Determination of Serum Lipid Levels During Mid Trimester Hypertonic Saline Solution Induced Abortion

Abstract

Lipid metabolism modifications during pregnancy are strictly correlated with changes of the hormonal factors which regulate it. Serum lipid levels rise during the progression of gestation and reach the peak at the end of pregnancy. Although these changes are reversible, the possible influence of elevated serum lipids on atherosclerotic and ischemic cardiovascular disease as well as biliary tract lithiasis development is still unresolved. The aim of this study was to investi gate interrelationship between serum lipids during mid-trimester hypertonic saline solution induced abortion. Blood samples were taken from the cubital vein of 30 primigravid women, without any endocrine and metabolic disorders, ages 15-40, admitted for the mid-trimester pregnancy abortion, four times: 1) before instillation intraamnion ultrasonographically guided hypertonic saline solution application (control), II) three hours after, III) in the active phase of abortion, and IV) twelve hours after the curettage. Quantitative assay was used for determination of total cholesterol, triglycerides, phospholipids, LDL and HDL, while apolipoprotein Al and apolipoprotein B were determined by immunochemical methods. Three hours after instillation levels of cholesterol, phospholipids, HDL and apolipoprotein A1 were higher, while other lipids were lower, compared to the control group. During the abortion's active phase all lipid concentrations were higher, compared to the control ones, but only apolipoprotein B level was lower. Triglyceride was found to be on the same level as to that before the procedure. Twelve hours after curettage, serum lipid concentrations decreased, reaching control levels. Apolipoprotein Al and apolipoprotein B were supposed to have a protective role against biliary tract disease development, while decreased proportions of LDL to HDL suggest that they are relevant to atherosclerosis development. (Thai J Obstet Gynaecol 1993;4:99-103.)