Diagnostic significance of carboxyhemoglobin (CoHb) among older primapara

Аннотация

A change of the level of (CoHb) in blood of pregnant women is one of the factors of obstetrics and perinatal complications. Influence of CoHb level on the emergence of fetoplacental deficiency was proved in experiments on the chronic hypoxia model (Nazyrov A.T., Israilova M.Z.).

Полный текст

Objective: The objective of the research was to study the content of CoHb in the blood of pregnant women as one of the factors of obstetrics and perinatal complications.

Methods: We determined CoHb content in the blood of pregnant women by means of the spectrophotometry methods during the second and third trimester of pregnancy. The study covers 90 older primapara.

Results: We found out that the value of CoHb content among older primapara increased by 36% (p<0,001) in the first trimester, by 92% in the second trimester and there was a 2,5 — fold increase in the third trimester.

The research shows that the rise in the intensity of endogenic CoHb production in the blood has led to considerable disorders of metabolism during glycolysis.

The increase of CoHb (p<0,001) led to the increase lactic acid both in the mother’s and fetus’ organism; changes in the lactate content correlate (r=0,77) with changes in umbilical blood. The research into concentration of substrates in placenta tissue shows that the lactate content went up by 48% (p<0,001), pyruvate concentration increased simultaneously wish lactate level. The correlation ratio was (r=0,70).

Probably, the increase of the level of these substrates coming from the fetus is linced with activation of adaptation reactions in placenta.

Later this leads to the increase of concentration intermediate metabolites Krebs cycle: isocytrate by 83% (p<0,001), valate by 31% (p<0,05), PHEP - by 56% (p<0,05).

Conclusions: This the increase endogenic CoHb in the blood of older primapara has led to anaerdisation of metabolism caused by the decrease of oxygen content, acidosis, increase of substrate concentration, which is of compensatory-adaptive character and is an indicator of excessive exertion of adaptive capabilities of placenta and a threat to the fetus.