Vaginal delivery and serum markers of ischemia/reperfusion injury.
OBJECTIVE
Vaginal deliveries have been associated with pelvic organ prolapse and incontinence. The objective was to show whether markers of ischemia/reperfusion injury are dependent upon the mode of delivery and length of labor.


METHODS
Complete venipuncture sets were obtained on 62 subjects. All samples collected were analyzed for serum creatine phosphokinase (CPK) and lactate dehydrogenase (LDH). Lipid peroxidation was analyzed, using thiobarbituric acid reactive substances (TBARS), on a subset of 37 patients.


RESULTS
There was a significant increase in CPK from admission to 1 h postpartum and postpartum day 1 in vaginal delivery versus cesarean delivery. Longer second stages were associated with significant increases in CPK. There were no significant changes in either LDH or TBARS from admission to any other time point regardless of mode of delivery.


CONCLUSIONS
Vaginal delivery and longer second stages were associated with a much greater increase in one of these injury markers.
Conner
E
E
Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey, USA. connerbennett@msn.com
Margulies
R
R
Liu
Mengling
M
Smilen
S W
SW
Porges
R F
RF
Kwon
C
C
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002585:Cesarean Section / Q000009:adverse effects; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D007748:Labor Stage, Second; D015227:Lipid Peroxidation; D007744:Obstetric Labor Complications; D036801:Parturition; D011247:Pregnancy; D011391:Prolapse; D015427:Reperfusion Injury / Q000209:etiology*; D014549:Urinary Incontinence / Q000209:etiology
D015415:Biomarkers; D007770:L-Lactate Dehydrogenase; D003402:Creatine Kinase