я безусловно мало что понимаю в гинекологии с эндокринологией, а объясняю еще хуже. но сделаю все же попытку
разве я утверждаю, что все что есть в таблице нужно делать? и является ли какая либо таблица руководством к действию?
выберу то что ближе мне:
в таблице присутствуют нормы холестерина, но разве ето заставляет меня исследовать етот показатель у беременных?
за адреналовую систему, вот такая ссылка
| Цитата |
|---|
PubMed
TIAssessment of adrenal reserve in pregnancy: defining the normal response to the adrenocorticotropin stimulation test.
AUSuri D, Moran J, Hibbard JU, Kasza K, Weiss RE
SOJ Clin Endocrinol Metab. 2006;91(10):3866.
CONTEXT: Normal pregnancy is a state of hypercortisolism, making adrenal insufficiency difficult to diagnose. Objective: We sought to identify a normative, minimum-response threshold for the ACTH stimulation test in pregnancy. We hypothesized that salivary free cortisol (SaFC) would prove a more physiological and less variable measure of adrenal reserve in pregnancy than serum cortisol (SC).
DESIGN: This is a prospective study of normal controls.
SETTING: The study was conducted in an obstetrical clinic in a tertiary care hospital.
PATIENTS: Patients included 36 healthy ambulatory pregnant women (aged 18-37 yr) with singleton pregnancies.
INTERVENTION: The 250-microg ACTH stimulation test was performed in the healthy pregnant volunteers. Based on their gestational age at the time of recruitment, women were studied in one of the trimesters and were restudied at 11-14 wk postpartum.
MAIN OUTCOME MEASURES: Total SC, aldosterone, and SaFC concentrations were measured before and after ACTH. The response in pregnancy was compared with postpartum values.
RESULTS: Basal SC (P = 0.01), aldosterone (P = 0.001), and SaFC (P = 0.01) values progressively increased during the trimesters of pregnancy and decreased postpartum, confirming that pregnant women have increased basal glucocorticoid and mineralocorticoid production. There was enhanced responsiveness of the maternal adrenal glands to ACTH stimulation as pregnancy progressed, as measured by peak stimulated SaFC (P = 0.009) and aldosterone (P = 0.01). In the milieu of altered binding globulins, SaFC is a more consistent, binding-globulin-independent measure of stimulated adrenal function than total SC. Minimum criteria for the normal SaFC response to ACTH stimulation in the second and third trimesters of pregnancy and postpartum have been generated based on a predominantly African-American group of subjects.
CONCLUSIONS: Reliable data are available for the evaluation of the adrenal axis in pregnancy with a noninvasive, outpatient measure of SaFC. Glucocorticoid therapy in pregnancy should take into account that adrenal reserve increases as pregnancy progresses.
ADThyroid Study Unit, Department of Medicine, University of Chicago, 5841 South Maryland Avenue, Mail Code 3090, Chicago, IL 60637, USA. |
если вопрос уровня ренина альдостерона изучался у здоровых беременных и беременных с АГ и мы получили некие данные почему об етом не знать?
| Цитата |
|---|
Renin, aldosterone, and serum-converting enzyme activity during normal and hypertensive pregnancy.
AU
Dux S, Yaron A, Carmel A, Rosenfeld JB
SO
Gynecol Obstet Invest. 1984;17(5):252.
Plasma renin activity, plasma aldosterone, and serum-converting enzyme activity were measured in 13 normotensive pregnant women in three sequential periods: 19-21, 29-31, and 38-40 weeks of gestation. The converting enzyme activity was also measured in a group of 6 women with hypertensive pregnancy and an age-matched control group of 35 normal nonpregnant women. Plasma renin activity and plasma aldosterone values were both significantly elevated in the three periods of pregnancy, but plasma aldosterone levels were relatively lower during the first two periods. This is suggested to be secondary to depressed aldosterone secretion by intravascular volume expansion. The serum-converting enzyme activity did not change during pregnancy, and the mean values (1.02 +/- 0.27 U) were lower than those found in the control group (1.23 +/- 0.26 U). Similar low values were found in the hypertensive pregnancy group (1.11 +/- 0.35 U). Therefore, we assume that the converting enzyme is not a limiting factor in the conversion of angiotensin nor does it contribute significantly to the pathogenesis of hypertensive pregnancy.
AD
PMID
6329926 |
если исходить из того, что лучше не публиковать, а то вдруг начнут применять не там где надо, то медицинскую литературу нужно запретить как класс... разве нет?
повторюсь, рядом с каждым значением есть ссылка на источник информации. не вызывает доверия? хотелось бы обоснования етого недоверия.
p.s. мы нигде не пишем за мочу по ничепоренко, МЭХО и проч.. разве ето мешает назначать все ето беремчатым.
p.s.s. все же хотелось бы примерно следующего
ТТГ референсы в талице не верны, т.к. вот ссылка которая ето опровергает
а вот ссылка которая доказывает что получить референсы етого исследования невозможно в силу таких то обстоятельств
касательно пролактина у беременных, он изучался например здесь:
| Цитата |
|---|
PubMed
TI
Prolactin secretion in molar and normal pregnancy.
AU
Carranza-Lira S, Hernández F, Sánchez M, Murrieta S, Hernández A, Sandoval C
SO
Int J Gynaecol Obstet. 1998;60(2):137.
OBJECTIVE: To describe the relation between PRL and hCG, T3, T4, fT4, TSH, E2 and P4 levels in normal pregnancies and those complicated with GTD.
METHOD: Twenty women, 10 with normal pregnancy and 10 with molar pregnancy were studied. The differences between them and the relation between prolactin (PRL) and human chorionic gonadotropin (hCG), estradiol and thyroid hormones, thyroid stimulating hormone (TSH) and progesterone, was determined by Mann-Whitney U-test and Pearson's correlation coefficient, respectively.
RESULTS: HCG, estradiol and thyroid hormones were higher in molar pregnancy, but PRL and progesterone were similar and TSH was lower in molar pregnancy. A negative correlation was found between PRL level and all the hormones in normal pregnancy, with the exception of TSH, and in molar pregnancy there was a positive correlation of PRL with all hormones.
CONCLUSION: HCG, E2, T3, T4, fT4 levels were higher in the group with molar pregnancy.Differences in correlation analysis suggest different endocrine regulation mechanisms in molar and normal pregnancies.
AD
Hospital de Ginecología y Obstetricia Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, Mexico DF. 103144,522@compuserve.com
PMID
9509951 |
