Left ventricular dimensions, systolic functions, and mass in term neonates with symmetric and asymmetric intrauterine growth restriction

2013 ◽  
Vol 25 (2) ◽  
pp. 301-307 ◽  
Author(s):  
Bahar Cinar ◽  
Ahmet Sert ◽  
Zeynel Gokmen ◽  
Ebru Aypar ◽  
Eyup Aslan ◽  
...  
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Left Ventricular Dimensions ◽  
Appropriate For Gestational Age ◽  
Ventricular Dimensions

AbstractBackground:Previous studies have demonstrated structural changes in the heart and cardiac dysfunction in foetuses with intrauterine growth restriction. There are no available data that evaluated left ventricular dimensions and mass in neonates with symmetric and asymmetric intrauterine growth restriction. Therefore, we aimed to evaluate left ventricular dimensions, systolic functions, and mass in neonates with symmetric and asymmetric intrauterine growth restriction. We also assessed associated maternal risk factors, and compared results with healthy appropriate for gestational age neonates.Methods:In all, 62 asymmetric intrauterine growth restriction neonates, 39 symmetric intrauterine growth restriction neonates, and 50 healthy appropriate for gestational age neonates were evaluated by transthoracic echocardiography.Results:The asymmetric intrauterine growth restriction group had significantly lower left ventricular end-systolic and end-diastolic diameters and posterior wall diameter in systole and diastole than the control group. The symmetric intrauterine growth restriction group had significantly lower left ventricular end-diastolic diameter than the control group. All left ventricular dimensions were lower in the asymmetric intrauterine growth restriction neonates compared with symmetric intrauterine growth restriction neonates (p>0.05), but not statistically significant except left ventricular posterior wall diameter in diastole (3.08±0.83 mm versus 3.54 ±0.72 mm) (p<0.05). Both symmetric and asymmetric intrauterine growth restriction groups had significantly lower relative posterior wall thickness (0.54±0.19 versus 0.48±0.13 versus 0.8±0.12), left ventricular mass (9.8±4.3 g versus 8.9±3.4 g versus 22.2±5.7 g), and left ventricular mass index (63.6±29.1 g/m2versus 54.5±24.4 g/m2versus 109±28.8 g/m2) when compared with the control group.Conclusions:Our study has demonstrated that although neonates with both symmetric and asymmetric intrauterine growth restriction had lower left ventricular dimensions, relative posterior wall thickness, left ventricular mass, and mass index when compared with appropriate for gestational age neonates, left ventricular systolic functions were found to be preserved. In our study, low socio-economic level, short maternal stature, and low maternal weight were found to be risk factors to develop intrauterine growth restriction. To our knowledge, our study is the first to evaluate left ventricular dimensions, wall thicknesses, mass, and systolic functions in neonates with intrauterine growth restriction and compare results with respect to asymmetric or symmetric subgroups.

scholarly journals AMPK activation in pregnant human myometrial arteries from high-altitude and intrauterine growth-restricted pregnancies

2020 ◽  
Vol 319 (1) ◽  
pp. H203-H212
Author(s):  
Ramón A. Lorca ◽  
Christopher J. Matarazzo ◽  
Elise S. Bales ◽  
Julie A. Houck ◽  
David J. Orlicky ◽  
...  
Keyword(s):  
High Altitude ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Well Being ◽  
Growth Restriction ◽  
Ampk Activation ◽  
Intrauterine Growth ◽  
Mother And Child ◽  
Appropriate For Gestational Age

Intrauterine growth restriction (IUGR) impairs infant well being and increases susceptibility to later-in-life diseases for mother and child. Our study reveals a novel role for AMPK in vasodilating the myometrial artery (MA) from women residing at high altitude (>2,500 m) with appropriate for gestational age pregnancies but not in IUGR pregnancies at any altitude.

scholarly journals Perinatal Plasma Monocyte Chemotactic Protein-1 Concentrations in Intrauterine Growth Restriction

2007 ◽  
Vol 2007 ◽  
pp. 1-5 ◽  
Author(s):  
Despina D. Briana ◽  
Maria Boutsikou ◽  
Stavroula Baka ◽  
George Papadopoulos ◽  
Dimitrios Gourgiotis ◽  
...  
Keyword(s):  
Immune Response ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Trophoblast Invasion ◽  
Intrauterine Growth ◽  
Monocyte Chemotactic Protein ◽  
Chemotactic Protein ◽  
Appropriate For Gestational Age

Monocyte chemotactic protein-1 (MCP-1) plays vital roles in immune response, angiogenesis, and pregnancy outcome. We investigated plasma MCP-1 concentrations in 40 mothers and their 20 intrauterine-growth-restricted (IUGR) and 20 appropriate-for-gestational-age (AGA) fetuses and neonates on postnatal days 1 (N1) and 4 (N4). Maternal and fetal MCP-1 concentrations were decreased (P<001andP= .018, resp.), whereas N1 MCP-1 concentrations were elevated in IUGR group (P= .012). In both groups, fetal MCP-1 concentrations were lower compared to N1 and N4 ones (P= .045,P= .012, resp., for AGA,P<.001 in each case for IUGR). Reduced maternal and fetal MCP-1 concentrations in IUGR may reflect failure of trophoblast invasion, suggesting that down-regulation of MCP-1 may be involved in the pathogenesis of IUGR. Increased MCP-1 concentrations in IUGR neonates and higher postnatal ones in all infants may be attributed to gradual initiation of ex utero angiogenesis, which is possibly enhanced in IUGR.

scholarly journals Maternal Smoking, Intrauterine Growth Restriction, and Placental Apoptosis

2004 ◽  
Vol 7 (5) ◽  
pp. 433-442 ◽  
Author(s):  
Christina Vogt Isaksen ◽  
Rigmor Austgulen ◽  
Lisa Chedwick ◽  
Pål Romundstad ◽  
Lars Vatten ◽  
...  
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Growth Restriction ◽  
Tunel Method ◽  
Cytokeratin 18 ◽  
University Of Pittsburgh ◽  
Intrauterine Growth ◽  
Appropriate For Gestational Age ◽  
The Difference ◽  
Syncytiotrophoblast Layer

Pregnant women who smoke are at greater risk of delivering a growth-restricted infant than nonsmoking mothers. We wanted to see if apoptosis could be involved in the mechanisms behind smoke-induced growth restriction, and our aim was to compare apoptosis in the placenta of smoking mothers giving birth to growth-restricted infants and nonsmoking mothers with infants of appropriate weight. The project was conducted at the Magee—Womens Hospital and Magee—Womens Research Institute, University of Pittsburgh, PA. Histological sections from 20 placentas were selected from smoking mothers who had given birth to small-for-gestational-age infants (birth weight ≤ 2 SD). The controls were gestational-age matched nonsmoking mothers with infants having appropriate-for-gestational-age weight. The TUNEL method was used to demonstrate DNA fragmentation in nuclei, and a monoclonal antibody M30, specific for a neo-epitope on cytokeratin 18, was used to identify apoptotic epithelial cells. The positive nuclei (TUNEL) and positive cells (M30-positive cytoplasm) were counted blindly both in villous tissue and in decidual/basal plate tissue. M30-positive cells in villous tissues were significantly increased in placentas from smoking mothers compared to nonsmoking mothers. When evaluated by the TUNEL method, the difference between the two groups of women was not significant. Our study shows that apoptosis was increased in the placentas of smoking mothers with growth-restricted infants. The difference between the two groups was mainly in the syncytiotrophoblast layer and in connection with perivillous fibrin deposition. Cigarette smoke with reduction in blood flow has previously been shown to increase apoptosis, and it is possible that this could be one of the mechanisms playing a role in the growth restriction.

scholarly journals Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment

2019 ◽  
Vol 21 (1) ◽  
pp. 62
Author(s):  
Gabriela Corina Zaharie ◽  
Monica Hasmasanu ◽  
Ligia Blaga ◽  
Melinda Matyas ◽  
Daniel Muresan ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Growth Restriction ◽  
Control Group ◽  
Left Heart ◽  
Functional Changes ◽  
Intrauterine Growth ◽  
Cardiac Adaptation ◽  
And Function

Aim: To asses the cardiac morphology and functional changes specific for newborns from intrauterine growth restriction (IUGR) pregnancies.Material and method: A cohort of IUGR infants were evaluated by serial echocardiographies at delivery and at the first and six months follow-ups. IUGR newborn delivery status was compared to that of newborns in the control group according to gestational age (AGA).Results: Left heart measurements were significantly lower in IUGR newborns compared to AGA babies. Left ventricular size increased at follow-up inthe IUGR group (p<0.05). Systolic dysfunction (the myocardial performance index (MPI)> 0.47) was identified in 40% of the neonates in the IUGR group (16/40), respectively 4.76% in the control group. IUGR neonates had a significantly increased proportion of systolic malfunction (p=0.004).Conclusion: IUGR patients had reduced left ventricle dimensions compared to AGA babies. The MPI stands out as a marker of leftheart function in newborns. Systolic dysfunction was a hallmark of the cardiac adaptation in IUGR neonates. 

scholarly journals LEFT VENTRICULAR REMODELING PROCEEDS FROM YOUNG ADULTHOOD INTO MIDLIFE IN INTRAUTERINE GROWTH RESTRICTION BABOONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S106-S106
Author(s):  
Geoffrey D Clarke ◽  
Hillary Huber ◽  
Cun Li ◽  
Anderson Kuo ◽  
Peter Nathanielsz
Keyword(s):  
Body Weight ◽  
Intrauterine Growth Restriction ◽  
Ventricular Remodeling ◽  
Heart Function ◽  
Left Ventricular ◽  
Growth Restriction ◽  
Breath Holding ◽  
Control Group ◽  
Phase Array ◽  
Intrauterine Growth

Abstract Previous cross-sectional studies have shown young adult baboons (~5-6 y.o.), subjected to intrauterine growth restriction (IUGR) by maternal calorie restriction during pregnancy and lactation, exhibit ventricular remodeling with mildly impaired heart function relative to age/sex-matched controls (CTL). METHODS: In this longitudinal study cardiac MRI was performed on male IUGR baboons (n=7). A 3 Tesla, Siemens TIM Trio MRI system was used with phase-array coils with parallel imaging acquisition and breath-holding during the scan. Studies of IUGR animals occurred at 4.7 + 0.1 yr. intervals; the first scan (scan1) at 5.8 + 1.2 y (human equivalent - HE ~24 years) and the second (scan2) at 10.4 + 1.2 yr (HE~40 y). Scans on the CTL animals (N=4) occurred at 5.3 + 1.4 years and 10 + 1.4 years. RESULTS: Change in body weight over 4.7 years was less in the IUGR group (Δwt=6.3 + 6.1 kg) than in the control group (Δwt =11.5 + 8.2 kg). Left ventricular (LV) ejection fraction (EF) was significantly greater in IUGR animals for scan2 (+10.7%, p=0.03) but not in normal controls (+1.8%, p=0.75). Stroke volume and end-diastolic LV volume were normalized to body surface area (BSA). SV/BSA (17.6 + 4.9, 31.5 + 12.3 mL/sq.m; p=0.016) and EDV/BSA (47.3 + 13.6, 64.5 + 18.8 mL/sq.m; p=0.045) were also significantly increased in IUGR animals but not controls. In IUGR subjects, Δweight was significantly and positively correlated with ΔEF (r=0.86, p=0.01). CONCLUSIONS: In IUGR, but not in CTL baboons, cardiac function adaptations continue into midlife and are related to increases in body weight with aging. We conclude that IUGR programs cardiovascular function and that programmed changes continue into midlife.

scholarly journals New Approaches to Treatment of Severe Intrauterine Growth Restriction

2014 ◽  
Vol 3 ◽  
Author(s):  
Zhanar Kurmangali
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
New Approaches ◽  
Port System

Introduction. Intrauterine growth restriction (IUGR) is a leading cause of perinatal morbidity and mortality due to placental insufficiency. Currently, one of the new approaches to treating this disease is the injection of nutrients to the fetus through intravascular port-systems (catheters).Objective. To assess the impact of nutrient injections as treatment to fetuses with severe growth retardation.Materials and methods. Pregnant women with IUGR (abdominal circumference (AC) < 5th percentile) with the absence of diastolic flow in the umbilical artery and a fetal gestational age of less than 30 weeks were randomly divided into two groups. The treatment group included six pregnant women who had an intravascular port-system for the infusion of nutrients (amino acids and glucose) in the umbilical vein of the fetus for 14 ± 3 days. The control group consisted of eight patients who received only traditional dynamic monitoring and delivery at the optimum time of pregnancy. Fetal status was assessed using ultrasound equipment Accuvix V20 (Medison, South Korea) by examining indicators of biometry and Doppler study of blood flow in utero, umbilical arteries, middle cerebral artery, and ductus venosus with fetal vascular resistance index calculation - pulsatility index (PI). Criteria for blood flow disturbances in the vessels were considered PI values above normal values for their gestational age, which were defined as absence or reverse blood flow in a diastole in the umbilical artery.Results. In a comparative analysis of the two groups, the treatment led to a 44.7% increase in AC of the fetus (121.0 ± 11.5 mm and 219.3 ± 18.3 mm, respectively, p ˂ 0.001). In all cases, the profile of blood flow in the umbilical artery had a positive diastolic component. As a result, there was a 45.3% decrease in PI in the umbilical artery (2.14 ± 0.54 and 1.17 ± 0.15, respectively, p < 0.05). Average fetal weight in the study group was not significantly higher than the control group (1,120.3 ± 213.6 g and 909.6 ± 131.4 g, p > 0.05).Conclusion. Thus, injection of nutrients to the fetuses through intravascular port-system improved placental perfusion and metabolism, which has the potential for improved fetal growth. This, in turn, promoted full-term pregnancy and improved perinatal outcomes in fetal pathology.

Effects of endurance training on left ventricular dimensions in healthy men

1979 ◽  
Vol 47 (1) ◽  
pp. 207-212 ◽  
Author(s):  
L. A. Wolfe ◽  
D. A. Cunningham ◽  
P. A. Rechnitzer ◽  
P. M. Nichol
Keyword(s):  
Training Group ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Control Group ◽  
Moderate Increase ◽  
Septal Thickness ◽  
Posterior Wall Thickness ◽  
Left Ventricular Dimensions ◽  
And Function ◽  
Ventricular Dimensions

Echocardiography was employed to measure the serial effects of jogging on resting left ventricular dimensions and function. Twelve men were exercised (mean age 36.8 yr) and 10 served as controls (mean age 34.8 yr). Increases of 14 and 18% were observed for predicted aerobic capacity in the training group (TG) after 3 and 6 mo of training, respectively; the control group (CG) displayed a small detraining effect. Echocardiographic findings included a significant (P less than 0.05) reduction in resting heart rate and a moderate increase in stroke volume (SV) in the TG compared to the CG. The increased SV appeared to be due to increased end-diastolic dimensions (LVIDd, LVEDV), secondary to greater ventricular filling rather than a more vigorous ventricular contraction. Posterior wall thickness, septal thickness, and calculated left ventricular muscle mass were not significantly increased in the TG compared to CG after either 3 or 6 mo training. It was concluded that left ventricular structure and resting contractile status are not altered by 6 mo of jogging training in healthy, previously sedentary men.

Pathological features of the sequence in pregnant women with delayed fetal growth

2019 ◽  
pp. 50-54
Author(s):  
V.O. Golyanovskiy ◽  
◽  
Ye.O. Didyk ◽  
Keyword(s):  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Normal Development ◽  
Intrauterine Infection ◽  
Normal Pregnancy ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Increased Risk ◽  
Infection And Inflammation

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.

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