engleski

Requirement For Oxytocin Augmentation In Spontaneous Parturition Is Associated With The Maternal Serum Steroid Hormones Assessed By LC-MS/MS

Objective: The aim of this study was to evaluate the maternal serum concentration of selected endogenous steroid hormones during spontaneous parturition at term and to determinate their association with the need for oxytocin augmentation. PAtients and methods: Blood of 108 healthy pregnant women whose parturition started with the regular spontaneous uterine contractions, with or without a premature rupture of membranes, was drawn at the beginning of the process. LC-MS/MS device was utilized for measurement of the following maternal serum steroid hormones: aldosterone, androstenedione, cortisol, cortisone, corticosterone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate(DHEA-S), 17-hydroxyprogesterone (17-OHP), progesterone(P4) and testosterone. Mann Whitney U test, Chi-square Test, univariate and multivariate logistic regression and ROC analysis were used for the data analysis. Results: Reference ranges of the selected hormones assessed by the LC-MS/MS in maternal serum of women having spontaneous parturition were established. Statistically significant differences in the serum corticosterone, DHEA and androstenedione between cases requiring oxytocin augmentation and the rest of women having spontaneous parturition were found (p=0.002, p=0.008 and p=0.04 respectively). Concentrations of these steroids were lower in the group of pregnant women who required oxytocin infusion for progression of labor. ROC analysis showed that all the examinees whose DHEA concentration was above 21.6 nmol/L have lower chance to use oxytocin infusion for the labor progression (AUC= 0.649, sensitivity=71.7%, specificity=59.6%, P=0, 006). Conclusion: This study provided reference ranges for the selected maternal serum steroid hormone concentrations at the beginning of parturition. Association of selected steroid hormones with the oxytocin infusion has been established. DHEA is a potential predictor of oxytocin infusion augmentation for successful progression of the parturition.

aldosterone ; labor augmentation ; oxytocine ; steroids

nije evidentirano