scholarly journals 91 SILDENAFIL CITRATE MODIFIES FETOPLACENTAL DEVELOPMENT IN A RABBIT MODEL OF INTRAUTERINE GROWTH RESTRICTION

2015 ◽  
Vol 27 (1) ◽  
pp. 138 ◽  
Author(s):  
J. López-Tello ◽  
M. Arias-Alvarez ◽  
A. González-Bulnes ◽  
S. Astiz ◽  
R. M. García-García ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Intrauterine Growth Restriction ◽  
Daily Intake ◽  
Rabbit Model ◽  
Growth Restriction ◽  
Growth Potential ◽  
Sildenafil Citrate ◽  
Control Group ◽  
Crown Rump Length ◽  
Intrauterine Growth

The failure of fetuses to achieve their full growth potential is known as intrauterine growth restriction (IUGR). Sildenafil citrate (SC) is a phosphodiesterase 5 (PDE-5) inhibitor, which enhances nitric oxide (NO)-dependent vasodilatation, and it may have a potential therapeutic role in the treatment of IUGR. The aim of this study was to evaluate the effect of SC on placental and fetal development in a diet-induced rabbit model of IUGR. A total of 24 rabbits does weighing 4.3 ± 0.49 kg on average were used. At Day 9 of pregnancy, females were randomly allocated into 3 experimental groups: one group was fed ad libitum during pregnancy (Group C; n = 8); the rest of the does had 50% restricted daily intake and were treated or not with 20 mg of SC daily from Day 22 of pregnancy until parturition (Groups SC and R, respectively, n = 8 for both). At Day 28 of pregnancy, half of the pregnant does from each group were euthanised to study fetoplacental development, while the remaining does were allowed to deliver. At Day 28, weight, length, and thickness of fetal and maternal placentas, and fetal weight and size [crown-rump length (CRL), and transversal thoracic diameter (TD)] were assessed. A fetus was considered IUGR when it weighted less than the 10th percentile for its normal gestational weight. Statistical analysis was performed using the PROC GLM procedure. Nutritional restriction induced a higher rate of fetuses IUGR than control group (31.0% v. 15.1%; P < 0.05). The percentage of fetuses with IUGR was 23% in SC group (no significant differences with groups C and R). However, SC increased the thickness of maternal and fetal placentas compared to group R (0.4 ± 0.02 v. 0.2 ± 0.02 cm; 0.6 ± 0.02 v. 0.3 ± 0.02 cm; P < 0.05 respectively), being similar to group C (0.4 ± 0.02 and 0.5 ± 0.03 cm). Maternal placental weight in group C showed higher values (1.5 ± 0.08 g; P < 0.05) than both restricted groups (1.2 ± 0.07 g). CRL in group SC was larger than in group R (10.5 ± 0.12 v. 10.0 ± 0.12 cm; P < 0.05) and similar to that in group C (10.5 ± 0.15 cm). The neonates in group SC showed higher values for CRL (10.9 ± 0.15 cm) than those from groups R and C (10.5 ± 0.11, 10.2 ± 0.20 cm; P = 0.05). Regarding TD, fetuses in group SC showed higher values than group R (2.3 ± 0.04 v. 2.1 ± 0.03 cm; P < 0.05) and equaled that of group C (2.3 ± 0.03 cm). In conclusion, maternal malnutrition prejudices fetoplacental development, causing IUGR. Treatment with SC in the last third of gestation counteracts fetal growth retardation by favouring placental development and function and, thus, fetal growth. These results confirm that administration of SC may have a potential benefit in pregnancies complicated by placental insufficiency and IUGR.We acknowledge CM, FSE, and AGL2011-23822 for funding.

scholarly journals Analysis of fetal growth restriction in pregnancy in subjects attending in an obstetric clinic of a tertiary care teaching hospital

2018 ◽  
Vol 7 (3) ◽  
pp. 973
Author(s):  
Ashish Seal ◽  
Arup Dasgupta ◽  
Mousumi Sengupta ◽  
Rinini Dastider ◽  
Sukanta Sen
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Intrauterine Growth Restriction ◽  
Tertiary Care ◽  
Growth Restriction ◽  
Growth Potential ◽  
Crown Rump Length ◽  
Mortality And Morbidity ◽  
Intrauterine Growth ◽  
In Pregnancy

Background: Intrauterine growth restriction (IUGR) is defined as fetal growth less than the normal growth potential of a specific infant because of genetic or environmental factors. Fetal growth restriction or intrauterine growth restriction is one of the leading causes of perinatal mortality and morbidity in newborns. Fetal growth restriction is a complex multifactorial condition resulting from several fetal and maternal disorders. Objective of present study was to find out incidence of IUGR and assessment and evaluation of different important changes in IUGR.Methods: Women who attended the Obstetric OPD in their 1st trimester of pregnancy and those who were thought would be able to visit the antenatal clinic for their fortnightly check-up regularly were screened for intrauterine foetal growth retardation. Women with irregular and uncertain menstrual history and where the 1st trimester USG foetal crown rump length did not corroborate with the menstrual gestational age were excluded from this study.Results: Incidence of IUGR was 18.2% and 84% were found to be asymmetrical. IUGR was found to be double among primigravids and women above 30 years. It had been observed that IUGR was associated with certain conditions like short stature (52%), pregnancy induced hypertension (24%) and anaemia (12%).Conclusions: Thus, early USG screening along with robust screening for maternal BMI, nutritional status, and anaemia can assist the obstetric team in providing early diagnosis, prompt intervention, and better outcome in pregnancy with fetal growth restriction.

scholarly journals The effects of sildenafil citrate on feto–placental development and haemodynamics in a rabbit model of intrauterine growth restriction

2017 ◽  
Vol 29 (6) ◽  
pp. 1239 ◽  
Author(s):  
Jorge López-Tello ◽  
María Arias-Álvarez ◽  
Maria-Ángeles Jiménez-Martínez ◽  
Alicia Barbero-Fernández ◽  
Rosa María García-García ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Intrauterine Growth Restriction ◽  
Rabbit Model ◽  
Growth Restriction ◽  
Sildenafil Citrate ◽  
Placental Development ◽  
Negative Effects ◽  
Intrauterine Growth ◽  
Potential Benefits ◽  
The Brain

The present study evaluated the effectiveness of sildenafil citrate (SC) to improve placental and fetal growth in a diet-induced rabbit model of intrauterine growth restriction (IUGR). Pregnant rabbits were fed either ad libitum (Group C) or restricted to 50% of dietary requirements (Group R) or restricted and treated with SC (Group SC). The treatment with SC improved placental development by increasing vascularity and vessel hypertrophy in the decidua. The assessment of feto–placental haemodynamics showed higher resistance and pulsatility indices at the middle cerebral artery (MCA) in fetuses treated with SC when compared with Group R, which had increased systolic peak and time-averaged mean velocities at the MCA. Furthermore, fetuses in the SC group had significantly higher biparietal and thoracic diameters and longer crown–rump lengths than fetuses in Group R. Hence, the SC group had a reduced IUGR rate and a higher kit size at birth compared with Group R. In conclusion, SC may provide potential benefits in pregnancies with placental insufficiency and IUGR, partially counteracting the negative effects of food restriction on placental development and fetal growth. However, the present study also found evidence of a possible blood overflow in the brain that warrants further investigation.

scholarly journals Changes of the sleep in pregnant women with intrauterine fetal growth restriction

2018 ◽  
Vol 22 (1) ◽  
pp. 160-162
Author(s):  
A.M. Berbets
Keyword(s):  
Pregnant Women ◽  
Sleep Disorders ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Intrauterine Growth Restriction ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Intrauterine Fetal Growth Restriction

Objective – to study the reasons of appearance, terms of manifestation and types of the sleep disorders in pregnant women with intrauterine growth restriction of fetus. 80 pregnant women with placental insufficiency, manifesting as intrauterine fetal growth restriction (IUGR) of II–III degree in the 3rd pregnancy trimester (study group) and 30 women with normal clinical flow of pregnancy (control group) were questioned. They were asked about pregnancy term when the complains of the sleep disorders were firstly expressed, as well as about types of the sleep disorders and their frequency (in times per week). Questioning showed that pregnant women with IUGR in 86% cases experience the sleep disorders starting from pregnancy term 12–22 weeks (healthy pregnant women — mostly after 30 weeks, 57% cases), more commonly wake up 2 or more times per night (71% of positive answers, in control group – 23%), and 3 or more times per week (78% of positive answers, in control group – 17%). Thus, sleep disorders in pregnant women with IUGR appear earlier and seem to be more expressed then in pregnant women with normal fetal growth. Expression of the complains of insomnia, in our opinion, might be considered as an early diagnostic sign of forming of placental insufficiency, which is later realized as IUGR.

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.

INTRAUTERINE GROWTH RETARDATION - A REVIEW ARTICLE

2018 ◽  
pp. 184-195
Author(s):  
Minh Son Pham ◽  
Vu Quoc Huy Nguyen ◽  
Dinh Vinh Tran
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Growth Potential ◽  
National Guidelines ◽  
Intrauterine Growth ◽  
No Gold Standard

Small for gestational age (SGA) and fetal growth restriction (FGR) is difficult to define exactly. In this pregnancy condition, the fetus does not reach its biological growth potential as a consequence of impaired placental function, which may be because of a variety of factors. Fetuses with FGR are at risk for perinatal morbidity and mortality, and poor long-term health outcomes, such as impaired neurological and cognitive development, and cardiovascular and endocrine diseases in adulthood. At present no gold standard for the diagnosis of SGA/FGR exists. The first aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines. Another aim to summary a number of interventions which are being developed or coming through to clinical trial in an attempt to improve fetal growth in placental insufficiency. Key words: fetal growth restriction (FGR), Small for gestational age (SGA)

Is ProBNP a New Marker for Predicting Intrauterine Growth Restriction?

2021 ◽  
Vol 225 (02) ◽  
pp. 125-128
Author(s):  
Hasan Eroğlu ◽  
Nazan Vanlı Tonyalı ◽  
Gokcen Orgul ◽  
Derya Biriken ◽  
Aykan Yucel ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Final Analysis ◽  
First Trimester ◽  
Maternal Serum ◽  
Growth Restriction ◽  
Control Group ◽  
Aneuploidy Screening ◽  
Intrauterine Growth ◽  
Potential Marker ◽  
The Mean

Abstract Purpose To evaluate the usability of first-trimester maternal serum ProBNP levels in the prediction of intrauterine growth restriction (IUGR). Methods In this prospective study, blood samples taken from 500 women who applied to our polyclinic for routine serum aneuploidy screening between the 11–14th gestational weeks were centrifuged. The obtained plasma samples were placed in Eppendorf tubes and stored at −80+°C. For the final analysis, first-trimester maternal serum ProBNP levels of 32 women diagnosed with postpartum IUGR and 32 healthy women randomly selected as the control group were compared. FGR was defined as estimated fetal weight below the 10th percentile for the gestational age. Results The mean ProBNP levels were statistically and significantly higher in the women with intrauterine growth restriction (113.73±94.69 vs. 58.33±47.70 pg/mL, p<0.01). At a cut-off level of 50.93, ProBNP accurately predicted occurrence of IUGR (AUC+= 0.794 (95% confidence interval 0.679–0.910), p+= 0.001) with sensitivity and specificity rates of 78.1 and 69.0%, respectively. Conclusion First-trimester serum ProBNP level was significantly higher in women who developed IUGR compared to healthy controls. First-trimester ProBNP level can be used as a potential marker to predict the development of IUGR in pregnant women.

Strategies for intra-amniotic administration of fetal therapy in a rabbit model of intrauterine growth restriction

2021 ◽  
pp. 153537022110035
Author(s):  
Mari Kinoshita ◽  
Fàtima Crispi ◽  
Carla Loreiro ◽  
Eduard Gratacós ◽  
Míriam Illa ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Intraperitoneal Injection ◽  
Rabbit Model ◽  
Osmotic Pump ◽  
Growth Restriction ◽  
Technical Failure ◽  
Fetal Therapy ◽  
Amniotic Cavity ◽  
Intrauterine Growth ◽  
Fetal Survival

Intrauterine growth restriction affects up to 10% of all pregnancies, leading to fetal programming with detrimental consequences for lifelong health. However, no therapeutic strategies have so far been effective to ameliorate these consequences. Our previous study has demonstrated that a single dose of nutrients administered into the amniotic cavity, bypassing the often dysfunctional placenta via intra-amniotic administration, improved survival at birth but not birthweight in an intrauterine growth restriction rabbit model. The aim of this study was to further develop an effective strategy for intra-amniotic fetal therapy in an animal model. Intrauterine growth restriction was induced by selective ligation of uteroplacental vessels on one uterine horn of pregnant rabbits at gestational day 25, and fetuses were delivered by cesarean section on GD30. During the five days of intrauterine growth restriction development, three different methods of intra-amniotic administration were used: continuous intra-amniotic infusion by osmotic pump, multiple intra-amniotic injections, and single fetal intraperitoneal injection. Technical feasibility, capability to systematically reach the fetus, and survival and birthweight of the derived offspring were evaluated for each technique. Continuous intra-amniotic infusion by osmotic pump was not feasible owing to the high occurrence of catheter displacement and amnion rupture, while methods using two intra-amniotic injections and one fetal intraperitoneal injection were technically feasible but compromised fetal survival. Taking into account all the numerous factors affecting intra-amniotic fetal therapy in the intrauterine growth restriction rabbit model, we conclude that an optimal therapeutic strategy with low technical failure and positive fetal impact on both survival and birthweight still needs to be found.

Association of maternal and/or fetal factor V Leiden and G20210A prothrombin mutation with HELLP syndrome and intrauterine growth restriction

2003 ◽  
Vol 105 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Dietmar SCHLEMBACH ◽  
Ernst BEINDER ◽  
Juergen ZINGSEM ◽  
Ute WUNSIEDLER ◽  
Matthias W. BECKMANN ◽  
...  
Keyword(s):  
Blood Flow ◽  
Intrauterine Growth Restriction ◽  
Hellp Syndrome ◽  
Factor V Leiden ◽  
Growth Restriction ◽  
Control Group ◽  
Factor V ◽  
Intrauterine Growth ◽  
Prothrombin Mutation ◽  
Thrombophilic Mutations

This study was conducted to investigate the association of maternal and/or fetal factor V Leiden (FVL) and G20210A prothrombin mutation with HELLP syndrome. FVL and G20210A prothrombin mutation were determined using PCR. Sixty-three pregnant women, 36 of them diagnosed with HELLP syndrome, were included in the study. Overall, 68 children were born as a result of these pregnancies and blood sampling was possible in 28 out of 39 children from HELLP patients and 25 out of 29 children from the control women. The prevalence of a maternal FVL was elevated 2-fold in HELLP patients compared with the control women [six out of 36 (16.7%) compared with two out of 27 (7.4%); P=0.282]. None of the HELLP patients and only one woman in the control group was found to be positive for the G20210A prothrombin mutation (P=0.251). The fetal carrier frequency was four out of 28 compared with three out of 25 for FVL (P=0.811), and two out of 28 compared with one out of 25 for G20210A prothrombin mutation (P=0.629). Intrauterine growth restriction (IUGR) was significantly higher in fetuses found to be positive for a thrombophilic mutation (P=0.022). IUGR occurred in seven out of ten fetuses with a thrombophilic mutation compared with 11 out of 43 in fetuses without a mutation. The prevalence of FVL, but not of the G20210A prothrombin mutation, seems to be elevated in women with HELLP syndrome. A fetal thrombophilic mutation does not contribute significantly to the clinical features of the HELLP syndrome. Our results demonstrate a fetal contribution to IUGR. Fetal thrombophilic mutations may lead to placental microthrombosis, which consecutively could lead to a disturbed fetoplacental blood flow and thus cause growth restriction.

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