الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
EVALUATION OF THE ROLE OF INTEREUKIN -4 Pre-eclampsia is a disease of theories; cytokines, as well as antioxidants and study of umbilical and uterine blood flow has great importance for the fetal wellbeing, surveillance and fetal outcome.
ABESTRACT:
Aim of the work:
To study the relationship of interleukin-4 and antioxidant (ascorbic acid ) serum leveles to the deveopment and degree of pregnancy induced hypertension (preeclampsia),and the reflection of this syndrome on maternal and fetal blood flow detected by doppler studies.;and its relation to fetal outcome. (birth weight, gestational age at birth, Apgar score at 1&5 min., NICU, perinatal mortality.)
Materials and methods:
The study include three groups: the first group is the control group, includes healthy twenty primigravida at the 3rd trimester from 30-36weeks. The second and third pre-eclamptic groups, each of them is thirty primigravida at the 3rd trimester from 30 to 36 weeks, with mild and sever pre-eclampsia sequentially.
The groups were estimated for, plasma interleukin-4, Vit.C serum levels and Doppler studies of umbilical and uterine arteries was done; follow up till delivery to assess fetal outcome.
Results:
IL-4, was significantly higher when compare pre-eclamptic groups with control group, and when compare severe with mild pre-eclampsia. also the Vit C serum levels show a very high significant decrease in pre-eclamptic groups than control group, but show no significant decrease when compare severe with mild pre-eclamptic groups. The umbilical and uterine arteries Doppler indices are significantly higher in pre-eclamptic groups than control group, and when compare severe with mild pre-eclampsia, except in uterine arteries RI index. The fetal outcomes show earlier delivery with lower birth weight, Apgar score, more admission to NICU and more increase in prenatal mortality(stillbirth) in pre-eclamptic groups than the control group and in severe pre-eclampsia than mild pre-eclamptic group. In addition, in cases with persistent uterine diastolic notch than without notch. There is high significant negative correlation between IL-4 and VIT-C serum levels, fetal outcome parameters. while there is positive significant correlation between IL-4 serum levels and umbilical & uterine arteries Doppler indices, S/D ratio, RI, PI, and mean arterial blood pressure (MAP), On the other hand there is positive significant correlation between VIT-C serum levels and fetal outcome parameters. Though there is significant negative correlation between VIT. C, IL-4 serum levels, umbilical RI & uterine arteries Doppler indices, RI, PI, there is no significant correlation between Vit.C level & umbilical artery S/D ratio, PI, uterine S/D and MAP. However there is significant negative correlation between umbilical & uterine arteries Doppler indices & fetal outcome parameters.
Conclusion:
IL-4 and VIT-C play a role in pathogenesis of pre-eclampsia with a disparate effect on its severity with bad effect on fetal outcomes; IL-4 has a direct correlation with the severity of pre-eclampsia while the Vit.C has no significant correlation with it. The umbilical and uterine arteries Doppler studies help in prognosis of pre-eclampsia and fetal outcomes particularly umbilical & uterine RI index, uterine diastolic notch.
Recommendation:
Antioxidants (VIT-C) supplementation should be recommended for pregnant women diet. Interleukin-4, Vit.C serum levels estimation may help to detect cases of pre-eclampsia early and may be one of the tools to detect the severity of the disease. The Doppler studies of uterine and umbilical blood flow should be offered to a pregnant women at risk of development or who developed the disease to detect adverse effect on fetal outcomes.