Features of fetoplacental complex function in prolonged pregnancy
DOI:
https://doi.org/10.14739/2310-1210.2017.1.91636Keywords:
prolonged pregnancy, maternal-fetal, metabolism, progesterone, estriol, placental lactogen, cortisol, hydrocortisoneAbstract
The frequency of post-term pregnancy ranges from 3.5 to 16%. Compared to full-term newborns perinatal morbidity was in the post-term pregnancy group 1.7 times higher and mortality - in 5.5 times.
The aim. To study the features of feto-placental complex functioning in the post-term pregnancy; to detect relationship between complications of the gestational period and perinatal outcomes based on the feto-placental complex violations.
Materials and Methods. To study the features of delayed delivery and perinatal outcomes in this case 96 pregnant women with prolonged delivery were analyzed for 2013-2015, who gave birth in the term of 41-42 weeks. As a control group we examined 41 pregnant women, who did not differ from the comparison group by clinical and demographic characteristics, but with delivery in term of 37-40 weeks.
Results. In women with term pregnancy placental lactogen was 14.64 mg / ml and it was higher than the same indicator of post-term pregnancy (10.31 mg / ml). Reducing placental lactogen leads to a decrease in biosynthetic processes and growth retardation. In women of term pregnancy we found increased levels of estriol – 12.11 ng / ml at the end of gestational period, compared with prolonged pregnancy group (7.16 ng / ml), which corresponds to our concepts of the post-term pregnancy pathogenic features formation – lack of estriol level increasing before the start of delivery. The examination of the control group women showed a strong increase of progesterone – 158.79 ng / ml, while in the group of post-term pregnancy this index was almost 2 times less – 85.83 ng / ml. In women of term pregnancy group marked increase cortisol level before delivery was observed to 36.11 nmol / ml, more than the same indicator of post-term pregnancy (29.25 nmol / ml). Increased stress hormone cortisol indicates the hypothalamus-pituitary- adrenal cortex system activation for childbirth preparation.
Conclusions. There is a statistically significant decrease in hormones of the fetoplacental complex in prolonged pregnancy compared to the control group: cortisol - 19 % (р<0.05), placental lactogen – 30 % (р<0.05), estriol – 41 % (р<0.08) and progesterone - 46 % (р<0.05), which leads to the pathological hormonal background formation corresponding to prolonged pregnancy and is characterized by placental dysfunction in this category of pregnant women.
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