The Features of the Sympathoadrenal System Functional State in Women with Threatening of Pregnancy Prevention

Premature childbirth is an urgent medical-social and demographic problem at the present stage. Multifactorial nature of the premature abortion pathogenesis motivates specialists to study it more deeply in order to determine the effective complex of treatment for the prevention of reproductive losses. A significant number of factors affect the course of pregnancy, the effect of which is realized at the central nervous system level through numerical metabolic interconnections. Sympathoadrenal system provides the pregnant woman body a with energy sources, is responsible for a range of metabolic and hemodynamic changes occurring during pregnancy. Connection of the sympathoadrenal system activity with the development of obstetric complications, including premature births has been demonstrated. The purpose of the study is to examine the peculiarities of the sympathoadrenal system state by determining the level of excretion from the daily urine of DOPA, dopamine, nor-epinephrine and epinephrine in women with different periods of abortion. Materials and Methods. 227 pregnant women were admitted to the Kharkov perinatal center, 190 of them had clinical signs of premature birth in the gestation period of 23-36 weeks. Diagnosis of preterm functional activity decrease was carried out in the presence of abdominal pain syndrome and structural changes in the cervix. Results and Discussion. According to the obtained results, in pregnant women with a threat of preterm birth, the intensity of neuroendocrine regulation of the gestational process arises with the development of compensatory breakdown and adaptive reactions, which is confirmed by the dynamics of changes in the content of the monoamines of the sympathoadrenal system – dopamine, nor-epinephrine, epinephrine and their precursor DOPA. Reducing the activity and reserve of the sympathoadrenal system in pregnant women may be a pathogenetic factor in the development of preterm birth. Conclusions: Functional activity decreasing and reserving the ability of sympathoadrenal system indicates the failure of adaptive mechanisms aimed at preservation of pregnancy. It occurs in women with preterm birth in the period of 23-36 weeks in relation to women with a physiological course of pregnancy. Women with early premature pregnancy are characterizes by violation of the sympathoadrenal system functional state by accelerating the synthesis at the DOPHA-dopamine stage, a significant decrease in the synthesis and secretion of nor-epinephrine and epinephrine, excessive activity of the nerve component over hormonal in comparison with women with the physiological course of pregnancy. Women with late premature pregnancy are characterized by disturbance of sympathoadrenal system functional state by accelerating synthesis and secretion of dopamine and nor-epinephrine, inhibition of synthesis at the stage of nor-epinephrine-epinephrine, excessive activity of the hormonal component over the nervous system compared with women with the physiological course of pregnancy. In the future, it is planned to continue a series of sympathoadrenal system state studies in women with miscarriage risks.