Oxytocinase as the most important marker of fetal development.
Enzymes as biochemical markers come within the entire scope of the live mother-fetus system. The most important are the enzymes which regulate physiological processes, of which oxytocinase (a type of aminopeptidase) has a much wider scope of action than its name suggests, as it regulates also the level of aminopeptide hypothalamic hormones. Thus, it determines neurological, endocrinological and immunological regulation of entire steroidogenesis. Under the influence of gestational enlargement of the uterine cavity, the mothers hypothalamus produces an increasing amount of hormones, which in turn induces an increasing oxytocinase synthesis in the placenta in order to prevent the hormone in the blood reaching the level which could bring about uterine contractions. Also, the growing fetus additionally induces the production of oxytocinase by releasing its own hormones. All this occurs in combined action of the mother, fetus, placenta and even fetal membranes in one space-time process called pregnancy. When in the late pregnancy the enzyme remains at constant level or decreases without appearance of uterus contractions, labour induction is necessary due to fetus life hazard of as much as several percent. Reduction in enzyme level and even its insufficient growth in the second trimester of pregnancy, occur several weeks before preterm birth or death of the fetus. On the other hand, in the event of treatment of diseases accompanying the pregnancy,normalization of oxytocynasaemia shows the effectiveness of treatment. With the dominating profile of the steady increase of oxytocinase (>90% of cases), the target values are higher than in the case of irregular growth. Their close values are a result of the hormonal treatment of threatened pregnancies with ACTH depot. In the cases of the primary hypothalamic insufficiency, this treatment reduces the rate of fetal deaths, which would stand at several dozen percent. It is a classical example of biological pregnancy monitoring since the risk of fetal death can be predicted several weeks earlier when assessment of chemical compounds or physical changes still gives accurate results within physiological limits.
Klimek
R
R
Chair of Endocrinology and Fertility Jagiellonian University Cracow Poland.
D015415:Biomarkers; D010122:Cystinyl Aminopeptidase / Q000378:metabolism / Q000502:physiology*; D005314:Embryonic and Fetal Development / Q000502:physiology*; D005260:Female; D005313:Fetal Death / Q000201:enzymology; D006801:Humans; D007751:Labor, Induced; D011247:Pregnancy; D014590:Uterine Contraction
D015415:Biomarkers; D010122:Cystinyl Aminopeptidase