1085: Fetal growth restriction in hypertensive vs. smoking women- pregnancy outcomes, ultrasound findings, and placental pathology

Objective This study aimed to analyze the effect of pravastatin on angiogenic factors, feto–maternal Doppler findings and pregnancy outcomes in women with early-onset fetal growth restriction (FGR) treated with pravastatin compared with nontreated controls. Study Design This was a pilot study conducted between March 2016 and September 2017. Women with single pregnancies and FGR diagnosed at ≤ 28 weeks of gestation were offered 40 mg of pravastatin daily. Doppler progression, soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) values, and pregnancy outcomes were assessed and compared with consecutive historical controls. Controls were matched to treated women for gestational age, maternal characteristics, maternal and obstetric history, Doppler severity classification, and angiogenic factors at diagnosis. The sFlt-1/PlGF was measured in maternal serum at two different times: before pravastatin was started (ratio M0) and during pravastatin treatment (ratio M1). Doppler severity was classified into four categories: normal, mild, moderate, and severe. Results A total of 38 women were enrolled in this study. No differences were observed in baseline characteristics between groups. However, when compared with the ratio M0, M1 was increased by a median (interquartile range) of 67.0 (−34.8 to 197.3) in the control group but decreased by a median (interquartile range) of −10.1 (−53.1 to −0.07) in the pravastatin treated group (p < 0.001). No significant differences were observed in Doppler progression throughout pregnancy. Median interval from diagnosis to delivery was extended by 16.5 days, the median newborn birthweight was increased from 1,040 to 1,300 g, and the number of women with preeclampsia decreased from 9 (47.4%) to 6 (31.6%) in treated women; however, these trends were not statistically significant. Conclusion In women with early-onset FGR, treatment with pravastatin 40 mg daily was associated with significant improvement in the angiogenic profile. Additionally, median pregnancy duration and median birthweight increased and the incidence of PE was reduced in treated women. Nevertheless, since this pilot study was underpowered, none of these differences were statistically significant. Key Points

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Placental pathology in fetal growth restriction

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/j.ejogrb.2010.11.017 ◽

2011 ◽

Vol 155 (1) ◽

pp. 36-40 ◽

Cited By ~ 74

Author(s):

Natalija Vedmedovska ◽

Dace Rezeberga ◽

Uldis Teibe ◽

Ivars Melderis ◽

Gilbert G.G. Donders

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Placental Pathology

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Analysis of Maternal and Infant Pregnancy Outcomes in Preeclampsia Combined with Fetal Growth Restriction

Advances in Clinical Medicine ◽

10.12677/acm.2020.1012451 ◽

2020 ◽

Vol 10 (12) ◽

pp. 2999-3004

Author(s):

昱翠李

Keyword(s):

Fetal Growth ◽

Pregnancy Outcomes ◽

Fetal Growth Restriction ◽

Growth Restriction

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Placental pathology versus clinical risk of fetal growth restriction

Placenta ◽

10.1016/j.placenta.2014.06.126 ◽

2014 ◽

Vol 35 (9) ◽

pp. A38-A39

Author(s):

Jerzy Stanek ◽

Jacek Biesiada

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Placental Pathology ◽

Clinical Risk

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Effect of Endogenic and Exogenic Oxidative Stress Triggers on Adverse Pregnancy Outcomes: Preeclampsia, Fetal Growth Restriction, Gestational Diabetes Mellitus and Preterm Birth

International Journal of Molecular Sciences ◽

10.3390/ijms221810122 ◽

2021 ◽

Vol 22 (18) ◽

pp. 10122

Author(s):

Eun Hui Joo ◽

Young Ran Kim ◽

Nari Kim ◽

Jae Eun Jung ◽

Seon Ha Han ◽

...

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Preterm Birth ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Fetal Growth ◽

Pregnancy Outcomes ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Adverse Pregnancy

Oxidative stress is caused by an imbalance between the production of reactive oxygen species (ROS) in cells and tissues and the ability of a biological system to detoxify them. During a normal pregnancy, oxidative stress increases the normal systemic inflammatory response and is usually well-controlled by the balanced body mechanism of the detoxification of anti-oxidative products. However, pregnancy is also a condition in which this adaptation and balance can be easily disrupted. Excessive ROS is detrimental and associated with many pregnancy complications, such as preeclampsia (PE), fetal growth restriction (FGR), gestational diabetes mellitus (GDM), and preterm birth (PTB), by damaging placentation. The placenta is a tissue rich in mitochondria that produces the majority of ROS, so it is important to maintain normal placental function and properly develop its vascular network to ensure a safe and healthy pregnancy. Antioxidants may ameliorate these diseases, and related research is progressing. This review aimed to determine the association between oxidative stress and adverse pregnancy outcomes, especially PE, FGR, GDM, and PTB, and explore how to overcome this oxidative stress in these unfavorable conditions.

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Prenatal diagnosis of fetal growth restriction with polyhydramnios, etiology and impact on postnatal outcome

Scientific Reports ◽

10.1038/s41598-021-04371-9 ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Adeline Walter ◽

Elina Calite ◽

Christoph Berg ◽

Ulrich Gembruch ◽

Andreas Müller ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Growth Restriction ◽

Growth Delay ◽

Chromosomal Anomalies ◽

High Morbidity ◽

Ultrasound Findings ◽

Long Term Follow Up ◽

Postnatal Outcome ◽

Malformation Syndromes

AbstractTo assess the spectrum of different etiologies, the intrauterine course, outcome and possible prognostic markers in prenatally detected fetal growth restriction (FGR) combined with polyhydramnios. Retrospective study of 153 cases with FGR combined with Polyhydramnios diagnosed by prenatal ultrasound over a period of 17 years. Charts were reviewed for ultrasound findings, prenatal and postnatal outcome. All cases were categorized into etiological groups and examined for differences. Five etiological groups were identified: chromosomal anomalies (n = 64, 41.8%), complex malformation syndromes (n = 37, 24.1%), isolated malformations (n = 24, 15.7%), musculoskeletal disorders (n = 14, 9.2%) and prenatal non-anomalous fetuses (n = 14, 9.2%). Subgroups showed significant disparities in initial diagnosis of combination of both pathologies, Ratio AFI/ gestational weeks and Doppler ultrasound examinations. Overall mortality rate was 64.7%. Fetuses prenatally assigned to be non-anomalous, showed further complications in 42.9% (n = 6). Fetuses prenatally diagnosed with FGR combined with polyhydramnios are affected by a high morbidity and mortality. Five etiologic groups can be differentiated, showing significant disparities in prenatal and postnatal outcome. Even without recognizable patterns prenatally, long-term-follow up is necessary, as neurodevelopmental or growth delay may occur.

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