[Enzymatic diagnostics in obstetrics and gynecology. Part I]. / Enzymatyczna diagnostyka w poloznictwie i ginekologii. Czesc I.

The object of this paper is to highlight the importance of enzymatic diagnostics in obstetrics and gynecology. Enzymatic diagnostics through the assessment of oxytocinase allows to monitor the pregnancy and predict the delivery. Oxytocinase and its isoenzymes reflect the present state of the mother, the fetus and the placenta. The constant increase of oxytocinase in maternal blood up to the time of delivery and its appropriate level indicates the proper development of pregnancy. Low lewel and above all decrease in level instead of the normal constant increase precedes by several weeks clinical symptoms of abortions and preterm deliveries. Maternal blood levels of cystine-amino-peptidases (CAP1 and CAP2) show high correlation with the fetal and placental mass as well as fetal maturity. The levels of oxytocinase allow to objectivize the duration of pregnancy and to reduce induced and operative deliveries.

[Enzymatic diagnosis of neurological risk of premature labor]. / Enzymatyczne rozpoznawanie neuroendokrynologicznego ryzyka porodu przedwczesnego.

The level of oxytocinase in the pregnant woman's blood is a sensitive marker of the efficiency of the hypothalamus/hypophisis/suprarenal glands in mother and fetus, as well as the quantity of hormone production, also in placenta, which determines the duration of pregnancy and the course of labor. In the study, the level of oxytocinase was measured before the labour in 485 pregnant women at risk of premature labour. After the mean duration of pregnancy of 264 +/- 12 days, 353 infants were born fully mature (group I), and 132 with the lowered maturity of 6-9 Klimek points (group II). In group II, the mean pregnancy duration (249 days), body mass (2700 g) and oxytocinase level (5.6 mumol/l/min) were significantly lower and tocolysis was necessary twice as often (41% vs. 21%). Independently of the level of newborn maturity in cases of tocolysis the mean level of oxytocinase was significantly 2.6 times lower (3 +/- 0.8 mumol/l/min) than in the other pregnant women (7.9 mumol/l/min). It proves, that low oxytocinasaemia becomes normal following the ACTH-depot therapy, which eliminates the necessity of tocolysis.