Мать и дитя в Кузбассе (May 2020)
NON-SELECTIVE PERMEABILITY OF THE PLACENTAL BARRIER WITH PREMATURE RUPTURE OF THE MEMBRANES AND INTRAUTERINE INFECTION OF THE NEWBORN
Abstract
Purpose of research – determine the relationship of serum markers of fetoplacental barrier permeability in the blood and amniotic fluid of pregnant women with premature rupture of the fetal membranes to identify non-selective permeability in VUI in newborns. Materials and methods. 63 pregnant women with premature rupture of the fetal membranes (PRPO) at 24-33 weeks were examined. 35 women had children without signs of VUI; 28 had severe VUI (early neonatal sepsis, spilled herpes, Chlamydia and Candida infections, pneumonia and meningitis). The content of alpha-2-macroglobulin (α2-MG) in the serum of pregnant women and umbilical cord serum (PS) was determined by quantitative rocket immunoelectrophoresis, in amniotic fluid (OV) – by ELISA, the concentration of albumin (ALB) in SB and PS – by biochemical method, in OV – by quantitative rocket immunoelectrophoresis. Statistical analysis was performed using logistic regression. Results. When a child is born with severe VUI in PRPO, there is a significant increase in the concentration of high-molecular α2-MG (720 kDa) and low-molecular albumin (56 kDa) of serum origin in the amniotic fluid of women who gave birth to children without VUI. At the same time, the serum content of α2-MG in women in labor with severe VUI is sharply reduced, and albumin is comparable to the comparison group. Significant differences in the levels of the studied proteins were not found in the study of PC. Conclusion. The low level of α2-MG (< 2.1 g/l) in blood serum on the background of increased concentrations of α2-MG (≥ 0.01 mg/l) and albumin (≥ 1.6 g/l) in S with premature rupture of membranes, indicate the presence of nonselective permeability of the fetoplacental barrier, including high molecular weight proteins and pathogens, the risk of infectious damage of the placenta and severe generalized IUI fetus and newborn.
