Objective. To determine the clinical and metabolic changes in children born from mothers with gestational diabetes mellitus and to predict perinatal injury of the central nervous system (CNS), taking into account the level of maternal hyperglycemia.Material and methods. The period of early postnatal adaptation was analyzed in 258 full-term infants, who were divided into two groups, depending on the glucose level in the mother’s venous blood during pregnancy: Group 1: 5,1–5,6 mmol/L, Group 2: 5,7–7,0 mmol/L.Results. Based on clinical, functional and laboratory markers (electrolyte balance and carbohydrate metabolism in the blood of a newborn) there was established a correlation between the severity of maternal hyperglycemia and the severity of neonatal disorders. In Group II infants born from mothers with more severe hyperglycemia are more likely to have a respiratory distress syndrome and ischemic-hypoxic injury of the central nervous system in combination with excess birth weight which significantly complicates postnatal adaptation.Conclusion. The concentration of neuron-specific enolase of 4,9 ng/ml in the fetal amniotic fluid is an antenatal marker of perinatal damage to the central nervous system in a newborn.
The article presents organization of three-level system of obstetrics service in rural region with large territory and lower population density (the Altai Krai) in actual conditions. The dynamic analysis of indices of maternal and perinatal mortality in 2007-2016 was implemented on the basis of evaluation of efficiency of implemented innovative informative technology "The Register of Pregnant Women". The priority directions of functioning of service are family planning and reproductive health care, safe maternity, perinatal care of fetus and newborn.
The aim of this study was to determine reference values of matrix metalloproteinase-1 (MMP-1), MMP-2, MMP-9 and tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) in the amniotic fluid at the first stage of labor in physiological pregnancy. 89 women at the first stage of term labor have been examined. Samples of amniotic fluid were taken at the first period of labor by vaginal amniotomy. Concentrations ofMMP-1, MMP-2, MMP-9, and TIMP-1 were investigated in amniotic fluid by ELISA kits. We have determined normal concentration ranges for MMP-1, MMP-2, MMP-9, TIMP-1, and ratios of concentrations of MMPs and TIMP-1 (MMP-1/TIMP-1, MMP-2/TIMP-1, MMP-9/TIMP-1) in the amniotic fluid at the first period of labor in physiological pregnancy. These included: MMP-1 - 5.1-16.8 pg/mg of protein, MMP-2 - 238.3-374.1 pg/mg of protein, MMP-9 - 66.1-113.3 pg/mg of protein, TIMP-1 - 4.7-13.6 pg/mg of protein, ratio of MMP-1/TIMP-1 - 0.1-2.2, ratio of MMP-2/TIMP-1 - 19.9-55.7, ratio of MMP-9/TIMP-1 - 4.2-17.2.
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