Normal ve Sezeyan Doğumlarda Maternal ve Umbinikal Kordon Karnında Endotelin-1 Düzeyleri

Abstract

Amaç: Spontan vajinal doğumlar ve sezeryan doğumlarda maternal ve umbilikal kordon kanında endotelin-1 düzeyini ölçmek. Gereç ve Yöntem: hastanemize doğum yapmak üzere başvuran toplam 37 kadından doğum sırasında maternal ve umbilikal kordon kanı alındı. Hipertansif, preeklamptik, erken membran rüptürü olan, diyabetik, kalp hastası kadınlar çalışma dışı bırakıldı. 37. haftadan önce doğum yapmış kadınlar preterm, 37 hafta ve sonrasında doğum yapmışlar term kabul edildi. Sezeryan olan kadınların hiçbiri ameliyat öncesi travay çekmedi. Normal term (n=17), preterm (n=4) ve sezeryan (n=16) doğumlarda maternal ve umbilikal kordon kanı endotelin-1 düzeyleri karşılaştırıldı. programında, Kruskal-Wallis varyans ve Mann-Whitney U testleri kullanılarak yapıldı. P<0,05 istatistiksel olarak anlamlı kabul edildi

Keywords

• Endotelin-1
• vajinal doğum
• sezeryan
• preterm doğum

Abstract

Aim: To measured endothelin-1 levels of maternal and umbilical cord blood plasma in normal spontaneous vaginal delivery and cesarean sections. Material and Methods: Maternal and umbilical cord blood plasma were taken from 37 pregnant women who admitted to our hospital during year 2003 for delivery to measure endothelin-1 levels. Women who have hypertension, preeclampsia, heart disease, diabetes were excluded from study. Women who delivered before 37 weeks of gestation were accepted as preterm and women who delivered in or after 37 weeks of gestation were accepted as term. None of the women in cesarean group had labour before operation. Normal vaginal term (n=17), preterm (n=4) and cesarean (n=16) delivery groups were compared for maternal and umbilical cord blood plasma endothelin-1 levels. Statistical analysis were performed in SPSS for windows version 10.0 using Kruskal-Wallis variance and Mann-Whitney U test. P<0,05 was considered statisticaly significant. Results: Maternal and umbilical cord blood plasma endothelin-1 levels were higher in normal vaginal delivery group, when compared to cesarean group, although it didn’t reach statisticaly significant level (1.37 ± 0,69 versus 1,11 ± 0,3 pg/ml in maternal blood, 3.9 ± 1,8 versus 3,7 ± 2,4 pg/ml in umbilical cord)(p>0,05). In preterm delivery group, maternal blood plasma endothelin-1 level was higher than cesarean group and was lower than term vaginal delivery group (1,15 ± 0,24). Conclusion: Higher endothelin-1 levels in vaginal delivery group (term or preterm) when compared to cesarean group shows that endothelin-1 may play a role in beginning uterine contractions in pregnant women. Key words: Endothelin-1, vaginal delivery, cesarean, preterm delivery

Keywords

• Endothelin-1
• vaginal delivery
• cesarean
• preterm delivery.

References

1. Malendowicz LK, Nussdorfer GG, Meneghelli V ve ark. Effects of endothelin-1 on the rat pituitary- adrenocortical axis under basal and stressful conditions. Endocr Res 1997; 23(4):349-64.
2. Kiefer F, Kellner M, Jahn H ve ark. Comparison of the effects of endothelin-1 and -3 on secretion of pituitary hormones in healthy male volunteers. Exp Clin Endocrinol Diabetes 2000;108(5): 378-81.
3. Challis JR, Smith SK. Fetal endocrine signals and preterm labor. Biol Neonate 2001; 79(3-4):163-7.
4. Maggi M, Vannelli GB, Fantoni G ve ark. Endothelin in the human uterus during pregnancy. J Endocrinol 1994; 142(3):385-96.
5. Dotsch J, Hogen N, Nyul Z ve ark. Increase of endothelial nitric oxide synthase and endothelin-1 mRNA expression in human placenta during gestation. Eur J Obstet Gynecol Reprod Biol 2001;97(2):163-7
6. Hasegawa M, Sagawa N, Itoh H ve ark. Endothelin receptors in human amnion, chorion laeve, decidua vera and placenta. Reprod Fertil Dev 1995; 7(6):1585-9.
7. Carbonne B, Mignot TM, Tsatsaris V ve ark. Changes in plasma and amniotic fluid endothelin levels during pregnancy: facts or artefacts? Eur J Obstet Gynecol Reprod Biol 1998;76(1):15-9.
8. Taguchi M, Kubota T, Hirata Y ve ark. Levels of endothelin-1 in maternal and cord plasma during pregnancy and delivery. Nippon Sanka Fujinka Gakkai Zasshi 1991; 43(4): 405-9.

9. Wolff K, Nisell H, Modin A ve ark. Contractile effects of endothelin 1 and endothelin 3 on myometrium and small intramyometrial arteries of pregnant women at term. Gynecol Obstet Invest 1993;36(3).166-71.
10. Svane D, Larsson B, Alm P ve ark. Endothelin-1 : immunocytochemistry, localization of binding sites, and contractile effects in human uteroplacental smooth muscle. Am J Obstet Gynecol 1993;168(1):233-41.
11. Dallot E, Pouchelet M, Gouhier N ve ark. Contraction of cultured human uterine smooth muscle cells after stimulation with endothelin-1. Biol Reprod 2003; 68(3):937-42.
12. Osada K, Tsunoda H, Miyauchi T ve ark. Pregnancy increases ET-1 induced contraction and changes receptor subtypes in uterine smooth muscle in humans. Am J Physiol 1997; 272(2Pt2): R541-8
13. Taylor RN, Varma M, Tengh NNH ve ark. Women with preeclampsia have higher plasma endothelin levels than women with normal pregnancies. J Clin Endocrinol Metab 1990; 71:1675-7.
14. Arslan M, Yazici G, Erdem A ve ark. Endothelin 1 and leptin in the pathophysiology of intrauterine growth restriction. Int J Gyneacol Obstet 2004; 84(2):120-6.
15. Iwata I, Takagi T, Yamaji K ve ark. Increase in the concentration of immureactive endothelin in human pregnancy. J Endocrinol 1991; 129: 301-7.
16. Usuki S, Saitoh T, Sawamura T ve ark. Increased maternal plasma concentration of endothelin-1 during labor pain or on delivery and the existence of a large amount of endothelin-1 in amniotic fluid. Gynecol Endocrinol 1990;4:85-97.
17. Haram K, Mortensen JH, Wollen AL. Preterm delivery: an overview. Acta Obstet Gynecol Scand 2003; 82: 687-704
18. Challis JR, Sloboda DM, Alfaidy N ve ark. Prostoglandins and mechanism of preterm birth. Reproduction 2002; 124: 1-17
19. Hakkinen LM, Vuolteenaho OJ, Leppaluoto JP ve ark. Endothelin in maternal and umbilical cord blood in spontaneous labor and at elective cesarean delivery. Obstet Gynecol 1992; 80(1):72-5.