FEATURES OF CYTOKINE REGULATION AND HEMODYNAMIC INDICES IN THE CERVIX BEFORE PHYSIOLOGICAL LABOUR
DOI:
https://doi.org/10.11603/24116-4944.2020.2.11861Keywords:
mature cervix, cytokines, cervical hemodynamicAbstract
The aim of the study – to learn the features of immunological regulation and hemodynamic characteristics of the cervix in preparation for physiological labour.
Materials and Methods. We examined 75 pregnant women at 38–40 weeks of gestation. General clinical studies, immunological studies – determination of serum concentration of cytokines IL-6, IL-1β and TNF-α, ultrasound and Doppler studies – determination of hemodynamic parameters in the common uterine artery in the descending and ascending sections, in the arteries and veins of the cervical stroma and in the isthmus, the resistance index (IR) and the systolic-diastolic ratio (SDR) were measured, for venous vessels – the average venous velocity (V mean).
Results and Discussion. Evaluation of the nature of production of the main cytokines involved in preparing for the labour (IL-1β, IL-6 and TNF-α) showed high concentrations of the studied proinflammatory cytokines in the blood serum of pregnant women with a mature cervix before the labour compared with women with insufficiently mature cervix. The results of the study of the main indicators of cervical hemodynamic in pregnant women of the studied groups showed significant differences in the indices of vascular resistance in the cervix vessels. A direct correlation (r=0.78) was revealed between the content of the studied cytokines and the levels of peripheral vascular resistance indices of the descending and ascending parts of the common uterine artery, as well as indicators of hemodynamic in the vessels of the cervical stroma. Such a relationship may demonstrate the important immunoregulatory effect of cytokines during pregnancy on the processes of vascularization and blood supply in the uterine vessels at the end of pregnancy.
Conclusions. The process of preparing for the labour is associated with immunological restructuring, which is characterized by a change in the systemic content of cytokines and is associated with an increase in the hemodynamics of the cervix. An integrated approach to the study of the features of various pathogenetic options for ensuring the readiness of a pregnant woman᾽s body for labour will make it possible to form objective approaches to the issues of predicting the effectiveness of induction and pre-induction of labour, as well as the occurrence of abnormalities of labour.
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