Features of the course of pregnancy and childbirth in women with syndrome of undifferentiated connective tissue dysplasia

Смирнова, Т. Л.; Герасимова, Л И; Sidorov, Anatoliy E.; Chernyshov, V. V.; Gubanova, E. A.

doi:10.32000/2072-1757-2018-16-6-39-44

Cited by 8 publications

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“…З огляду на генетичну детермінованість захворювання увага науковців останніми роками концентрується на дослідженні акушерських і неонатальних ускладнень, асоційованих з НДСТ у породілей [1,8,14,22,28]. За даними літератури, поширеність некласифікованих проявів сполучнотканинної дисплазії серед жінок фертильного віку в окремих випадках сягає 80% [8,18,21,23]. На сьогодні з'ясовано, що через надзвичайну поширеність сполучної тканини в організмі наявність її дисфункції у вагітної не лише створює несприятливі умови для внутрішньоутробного розвитку плода, але й зумовлює системність його ураження [4,8,14,22,24,28].…”

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The level of serum matrix metalloproteinase-1 and tissue inhibitor of matrix metalloproteinase-1 in newborns from mothers with undifferentiated connective tissue dysplasia

Chumak,

Volokha

2024

UJPP

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Laboratory markers of undifferentiated connective tissue dysplasia (UCTD) are indicators of the matrix metalloproteinases (MMP) system, which are involved in the remodeling of connective tissue components, morphogenesis, inflammation. Purpose - to analyze the correlation between signs of UCTD in postpartum women and the level of serum MMP-1, tissue inhibitor of MMP-1 (TIMP-1) and the MMP-1/TIMP-1 ratio in newborns. Materials and methods. We examined 122 women in labor and their 122 newborn children with a gestational age (GA) of 28-42 weeks, a body weight (BW) of 1270-4070 g. Clinical and anamnestic data and biochemical markers (level of serum MMP-1, TIMP-1, MMP-1/TIMP-1) were investigated in children. Clinical signs of UCTD in women in labor were registered. The main group (n=82) involved women with ≥3 UCTD markers, the control group (n=40) consisted of women with ≤2 UCTD features and their newborns. Accordingly, the main group of newborns - children from mothers with ≥3 markers of UCTD, the control group - babies from mothers with ≤2 signs of UCTD. For statistical analysis, Mann-Whitney (U) test and Cramer’s coefficient (φc) were used. Results. Newborns of the main group had a longer GA (U=1069.5; p=0.002), a lower Apgar score (U=1522.5; p=0.04), a smaller weight-for-age ratio (U=1511.0; p=0.038), higher concentrations of MMP-1 (U=55.0; p=0.000013) and higher values of the MMP-1/TIMP-1 (U=76.0; p=0.000323). The optimal range of MMP-1 in newborns is 2.72-3.91 ng/ml, TIMP-1 - 16.08-17.49 ng/ml, MMP-1/TIMP-1 - 0.16-0.24. MMP-1 concentration ranges ≥4.51 ng/ml and MMP-1/TIMP-1 values ≥0.31 were more typical for full-term infants (p<0.01) than prematurely born, and for children with lower BW (p<0.01). UCTD-associated obstetric complications were related to ranges of MMP-1 ≥4.51 ng/ml (p<0.001-0.05), TIMP-1 ≤16.07 ng/ml (p<0.05), MMP-1/TIMP-1 ≥0.31 (p<0.001-0.05) in children. Conclusions. UCTD in parturient mothers is an unfavorable factor in the formation of small weight-for-age ratio (p=0.038), a low postnatal adaptation (p=0.04), imbalance of serum MMP-1 (p=0.000013) and MMP-1/TIMP-1 (p=0.000323) in children. The optimal level of serum MMP-1 for newborns is 2.72-3.91 ng/ml, TIMP-1 - 16.08-17.49 ng/ml, MMP-1/TIMP-1 - 0.16-0.24. The values of MMP-1 ≥4.51 ng/ml and MMP-1/TIMP-1 ≥0.31 are markers of delayed physical development of the fetus (p<0.01). UCTD-associated obstetric complications are prognostically unfavorable for imbalance of MMP-1, TIMP-1, MMP-1/TIMP-1 in newborns. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an institution. The informed consent to participate in the study was obtained from each mother. No conflict of interests was declared by the authors.

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Section: вступunclassified

The level of serum matrix metalloproteinase-1 and tissue inhibitor of matrix metalloproteinase-1 in newborns from mothers with undifferentiated connective tissue dysplasia

Chumak,

Volokha

2024

UJPP

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“…), which complicate the course of pregnancy [7][8][9]. The prevalence of mitral valve prolapse (MVP) predominant in female patients, and its negative impact on myocardial contractility and frequent combination with cardiac arrhythmias and conduction can predict the adverse effects on pregnancy, childbirth in women and the development of the fetus [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Correction of Cardio-hemodynamics and Endothelial Function Disorders in Pregnant Women with Connective Tissue Dysplasia

Dobrianska¹,

Heryak²,

Shve³

2022

Act Sci wom hea

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Objectives:The negative impact of undifferentiated connective tissue dysplasia (UCTD) in myocardial contractility and endothelial microvascular dysfunction and their frequent combination with cardiac arrhythmias suggests an unfavorable course to pregnancy and childbirth due to the formation of uteroplacental dysfunction. The Aim of the Study:To reduce the incidence of obstetric complications in pregnants with UCTD by carnitine-arginine complex.Materials and Methods: There were examined 58 pregnants with UCTD, including mitral valve prolaps with and without frequent extrasystoles, and 14 pregnants of control group. Metabolic support by intravenous infusion of L-arginine and L-carnitine complex.Results: There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction and significantly more often diagnosed with obstetrics complications in pregnant women with MVP and extrasystolic arrhythmia on the background of UCTD. There was a significant reduction of arrhythmias in patients with MVP and frequent ventricular (90.6%) or mixed extrasystoles (77.8%) under the influence of complex drug treatment with L-arginine and L-carnitine. Conclusion:There are violations of morpho-functional parameters of the heart with the development of moderate systolic-diastolic myocardial dysfunction and endothelial microvascular dysfunction, which are triggers of complicated pregnancy and childbirth in pregnant women with MVP and extrasystolic arrhythmia on the background of UCTD in the initial state. The inclusion of L-arginine and L-carnitine led to a significant improvement in the parameters of central cardiohemodynamics and restoration of endothelial function of microvessels and pregnancy complications.

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“…Lesions of the cardiovascular system are very diverse: mitral valve prolapse (the most common of all cardiac anomalies in CTD is usually detected by echocardiography), venous insufficiency, varicose veins, and hemostasis pathologies [7].Diagnosis of uCDT is based on these symptoms and additional findings (e.g., anthropometry, external respiration, reduced heart size, decreased blood pressure, plethysmography, specific characteristics of ECG and ultrasound phleboscanning)[10]. According to the analysis of these phenotypic markers of uCDT, its prevalence may be relatively high in the general population (e.g., 8.5% in a sample of 400 people[9]). Although it is often stated that the etiology of DST has a genetic component, an exhaustive analysis of the relative roles of environmental factors (nutrition, environmental conditions, movement hygiene, psychoemotional background) and genetic factors has not been carried out.…”

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confidence: 99%

Debatable Issues of Pathological Course of Pregnancy and Childbirth in Connective Tissue Dysplasia

D.R.,

G.Z,

Z.M.

2024

ajsshr

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The main function of CT is to provide structural support to other tissues. Cartilage and bone are the main types of connective tissue, other types include areolar connective tissue, which holds organs together, and dense connective tissue, which forms ligaments and tendons. We examined 47 pregnant women with uCDT and 15 healthy pregnant women without uCDT aged 24-30 years. The threat of termination of pregnancy occurred in 50% of women with uCDT, and the threat of preterm birth was observed 6 times more often than in healthy pregnant women. Thus, pregnant women with signs of various forms of uCDT belong to high-risk groups of obstetric and perinatal pathology, and therefore they need close monitoring during pregnancy, childbirth and the postpartum period, and it is also necessary to examine newborns who have a high probability of inheriting this disease.

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Features of the course of pregnancy and childbirth in women with syndrome of undifferentiated connective tissue dysplasia

Cited by 8 publications

References 0 publications

The level of serum matrix metalloproteinase-1 and tissue inhibitor of matrix metalloproteinase-1 in newborns from mothers with undifferentiated connective tissue dysplasia

The level of serum matrix metalloproteinase-1 and tissue inhibitor of matrix metalloproteinase-1 in newborns from mothers with undifferentiated connective tissue dysplasia

Correction of Cardio-hemodynamics and Endothelial Function Disorders in Pregnant Women with Connective Tissue Dysplasia

Debatable Issues of Pathological Course of Pregnancy and Childbirth in Connective Tissue Dysplasia

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