Krasovs’ka O. V., Lakatosh V. P., Antoniuk M. I., Lakatosh P. V., Kostenko O. Y.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The single umbilical artery (SUA) is considered as an independent risk factor for chromosomal abnormalities and fetal malformations. Measurement of certain biochemical markers such as chorionic gonadotrophin (β-HG), its free β-subunit, protein associated with pregnancy (RARR-A), alpha-fetoprotein (AFP), free estriol and placental lactogen (PL), can timely identify certain fetal malformations associated with chromosomal or gestational dysbryogenesis. The article presents comparison data of estimation of some biochemical markers of pregnancy during pregnancy with SUA of a fetus and during pregnancy with two umbilical arteries and physiological births. The purpose of the study is to identify the features of some biochemical markers of pregnancy in pregnant women with a single umbilical artery of the fetus. Object and methods of research – 31 pregnant women with a single umbilical artery of the fetus (study group), 62 pregnant women with 2 umbilical cord blood arteries (control group). In both groups, the following indices were compared: free β-subunit HG, PARR-A in the 12-13 week period, β-HG, free estriol and alpha-fetoprotein (AFP) in the 17-18 week period, and placental lactogen (PL) on different terms of the 3rd trimester of pregnancy. Results of the study and their discussion. It has been established that among pregnant women with SUA there is a significant percentage of pregnancies (26.8%) with increased rates of PURR-A in the period of 12-13 weeks of gestation, which may serve as a marker for the presence of SUA in the early stages of pregnancy. Other biochemical markers of pregnancy did not differ from these indices in pregnant women with two umbilical arteries. Anamnestically, it was found that in pregnant women with EPA and obstetric complications in childbirths, there was a marked lower level of free subunit β-HG in 12-13 weeks of pregnancy compared with SUA pregnant women without such complications. Against the backdrop of a significant percentage of premature births in pregnant women with SUA, the PS level is likely to be lower in EPA pregnant women at 37-38 weeks, and tends to decrease in terms of 33-34 weeks of gestation compared with pregnant women with two umbilical arteries. Fluctuations in blood serum depending on the duration of pregnancy show that with an increase in placental insufficiency, the level of this hormone in the second and third trimesters of pregnancy progressively decreases. Low levels of TB in pregnant women may contribute to limited glucose uptake of the fetus, which in turn reduces the compensation of energy costs that occur when protein synthesis in the body occurs. The latter leads to the FVR. There is also an opinion that, in addition to an anabolic effect, PL has a multiplier effect on the cardiovascular and central nervous system, electrohonorary balance, which is the way to implement adaptive reactions of the mother and the fetus, aimed at the development of pregnancy. Conclusions: 26.8% of pregnant women with SUA have an increase in PURR-A levels at 12-13 weeks of gestation, which means that an increase in PURR-A may serve as a marker for the presence of SUA in the early stages of pregnancy. Pregnant women with EPA have a significantly lower TB level in the 37-38 weeks of pregnancy, which confirms the presence of an SUA pregnant woman, and is accompanied or facilitated by an earlier pregnancy in pregnant women with EPA.

single umbilical artery, biochemical markers of pregnancy, РАРР-A, β- chorionic gonadotropin, free estriol, alpha-fetoprotein, placental lactogen

1. Savel’еva GM, redaktor Akusherstvo: uchebnik. Moskva: Medicina; 2000. 816 s. [in Russian].
2. Peng HH, Wang TH, Chao AS. Prenatal diagnosis of monosomy 4p14–>pter and trisomy 11q25–>qter: clinical presentations and outcomes. Prenat Diagn. 2005 Dec;25(12):1133-7.
3. Hjortebjerg R, Berryman DE, Comisford R. Depot-specific and GH-dependent regulation of IGF binding protein-4, pregnancy-associated plasma protein-A, and stanniocalcin-2 in murine adipose tissue. Growth Horm IGF Res. 2018 Apr;39:54-61.
4. Ananth CV, Wapner RJ, Ananth S, DʼAlton ME, Vintzileos AM. First-Trimester and Second-Trimester Maternal Serum Biomarkers as Predictors of Placental Abruption. Obstet Gynecol. 2017 Mar;129(3):465-72.
5. Lise Huynh, John Kingdom, Sabrina Achtar. Low pregnancy-assosiated plasma protein A level in the first trimestr. Can Fam Physician. 2014 Oct;60(10):899-903.
6. Goto E. Meta-regression analysis to evaluate relationships between maternal blood levels of placentation biomarkers and low delivery weight. Int J Gynaecol Obstet. 2018;3:1002.
7. Cheryl A. Conover and Claus Oxvig. PAPP-A: a promising therapeutic target for healthy longevity. Aging Cell. 2017 Apr;16(2):205-9.
8. Gagarina AV. Placentarnaya nedostatochnost’ pri povyshennom soderzhanii al’fa-fetoproteina i horionicheskogo gonadotropina v krovi beremennyh zhenshchin [avtoreferat]. Sankt-Peterburg: NII ak. i ginek.; 2004. 60 s. [in Russian].
9. Tulek F, Kahraman A, Taskin S, Ozkavukcu E, Soylemez F. The effects of isolated single umbilical artery on first and second trimester aneuploidy screening test parameters. J Matern Fetal Neonatal Med. 2015 Apr;28(6):690-4.
10. Yudaev NA, redaktor. Biohimiya gormonov i gormonal’noj regulyacii. Moskva: 1976. 44 s. [in Russian].
11. Fuchs F, Klopper A, editors. Endocrinology of Pregnancy. Philadelphia: Harper and Row; 1983. p. 247-52.
12. Newnham JP, Lam RW, Hobel CJ, Padbury JF, Polk DH, Fisher DA. Differential response of ovine placental lactogen levels in maternal and fetal circulations following single umbilical artery ligation in fetal sheep. Placenta. 1986 Jan-Feb;7(1):51-64.
13. Sifakis S, Androutsopoulos VP, Pontikaki A. Placental expression of PAPPA, PAPPA-2 and PLAC-1 in pregnacies is associated with FGR. Mol Med Rep. 2018 May;17(5):6435-40. 

«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 128-133 pages, index UDK 616.33:616.38-005 :577.1

10.29254/2077-4214-2019-1-1-148-128-133