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Endorphins and the materno fetal unit



Endorphins and the materno fetal unit



Wiener Klinische Wochenschrift Supplementum 97(161): 3-15



Endorphins are endogenous opioid peptides derived from pro-opiomelanocortin. They are synthesized mainly in the pituitary gland and are secreted in response to stress. .beta.-endorphin is the most biologically active endorphin peptide consisting of 31 amino acids; .beta.-endorphin is cleaved from the larger peptide .beta.-lipotropin. The multiple effects of .beta.-endorphin include modulation of pain perception and tonic inhibition of gonadotropins. .beta.-endorphin levels were studied in different maternal and fetal compartments during labor and immediately after delivery, and to study a possible relationship with prolactin. For determination of .beta.-endorphin in maternal and fetal plasma as well as in amniotic fluid we used a radioimmunoassay. .beta.-endorphin levels were determined in the amniotic fluid of 89 healthy parturients (gestational age 38-41 wk), in maternal plasma of 52 healthy parturients (gestational age 38-41 wk) and of 36 pregnants during the oxytoxin stress test. Maternal .beta.-endorphin levels rose significantly during labor and reached the highest levels at delivery. The rise in maternal .beta.-endorphin activity was dependent on the analgetic used: when labor pain was suppressed by means of epidural analgesia maternal .beta.-endorphin levels did not rise. A positive correlation was found between maternal and cord plasma levels of .beta.-endorphin. Sequential analysis of .beta.-endorphin levels in amniotic fluid revealed no significant changes during labor and there was no relationship between amniotic fluid levels and maternal or cord plasma levels. In contrast to .beta.-endorphin, maternal prolactin fell slightly during the 1st and 2nd stage of labor and rose immediately post partum. There was no correlation between maternal .beta.-endorphin activity at delivery and maternal prolactin levels 1-h post partum. During the oxytoxin stress test plasma .beta.-endorphin rose in pregnant women who experienced painful contractions. Labor pain is associated with a rise in peripheral .beta.-endorphin. Epidural analgesia suppresses labor pain and abolishes the rise in maternal .beta.-endorphin. Maternal and fetal .beta.-endorphin levels are closely related. Maternal .beta.-endorphin and prolactin are under different regulatory control during the peripartum period. The importance of reducing stress to the mother during labor and delivery is emphasized.

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Accession: 005359045

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