FEATURES OF THE CATECHOLAMINES EXCHANGE IN WOMEN WITH PREMATURE BIRTH IN DIFFERENT TERMS OF GESTATION

Korovay S. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Preterm labor is an urgent medical-social and demographic issue at the present stage. The frequency of this pathology varies in the range of 10-30% with the absence of a tendency to decrease. Pathogenesis of thepremature abortion development is quite complicated and has a multifactorial nature. It stimulates specialists on its deep study in order to determine the effective complex of treatment and prevention measures for reproductive loss prevention and development of complications in the further. Catecholamines take an important place in the processes of compensatory and adaptive nature, which are necessary for ensuring the normal course of pregnancy and woman’s body preparing for childbirth. In addition, these physiologically active substances provide the pregnant woman’s body of energy sources, which are responsible for a number of metabolic and hemodynamic changes occurring during pregnancy. It has been shown that the level of dopamine, norepinephrine, epinephrine and their precursor dioksiphenylalanine (DOPA) in a daily urine is a mirror image of their blood content. Thus, the study of the peculiarities of the catecholamines exchange by determining the level of their excretion with daily urine in women with different periods of abortion had been the study goal. 227 pregnant women were examined, 190 among them have 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 childbirth. The criteria for including of 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 according to the bioethics principles. The results obtained have been statistically processed with using Licensed Standardized Applications for Multivariate Statistical Analysis of Statistica 6.1. The comparison of the indices in the groups was carried out by using the non-parametric Mann-Whitney test. The functional activity decreasing and sympathoadrenal system reserve ability occurs in women with preterm labor in the period of 23-36 weeks in relation to women with a physiological course of pregnancy, which ended with childbirth without complications in the period of 38-41 weeks. This indicates a adaptation mechanisms failure that are preserving pregnancy aimed. The disruption of the catecholamines exchange is characterized by acceleration of synthesis at the stage of DOPA-dopamine, a considerable decreasing of norepinephrine and epinephrine synthesis and secretion, excess of the nervous component activity over the hormonal one of the sympathoadrenal system in women with early premature pregnancy, which ended in childbirth period from 23 to 27 weeks, while comparing with physiological course of pregnancy. The disruption of the catecholamines exchange is characterized by acceleration of the dopamine and norepinephrine synthesis and secretion intensity, inhibition of synthesis at the stage of norepinephrine-epinephrine, excess of the hormonal component activity over the nervous system one of the sympathoadrenal system in women with late premature pregnancy, which ended in childbirth in the period from 28 to 36 weeks. Thus, compensatory and adaptive pregnancy mechanisms are a complex of neurohumoral process, which are realized through monoaminergic systems, the destabilization of which is important factor in its interruption. According to the obtained results, the tension of the neuroendocrine regulation with the development of the compensatory-adaptive reactions disruption occurs in pregnant women with the threat of premature birth. This is confirmed by the changes dynamics in the content of catecholamines – dopamine, norepinephrine, epinephrine and their precursor DOPA. Reducing the activity and reserve capacity of the sympathoadrenal system in pregnant women may be a pathogenetic factor in the development of preterm labor. Therefore timely determination of the initial manifestations of imbalance in the exchange of catecholamines may possibly prevent the loss of pregnancy in the early stages.

premature birth, catecholamines, norepinephrine, epinephrine, dopamine, sympathoadrenal system

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 144-149 pages, index UDK 577.122.38:[577.175.82:577,175,5].86,6:618,39-092

10.29254/2077–4214–2017–4–3–141–144-149