Diagnostic capabilities of the biochemical composition of amniotic fluid in assessing fetal conditions

Abstract

Aim. To analyze the nature of changes in the biochemical parameters of amniotic fluid during fetal hypoxia.

Methods. The study was carried out in the maternity ward of the Republican Clinical Hospital named after Kuvatov (Ufa) between January 2016 and September 2018. The main group — 72 women in labor with symptoms of fetal distress, the control group — 70 women in labor without it. The biochemical composition of the amniotic fluid was measured using an analyzer. Statistical analysis was performed by using the Statistica 10.0 software. Comparison of qualitative characteristics was carried out by using Fisher's exact test when comparing quantitative data, the Mann–Whitney test. The statistical significance of the differences was set at p <0.05.

Results. It was found that in fetal distress, there is a decrease in such biochemical indicators of the composition of amniotic fluid as the level of triglycerides (0.2±0.1 and 0.3±0.1 mmol/L, p=0.0036) and cholesterol (0.1±0.16 and 0.3±0.2 mmol/L, p=0.0275), gamma-glutamyl transpeptidase activity (34.5±11 and 48.7±6.8 U/L, p=0.0261), while the level the lactate (in the main group 3.5±1.2 and 3.1±0.9 mmol/L in the control group, p=0.0035), glucose (1.2±0.6 and 0.6±0.3 mmol/L, p=0.0002) and nitrogenous substances such as urea (4.5±1.1 and 3.0±1.3 mmol/L, p=0.0018) increases.

Conclusion. The biochemical composition of amniotic fluid reflects the state of the fetus at birth, and therefore the study of the amniotic fluid is a relevant and accessible method.

Keywords

amniotic fluid / fetal hypoxia / intrauterine hypoxia / biochemical analysis

References

[1] Sаvel'eva G.M., Shаlina R.I., Sichinava L.G., Pаnina O.B., Kurtser M.A. Akusherstvo. (Obstetrics.) M.: GEOTAR-Media. 2018; 576 р. (In Russ.)

[2] Сaвельева Г.М., Шaлина Р.И., Сичинава Л.Г., Пaнина О.Б., Курцер М.А. Акушерство. М.: ­ГЭОТАР-Медиа. 2018; 576 с.

[3] Radzinskii V.E., Fuks A.M. Akusherstvo. (Obstetrics.) M.: GEOTAR-Media. 2016; 1020 р. (In Russ.)

[4] Радзинский В.Е., Фукс А.М. Акушерство. М.: ГЭОТАР-Медиа. 2016; 1020 с.

[5] Акушерство. Национальное руководство. Под ред. Г.М. Савельевой. 2-е изд., перераб. и доп. М.: ГЭОТАР-­Медиа. 2019; 1080 с. [Аkusherstvo. Natsio­nal'noe rukovodstvo. (Obstetrics. National guidelines.) Ed. by G.M. Savel'evoi. Revised and Enlarged 2nd Edition M.: GEOTAR-Media. 2019; 1080 р. (In Russ.)]

[6] Mel'nik E.V., Maloletkina O.L., Shilkina E.V. Biochemical parameters of amniotic fluid in fetal distress during delivery. Zhurnal akusherstva i zhens­kikh bolezney. 2016; (5): 33–40. (In Russ.) DOI: 10.17816/JOWD65533-40.

[7] Мельник Е.В., Малoлеткина О.Л., Шилкина Е.В. Биoхимические параметры oкoлoплодных вод при ди­стрессе плoда в рoдах. Ж. акушерства и женских бoл. 2016; (5): 33–40. DOI: 10.17816/JOWD65533-40.

[8] Sorokina S.E. Vnutrimatochnaya gipoksiya ploda. (Intrauterine fetal hypoxia.) M.: Direkt-Media. 2012; 90 р. (In Russ.) DOI: 10.23681/87304.

[9] Сoрoкина С.Э. Внутриматoчная гипoксия плода. М.: Директ-Медиа. 2012; 90 с. DOI: 10.23681/87304.

[10] Popovtseva A.V., Burkova T.V., Suzopov E.V., Yartsev A.A., Remneva O.V., Korenovskii Yu.V. The concentration of lactate in amnio­tic fluid in delivery under physiological course of pregnancy. Klinicheskaya laboratornaya diagnostika. 2016; 61 (6): 356–358. (In Russ.) DOI: 10.18821/0869-2084-2016-61-6-356-358.

[11] Поповцева А.В., Буркова Т.В., Сузопов Е.В., Ярцев А.А., Ремнёва О.В., Кореновский Ю.В. Концентрация лактата в амниотической жидкости в родах при физиологически протекающей беременности. Клин. лаб. диагностика. 2016; 61 (6): 356–358. DOI: 10.18821/0869-2084-2016-61-6-356-358.

[12] Ginekologiya. Natsio­nal'noe rukovodstvo. (Gynecology. National guidelines.) Ed. by G.M. Savel'evoi. Revised and Enlarged 2nd Edition. M.: GEOTAR-Media. 2017; 1008 р. (In Russ.)

[13] Гинекология. Национальное руководство. Под ред. Г.М. Савельевой. 2-е изд., перераб. и доп. М.: ­ГЭОТАР-Медиа. 2017; 1008 с.

[14] Artyomenko V.V. Diagnostic value of clinical-laboratory research of amnione liquid at the physiological and patholo­gical course of pregnancy. Zdorov'e zhenshchiny. 2013; (5): 87–97. (In Russ.)

[15] Артеменко В.В. Диагностическое значение клинико-лабораторного исследования амниотической жидкости при физиологическом и патологическом течении беременности. Здоровье женщины. 2013; (5): 87–97.

[16] Bebeshko O.I., Khvorostukhina N.F., Kamalyan S.A., Trushina O.V., Gribova S.N. Perinatal outcomes in meconial color of amniotic fluid. Modern problems of science and education. 2017; (5): 72. (In Russ.)

[17] Бебешко О.И., Хворостухина Н.Ф., Камалян С.А., Трушина О.В., Грибова С.Н. Перинатальные исходы при мекониальной окраске околоплодных вод. ­Современные проблемы науки и образования. 2017; (5): 72.

[18] Perepelitsa S.A., Sednev O.V. Pathogenetic role of cholesterol and triglyceride metabolic disturbances in the development of critical conditions. ­Obshchaya reanimatologiya. 2015; 11 (5): 67–74. (In Russ.) DOI: 10.15360/1813-9779-2015-5-67-74.

[19] Перепелица С.А., Седнев О.В. Патогенетическая роль нарушения обмена холестерина и триглицеридов в развитии критических состояний. Общая реаниматол. 2015; 11 (5): 67–74. DOI: 10.15360/1813-9779-2015-5-67-74.

[20] Mochalova M.N., Mudrov V.A., Mudrov A.A. Amniotic fluid composition and its role in perinatal pathology. Zhurnal akusherstva i zhenskikh bolezney. 2019; 68 (2): 95–108. (In Russ.) DOI: 10.17816/JOWD68295-108.

[21] Мочалова М.Н., Мудров В.А., Мудров А.А. Роль состава околоплодных вод в структуре перинатальной патологии. Ж. акушерства и женских бол. 2019; 68 (2): 95–108. DOI: 10.17816/JOWD68295-108.

[22] Combs C.A., Gravett M., Garite T.J., Hickok D.E., Lapidus J., Porreco R., Rael J., Grove T., Morgan T.K., Clewell W., Miller H., Luthy D., Pereira L., Nageotte M., Robilio P.A., Fortunato S., Simhan H., Baxter J.K., Amon E., Franco A., Trofatter K., Heyborne K. Amniotic fluid infection, inflammation, and colonization in preterm labor with intact membranes. Am. J. Obstet. Gynecol. 2014; 210 (2): 125.e1–125.e15. DOI: 10.1016/j.ajog.2013.11.032.

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