I. Bik-Mukhametova |
| collection | DOAJ |
| description | Objectives. To determine the features of the synthetic function of the placenta in intrahepatic cholestasis of pregnancy (ICP) and its obstetric and perinatal complications.
Material and methods. The study involved 80 pregnant women. The main group included 54 patients with ICP, and the comparison group consisted of 26 women without clinical and laboratory criteria for cholestasis. In the study groups, the levels of placental proteins and hormones included in the biochemical prenatal screening of the first trimester of pregnancy, the concentration of sex steroids (progesterone, estradiol) in blood serum have been studied. The role of synthetic placental disorders in the development of maternal and perinatal complications in ICP has been determined.
Results. ICP is associated with higher blood progesterone levels in pregnant women (P<0.0001). Significant risk factors for preterm labor (PL) in ICP were: the level of pregnancy-associated protein-A (PAPP-A) ≤ 0.83 MoM (AUC=0.867; p=0.0001) and the level of human chorionic gonadotropin (hCG) ≤ 0.51 MoM (AUC=0.845; p=0.0001) in the blood at the end of the first trimester of pregnancy, the concentration of progesterone in the blood serum of pregnant women with ICP≤1760.1 nmol/l (AUC=0.846; p=0.0001). Predictors of meconium staining of amniotic fluid (MSAF) in women with ICP were: the level of placental growth factor (PlGF) ≤ 0.60 MoM (AUC=0.823; p=0.0001) and PAPP-A value > 1.35 MoM (AUC= 0.751; p=0.025) in the first trimester of pregnancy, the concentration of estradiol in the blood serum of pregnant women with ICP > 27.9 nmol/l (AUC=0.775; p=0.007). A lower concentration of progesterone in the blood (P(U)progesterone=0.012) in patients with ICP, in case of the development of respiratory disorders in their newborns, correlates with premature delivery (rs=-0.552; p=0.047).
Conclusions. In the pathogenesis of ICP, higher levels of progesterone in the blood of pregnant women are important. The development of PL in women with ICP is based on primary placental disorders. MSAF in ICP is associated with ischemia of the placenta against the background of a violation of the secondary wave of trophoblast invasion and leads to the activation of compensatory hormonal mechanisms that improve blood supply in it. |
| first_indexed | 2024-03-13T09:27:08Z |
| format | Article |
| id | doaj.art-5903df84a1724f9d93ba36d34e61ab75 |
| institution | Directory Open Access Journal |
| issn | 1607-9906 2312-4156 |
| language | English |
| last_indexed | 2024-03-13T09:27:08Z |
| publishDate | 2022-08-01 |
| publisher | Vitebsk State Order of Peoples’ Friendship Medical University |
| record_format | Article |
| series | Вестник Витебского государственного медицинского университета |
| spelling | doaj.art-5903df84a1724f9d93ba36d34e61ab752023-05-26T08:12:46ZengVitebsk State Order of Peoples’ Friendship Medical UniversityВестник Витебского государственного медицинского университета1607-99062312-41562022-08-012145258https://doi.org/10.22263/2312-4156.2022.4.52Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complicationsYa.I. Bik-Mukhametova0https://orcid.org/0000-0002-6134-4275T.N. Zakharenkova1https://orcid.org/0000-0002-0718-8881 N.M. Golubykh2https://orcid.org/0000-0002-3335-7159I.I. Ageeva3Gomel State Medical University, Gomel, Republic of BelarusGomel State Medical University, Gomel, Republic of BelarusGomel State Medical University, Gomel, Republic of BelarusGomel Regional Diagnostic Medical Genetic Center with “Marriage and Family” consultation, Gomel, Republic of BelarusObjectives. To determine the features of the synthetic function of the placenta in intrahepatic cholestasis of pregnancy (ICP) and its obstetric and perinatal complications. Material and methods. The study involved 80 pregnant women. The main group included 54 patients with ICP, and the comparison group consisted of 26 women without clinical and laboratory criteria for cholestasis. In the study groups, the levels of placental proteins and hormones included in the biochemical prenatal screening of the first trimester of pregnancy, the concentration of sex steroids (progesterone, estradiol) in blood serum have been studied. The role of synthetic placental disorders in the development of maternal and perinatal complications in ICP has been determined. Results. ICP is associated with higher blood progesterone levels in pregnant women (P<0.0001). Significant risk factors for preterm labor (PL) in ICP were: the level of pregnancy-associated protein-A (PAPP-A) ≤ 0.83 MoM (AUC=0.867; p=0.0001) and the level of human chorionic gonadotropin (hCG) ≤ 0.51 MoM (AUC=0.845; p=0.0001) in the blood at the end of the first trimester of pregnancy, the concentration of progesterone in the blood serum of pregnant women with ICP≤1760.1 nmol/l (AUC=0.846; p=0.0001). Predictors of meconium staining of amniotic fluid (MSAF) in women with ICP were: the level of placental growth factor (PlGF) ≤ 0.60 MoM (AUC=0.823; p=0.0001) and PAPP-A value > 1.35 MoM (AUC= 0.751; p=0.025) in the first trimester of pregnancy, the concentration of estradiol in the blood serum of pregnant women with ICP > 27.9 nmol/l (AUC=0.775; p=0.007). A lower concentration of progesterone in the blood (P(U)progesterone=0.012) in patients with ICP, in case of the development of respiratory disorders in their newborns, correlates with premature delivery (rs=-0.552; p=0.047). Conclusions. In the pathogenesis of ICP, higher levels of progesterone in the blood of pregnant women are important. The development of PL in women with ICP is based on primary placental disorders. MSAF in ICP is associated with ischemia of the placenta against the background of a violation of the secondary wave of trophoblast invasion and leads to the activation of compensatory hormonal mechanisms that improve blood supply in it.https://vestnik.vsmu.by/downloads/2022/4/2022_21_4_52-58.pdffetoplacental complexpregnancy-associated protein ahuman chorionic gonadotropinplacental growth factorsex steroidspreterm labormeconium staining of amniotic fluid. |
| spellingShingle | Ya.I. Bik-Mukhametova T.N. Zakharenkova N.M. Golubykh I.I. Ageeva Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications Вестник Витебского государственного медицинского университета fetoplacental complex pregnancy-associated protein a human chorionic gonadotropin placental growth factor sex steroids preterm labor meconium staining of amniotic fluid. |
| title | Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications |
| title_full | Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications |
| title_fullStr | Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications |
| title_full_unstemmed | Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications |
| title_short | Features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications |
| title_sort | features of the fetoplacental complex functioning in intrahepatic cholestasis of pregnancy and its obstetric and perinatal complications |
| topic | fetoplacental complex pregnancy-associated protein a human chorionic gonadotropin placental growth factor sex steroids preterm labor meconium staining of amniotic fluid. |
| url | https://vestnik.vsmu.by/downloads/2022/4/2022_21_4_52-58.pdf |
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