E. Romejko

Second trimester calcium-phosphorus-magnesium homeostasis in women with threatened preterm delivery

Objective: The effect of threatened preterm delivery on calcium, phosphorus, magnesium homeostasis in the second trimester of pregnancy was investigated. Methods: Serum concentrations of total and ionized calcium, inorganic phosphorus, magnesium, total protein, albumin, total estrogens and human placental lactogen were determined in women with threatened preterm delivery at 23–28 weeks of gestation (the studied group) and in women with uncomplicated pregnancy of the same duration (the control group). Additionally activities of total alkaline phosphatase and heat‐stable alkaline phosphatase fraction were measured. Results: Patients of the studied group compared to the control group showed decreased concentration of total calcium (2.15±0.073 vs. 2.25±0.11 mmol/l, P<0.001), inorganic phosphorus (1.21±0.26 vs. 1.34±0.22 mmol/l, P<0.01) and magnesium (0.63±0.053 vs. 0.71±0.12 mmol/l, P<0.001), total protein (64.0±5.4 vs. 68.6±1.0 g/l, P<0.001), albumin (546.3±55.1 vs. 579.6±49.3 μmol/l, P<0.003) and placental lactogen (3664±1806 vs. 4651±1858 ng/ml, P<0.02); they also demonstrated decreased activity of total alkaline phosphatase (42.17±16.99 vs. 50.66±6.56 IU/l, P<0.001) and its heat stable fraction (22.65±7.89 vs. 31.89±9.09 IU/l, P<0.001). Patients of the studied group showed normal values of ionized calcium and total estrogens. Conclusions: Premature uterine contractility in women in the second trimester is accompanied by lowered serum concentrations of total calcium, inorganic phosphorus, magnesium, total protein and albumin. There is also decreased activity of total alkaline phosphatase, its heat‐stable fraction and placental lactogen which may have diagnostic value. Premature uterine contractility in women in the second trimester may be related to the disturbances of calcium‐phosphorus‐magnesium homeostasis and calcium supplementation should be considered.

Calcium‐phosphorus‐magnesium homeostasis in women with threatened preterm delivery

Objective: The effect of threatened preterm delivery on calcium, phosphorus, magnesium homeostasis in the third trimester of pregnancy was investigated. Methods: Serum concentrations of total and ionized calcium, inorganic phosphorus, magnesium, total protein, albumin, total estrogens and human placental lactogen were determined in women with threatened preterm delivery at 29–36 weeks of gestation (the studied group) and in women with uncomplicated pregnancy of the same duration (the control group). Additionally, activities of total alkaline phosphatase and heat‐stable alkaline phosphatase fraction were measured. Results: Patients of the studied group compared to the control group showed decreased concentration of total calcium (2.17 ± 0.09 vs. 2.28 ± 0.13 mmol/l, P < 0.0005), inorganic phosphorus (1.13 ± 0.27 vs. 1.32 ± 0.23 mmol/l, P < 0.001) and magnesium (0.64 ± 0.07 vs. 0.70 ± 0.10 mmol/l, P < 0.003); they also demonstrated decreased activity of total alkaline phosphatase (70.8 ± 23.2 vs. 81.9 ± 14.9 IU/l, P < 0.01) and its heat‐stable fraction (30.2 ± 15.6 vs. 59.6 ± 14.9 IU/l, P < 0.001). In the studied group no difference was found in concentrations of investigated ions and enzymes between women who delivered at term and women who delivered prematurely. Patients with threatened preterm delivery showed serum deficiency of total calcium, phosphorus and magnesium which might be related to premature uterine contractility but does not predict premature labor by week 36 of gestation (66% of patients delivered at term). Conclusion: The deficiency of minerals and lowered activity of total alkaline phosphatase is observed in women with threatened preterm delivery. Laboratory tests of calcium‐phosphorus‐magnesium homeostatsis have limited predictive value in regard to the term of delivery in women with threatened preterm delivery.

Magnesium, calcium, phosphorus and renal function in pregnant women with chronic renal diseases and proteinuria

kPa, p<O.O5; base excess -2.97eO.34 vs. -1.8e1.2 mmol/L, p<O.OOl, standard HCO,~ 21.5?0.99 vs. 23.Oe1.2 mmol/L, p<O.OOl; total CO, 22.2k1.23 vs. 22.8e1.8 mm&L, NS. Conclusions: There were marked disturbances in calcium-phosphorusmagnesium homeostasis observed in women with preeclampsia caused due to renal function impairment: hypomagnesemia, hypocalcemia, hyperphosphatemia, hypermagnesiuria, hypocalciuria.

P3.12.06 Osmolarity and microalbuminuria in the course of intrahepatic cholestasis in pregnancy

are the infections of the uterus and the primary hemorrhage (total of 7 cases 60%), in the group of the hysterectomies after vaginal delivery, the main indications are the primary hemorrhage and the rupture of the uterus (3 cases 80%). Until 1995 there have been done 6 hysterectomies and during the second period4 hysterectomies. It is obvious from the table that this reduction is mainly due to the Cesarean hysterectomies 3 cases, compared to the 2 cases during the second period.

P3.12.02 Activity of lactic dehydrogenase (LDH), creatine kinase (CK) and gamma-glutamylotransferase (γGT) in the course of intrahepatic cholestasis in pregnancy

Results: There were 63853 childbirths in period of 15 years. Abruptio placentae occurred in 465 (0,737) D cases. In 38 cases or 8,6% abruptio placentae were associated with severe form of EPH Gestosis what mean that frequency rate is 11 time greater than in other pregnancies. Deliveries in 52,5% of cases with abruptio placentae and gestosis was finished with SC. 129 (28,01%) fetuses were dead before admitting in hospital. The mean age of the patient with this condition was 28,2 years. Conclusion: The analysis of data on our material is in conformity with results of other authors. Prognosis for mother and newborn depends on establishing diagnosis on time and appropriate therapy of EPH Gestosis. The severe forms of EPH Gestosis with abruptio placentae demanded urgent finishing of delivery and very often expose to danger life of mother and caused the dead of fetus.

P3.17.05 Hormonal changes and their influence on lipids metabolism in physiological pregnancy

Objective: The aim of the study was to investigate the influence of total estrogens, human placental lactogen, estradiol and prolactine on lipids’ metabolism in physiological pregnancy. Methods: One hundred thirty-six women in the third trimester (36.1e3.4 weeks) of the physiological pregnancy entered the study. The following serum parameters were measured: total lipids, total LDL fraction, total cholesterol, free cholesterol, phospholipids, triglicerides, HDLcholesterol, LDL-cholesterol, total estrogens, human placental lactogen, estradiol, prolactine. Methods generally accepted in clinical biochemistry were used. The statistical analysis and correlation were performed. Results: The following results were obtained: total estrogens and human placental lactogen create an increased of serum concentrations of: total lipids (p<O.OOl), total LDL fraction (p<O.OOl), phospholipids (p<O.OOl) and triglicerides (p<O.OOl) while total cholesterol, free cholesterol, HDL-cholesterol and LDL-cholesterol remain unchanged. Prolactine lowers the serum concentration of LDL-cholesterol (p<O.Ol) and does not alter any other of the lipids. Estradiol does not influence lipids’ metabolism. Conclusions: The elevated concentrations of lipids in women with physiological pregnancy are related to an increase of total estrogens and human placental lactogen. Prolactin has little effect on lipids also does not alter estradiol levels. This may suggest that the increase of the lipids’ concentration in physiological pregnancy might be related mainly to estradiol activity.

P3.17.06 Hormonal changes and their influence on lipids metabolism in the pregnancy complicated with primary hypertension

Objective: The aim of the study was to investigate the influence of total estrogens, human placental lactogen, estradiol and prolactine on lipids’ metabolism in physiological pregnancy. Methods: One hundred thirty-six women in the third trimester (36.1e3.4 weeks) of the physiological pregnancy entered the study. The following serum parameters were measured: total lipids, total LDL fraction, total cholesterol, free cholesterol, phospholipids, triglicerides, HDLcholesterol, LDL-cholesterol, total estrogens, human placental lactogen, estradiol, prolactine. Methods generally accepted in clinical biochemistry were used. The statistical analysis and correlation were performed. Results: The following results were obtained: total estrogens and human placental lactogen create an increased of serum concentrations of: total lipids (p<O.OOl), total LDL fraction (p<O.OOl), phospholipids (p<O.OOl) and triglicerides (p<O.OOl) while total cholesterol, free cholesterol, HDL-cholesterol and LDL-cholesterol remain unchanged. Prolactine lowers the serum concentration of LDL-cholesterol (p<O.Ol) and does not alter any other of the lipids. Estradiol does not influence lipids’ metabolism. Conclusions: The elevated concentrations of lipids in women with physiological pregnancy are related to an increase of total estrogens and human placental lactogen. Prolactin has little effect on lipids also does not alter estradiol levels. This may suggest that the increase of the lipids’ concentration in physiological pregnancy might be related mainly to estradiol activity.