Progesterone and its 5ß-metabolite are markers of the threatening course of pregnancy in cytomegalovirus infection

Abstract

Objective. The study objective is to assess the effect of recrudescence of cytomegalovirus (CMV) infection on the content of progesterone, its receptor and metabolite 5ß-dihydroprogesterone in the early placenta in various pregnancies. Methods. The material for the study was 60 villous chorions, 30 of them were taken during the scraping of the uterine cavity in pregnant women with spontaneous abortion onset 9-11 weeks against the background of an recrudescence of CMV infection (the main group) and 30 with medical abortions on the same period and recrudescence of the infectious process (comparison group). The control group consisted of 35 villous chorions from pregnant women with CMV infection in the latent stage, taken with medical abortions for a period of 9-11 weeks. Determination of CMV DNA, verification of type specific antibodies, avidity index, progesterone receptor content, peripheral blood progesterone and villous chorion homogenate were performed with enzyme immunoassay. The activity of 5ß-dihydroprogesterone dehydrogenase was determined by a histochemical method followed by analysis with a Scion (USA) program using a digital microscope. Results. Recrudescence of CMV infection during pregnancy led to a decrease in progesterone production to 63.3±2.0 nmol/L in peripheral blood, to 21.5.1 ±2.7 nmol/L - in villous chorion, a decrease in the content of the progesterone receptor up to 14,0±0,8 nmol/L, as well as a decrease in the activity of conversion of progesterone into 5ß-dihydroprogesterone in the trophoblast at the 8-10^th week of pregnancy. In the case of spontaneous abortion against the background of an Recrudescence of CMV infection, there were more pronounced disruptions in the activity of conversion of progesterone into 5ß-dihydroprogesterone, as well as a decrease in the progesterone concentration to 44.6±2.2 nmol/L in peripheral blood, to 21.5±2.7 nmol/L - in villous chorions and receptor content in the placenta - up to 11.3±0.9 nmol/L. Conclusions. These facts, in our opinion, reveal a possible mechanism for forming a threat of premature termination of pregnancy with recrudescence of CMV infection in the first trimester of gestation.