Biochemical environment of fetal development in the meconium stained amniotic fluid. i-glucose, bilirubine, optical density, H+ Ions, estrogens and placental lactogen

Amaç
  The aim of the study was to evaluate the influence of the presence of meconium in amniotic fluid on the concentrations of chosen biochemical parameters: glucose, bilirubine, H+ions, estrogens and placental lactogen. The optical density at 570 and at 650 nm was also estimated as a good clinical indicator of fetal's lungs maturity.

Yöntem The study covered 82 pregnant women: 54 with the meconium stained amniotic fluid (the study group) and 28 with the clear (physiological) amniotic fluid (the control group). The women in both group were at the same gestational age : 39.1+/-2.48 vs 39,2+/-2,37 weeks (NS). There were similar percentages of various pathologies in both groups: diabetes 11% vs 13% (NS), intrahepatic cholestasis of pregnaney 25% vs 20% (NS), pregnaney incluced hypertension (PIH) 21% vs 18% (NS) and healthy women 43% vs 49% (NS). The amniotic fluid was collected by the ultrasound guided abdominal amniocentesis. The indicalions tor the amniocentesis were: fetal death in anamnesis, the necessity of the evaluation of the fetal maturation and its condition before an elective cesarean section. The following biochemical parameters were evaluated: glucose, bilirubine, optical density at 570 and at 650 nm, H+ions (measured as titrate acidity of urine), total estrogens and placental lactogen .
İt was observed: 1) glucose 0,97+/-0,32 vs l,91+/-0,83 mmol/1 (p<0,001); 2) bilirubine 8,55+/-6,55 vs L81+/-1.16umol/l (p<0,001); 3) optical density at 570nm - 0.788+/-0.389 vs 0,358+/- 0,294 (p<0,00l);4) optical density at 650 nm - O,5O2+/-O,25O vs 0.228+/-0,163 (p<0,001) 5) H+ions - 0,322+/-0,307 vs 0,264+/-0,201 (NS); 6) total estrogens 1754.7+/-682,3 vs 2367,9+/-38],4 mmol/1 ( p<0.0001) and 7) placental lactogen 1282.0+/-695.1 vs 2688.5+/-616,1 ng/ml (p<0,0001).

Sonuç

Conclusion: Low concentration of glucose, total estrogens and placental lactogen indicates the risk of intraulerine fetal death. H+ ions concentration shows that the fetal's kidneys in pregnancies with the presence of meconium in amniotic fluid were as matured as the fetal's kidneys in the control group. Because of the presence of meconium in amniotic fluid it's impossible to evaluate the fetal's lungs maturity by using the optical density.

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