Circulating levels of adiponectin and leptin at 23–25 weeks of pregnancy in women with impaired placentation and in those with established fetal growth restriction

2008 ◽  
Vol 115 (7) ◽  
pp. 219-224 ◽  
Author(s):  
Makrina D. Savvidou ◽  
Alexandros Sotiriadis ◽  
Christine Kaihura ◽  
Kypros H. Nicolaides ◽  
Naveed Sattar
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Maternal Plasma ◽  
Second Trimester ◽  
Plasma Adiponectin ◽  
Normal Outcome ◽  
Group A ◽  
Group B ◽  
Circulating Levels

Adiponectin and leptin, two adipose-tissue-derived proteins, have been reported to be elevated in women with established PE (pre-eclampsia). The aim of the present study was to investigate whether alterations in adiponectin and leptin levels predate the development of PE and FGR (fetal growth restriction) in women at increased risk of these complications, as assessed by Doppler examination of the uterine arteries during the second trimester of pregnancy. We also sought to investigate the circulating levels of adiponectin and leptin in women with established severe early-onset FGR. The study included three groups of pregnant women at 23–25 weeks: Group A (n=44) with normal uterine artery Doppler waveforms, Group B (n=49) with abnormal Doppler waveforms and normal fetal growth at the time of the examination, and Group C (n=15) with established severe FGR and abnormal Doppler waveforms. All women had plasma adiponectin and leptin measured by sensitive immunoassays. In Group B, 19 women had a normal outcome, 17 delivered infants with FGR and 13 developed PE. The women who developed PE delivered smaller babies earlier than women with a normal outcome (P<0.001). There were no significant differences in adiponectin levels between any of the groups (overall P=0.3). Leptin concentrations, expressed as MoM (multiples of the median) of Group A, were higher in women in Group C, i.e. established severe FGR at 2.5 (1.2–2.7) MoMs (overall P<0.001), compared with all of the other groups and subgroups. In conclusion, we found that, in pregnancies complicated by severe early-onset FGR, the maternal plasma concentration of leptin is twice as high as in normal pregnancies. However, the second trimester levels of maternal plasma adiponectin and leptin in pregnancies that subsequently develop PE and/or FGR are not significantly different from normal and, consequently, it is unlikely that these markers will be useful as predictors of these pregnancy complications.

scholarly journals Solcoseryl versus Low Molecular Weighte Heparin for Intrauterine Fetal Growth Restriction

2021 ◽  
pp. 215-228
Author(s):  
Samar M. Abd El-Razek ◽  
Mohammed M. Elnamory ◽  
Mona K. Omar ◽  
Hesham M. Eltokhy
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Once Daily ◽  
Group A ◽  
Group B ◽  
Doppler Indices

Background: FETAL Growth Restriction (FGR) is a problem where the fetus fails to attain its normal growth potential and this affects nearly about 8% of all pregnancies Solcoseryl is a protein-free and antigen-free haemodialysate derived from calf blood. It is thought to activate the cellular respiratory chain leading to better oxygen utilisation by the tissues. Aim of the study was to compare between Solcoseryl and low molecular weight heparin in treatment of patients suffered from intrauterine growth restriction due to placental insufficiency. Methods: The patients who included in this study were divided randomly via (computer-generated random numeric tables prepared by a statistician) into two groups with 35 cases in each group. Group (A) (Solcoseryl. Group): 35 women received Solcoseryl ampule 42.5 mg intravenous infusion (Misr Compony) Once daily for 3 weeks. Group (B) (LMWH (Clexan) Group): 35 women received single dose of LMWH subcutaneous (clexane 40 mg) once daily for 3 weeks. Results: There is a significant decrease regarding umbilical artery RI in both groups but the significant decrease was better in group A compared to group B. Otherwise, there is no significant difference between the two groups umbilical artery RI at different time intervals. there is significant increase in Gestational age and birth weight in patients who receive solcoseryl and LMWH .There is an improvement in Doppler indices of both (UA and MCA) in  both group but is better in solcoseryl than LMWH and significant increase  in Apgar score at 1min and 5 min in both groups but is better in solcoseryl than LMWH. Conclusions: In this study, LMWH and Solcoseryl administration in IUGR fetuses enhance Doppler indices, promote significant increase in Gestational age so enhance neonatal birth weight.

Low dose aspirin for preventing fetal growth restriction: a randomised trial

2018 ◽  
Vol 46 (7) ◽  
pp. 776-779 ◽  
Author(s):  
Anca-Daniela Stanescu ◽  
Roxana Banica ◽  
Romina-Marina Sima ◽  
Liana Ples
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Low Dose ◽  
Growth Restriction ◽  
Controlled Study ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Group A ◽  
Group B

AbstractThe purpose of this study was to investigate when in pregnancy to stop the administration of low dose aspirin (150 mg/daily) so as to prevent fetal growth restriction (FGR) A randomised, placebo-controlled study was designed. The patients were all screened positive using the Fetal Medicine Foundation (FMF) early pregnancy screening test for preeclampsia (PE) and FGR prediction. One hundred and fifty patients were enrolled and divided equally into three groups: A – the controls who received placebo treatment; B – those who received aspirin till 32 weeks of gestation and C – those who received aspirin till 36 weeks of gestation. The mean gestational age at enrollment was similar for all the groups (12.4 weeks). The growth curves, fetal and maternal Doppler measurements and amniotic fluid index (AFI) were monitored every 4 weeks. Also, the outcome of the pregnancy was noted and all the results were compared between the groups. FGR was defined as a fetal weight below the 10thcentile for gestational age. In group C, there were less cases of FGR compared with the other groups: 6% vs. 10% in group B vs. 24% in controls. Also, there was a significant birth weight improvement in this group with a median of 3180 g compared with 2950 g in group B and 2760 g in group A (P=0.01). The gestational age at delivery was similar in all the groups (39 weeks in group C/39.2 weeks in group B/38.6 weeks in group A). In conclusion, low dose aspirin improves the outcome in the selected population and should be offered for prevention of FGR from 12 to 36 weeks.

641 Fetal growth restriction and risk of intrapartum cesarean among women with early onset preeclampsia

2021 ◽  
Vol 224 (2) ◽  
pp. S403
Author(s):  
Emily N. Flagler ◽  
Erin M. Cleary ◽  
Michelle R. Petrich ◽  
Emily A. Armstrong ◽  
Patricia K. Belle ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Growth Restriction ◽  
Early Onset Preeclampsia

scholarly journals Risk stratification for early-onset fetal growth restriction in women with abnormal serum biomarkers: a retrospective cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
L. Ormesher ◽  
L. Warrander ◽  
Y. Liu ◽  
S. Thomas ◽  
L. Simcox ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Late Onset ◽  
Area Under The Curve ◽  
Maternal Serum ◽  
Serum Biomarkers ◽  
Growth Restriction ◽  
Aneuploidy Screening ◽  
Internal Validation

AbstractAbnormal maternal serum biomarkers (AMSB), identified through the aneuploidy screening programme, are frequent incidental findings in pregnancy. They are associated with fetal growth restriction (FGR), but previous studies have not examined whether this association is with early-onset (< 34 weeks) or late-onset (> 34 weeks) FGR; as a result there is no consensus on management. The aims of this study were to determine the prevalence and phenotype of FGR in women with AMSB and test the predictive value of placental sonographic screening to predict early-onset FGR. 1196 pregnant women with AMSB underwent a 21–24 week “placental screen” comprising fetal and placental size, and uterine artery Doppler. Multivariable regression was used to calculate a predictive model for early-onset FGR (birthweight centile < 3rd/< 10th with absent umbilical end-diastolic flow, < 34 weeks). FGR prevalence was high (10.3%), however early-onset FGR was uncommon (2.3%). Placental screening effectively identified early-onset (area under the curve (AUC) 0.93, 95% confidence interval (CI) 0.87–1.00), but not late-onset FGR (AUC 0.70, 95% CI 0.64–0.75). Internal validation demonstrated robust performance for detection/exclusion of early-onset FGR. In this cohort, utilisation of our proposed algorithm with targeted fetal growth and Doppler surveillance, compared with universal comprehensive surveillance would have avoided 1044 scans, potentiating significant cost-saving for maternity services.

scholarly journals Maternal plasma fetuin-A levels in fetal growth restriction: A case-control study

2019 ◽  
Author(s):  
Mujde Can Ibano ◽  
Cem Yasar Sanhal ◽  
Seval Ozgu-Erdinc ◽  
Aykan Yucel
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Plasma Levels ◽  
Case Control Study ◽  
Maternal Plasma ◽  
Case Control ◽  
Growth Restriction ◽  
Fetuin A ◽  
Control Study

Background: Higher Fetuin-A (FA) concentrations were found to be associated with obesity and there is an interest to the relation between maternal FA and pregnancy outcomes. Objective: In this study, our aim was to evaluate the association of maternal plasma levels of FA with fetal growth restriction (FGR). Materials and Methods: 41 pregnant women with FGR and 40 controls were recruited in this case-control study between July and November 2015. At the diagnosis of FGR, venous blood samples (10 cc) were obtained for FA analysis. Results: Maternal plasma FA levels were significantly higher in fetal growth-restricted pregnant women compared with controls (19.3 ± 3.0 ng/ml vs 25.9 ± 6.8 ng/ml, p = 0.001). Area under receiver operating characteristic curve analysis of FA in FGR was 0.815 (95% confidence interval (CI): 0.718-0.912, p < 0.001). The maternal FA levels with values more than 22.5 ng/ml had a sensitivity of about 73.17% (95% CI: 56.79- 85.25) and a specificity of about 82.5% (95% CI: 66.64-92.11) with positive and negative predictive values of about 81.08% (95% CI: 64.29-91.45) and 75% (95% CI: 59.35-86.30), respectively. Therefore, the diagnostic accuracy was obtained about 77.78%. Conclusion: The results of this study show higher maternal plasma levels of FA in FGR. Further studies are needed in order to demonstrate the long-term effects of FA in pregnancies complicated with FGR and early prediction of FGR.

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