scholarly journals The Role of Proteoglycans in Contributing to Placental Thrombosis and Fetal Growth Restriction

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Joanne M. Said

Fetal growth restriction is an important pregnancy complication that has major consequences for the fetus and neonate as well as an increased risk of long-term morbidity extending into adulthood. The precise aetiology of most cases of fetal growth restriction is unknown although placental thrombosis is a common feature in many of these cases. This paper will outline the potential role of proteoglycans in contributing to placental thrombosis and fetal growth restriction.

Author(s):  
Sonia Tamanna ◽  
Eugenie R. Lumbers ◽  
Saije K. Morosin ◽  
Sarah J. Delforce ◽  
Kirsty G. Pringle

Angiotensin-converting enzyme 2 (ACE2) is a membrane-bound protein containing 805-amino acids. ACE2 shows approximately 42% sequence similarity to somatic ACE but has different biochemical activities. The key role of ACE2 is to catalyse the vasoconstrictor peptide Angiotensin (Ang) II to Ang-(1-7), thus regulating the two major counterbalancing pathways of the renin-angiotensin system (RAS). In this way, ACE2 plays a protective role in end-organ damage by protecting tissues from the pro-inflammatory actions of Ang II. The circulating RAS is activated in normal pregnancy and is essential for maintaining fluid and electrolyte homeostasis and blood pressure. Renin-angiotensin systems are also found in the conceptus. In this review, we summarise the current knowledge on the regulation and function of circulating and uteroplacental ACE2 in uncomplicated and complicated pregnancies, including those affected by preeclampsia and fetal growth restriction. Since ACE2 is the receptor for SARS-CoV-2, and COVID-19 in pregnancy is associated with more severe disease and increased risk of abnormal pregnancy outcomes, we also discuss the role of ACE2 in mediating some of these adverse consequences. We propose that dysregulation of ACE2 plays a critical role in the development of preeclampsia, fetal growth restriction and COVID-19-associated pregnancy pathologies and suggest that human recombinant soluble ACE2 could be a novel therapeutic to treat and/or prevent these pregnancy complications.


2019 ◽  
Vol 8 (7) ◽  
pp. 944 ◽  
Author(s):  
Sophie G. Groene ◽  
Lisanne S.A. Tollenaar ◽  
Dick Oepkes ◽  
Enrico Lopriore ◽  
Jeanine M.M. van Klink

The aim of this review was to assess the impact of selective fetal growth restriction (sFGR) and/or birth weight discordance (BWD) on long-term neurodevelopment in monochorionic (MC) twins. Five out of 28 articles assessed for eligibility were included. One article concluded that the incidence of long-term neurodevelopmental impairment (NDI) was higher in BWD MC twins (11/26, 42%) than in BWD dichorionic (DC) (5/38, 13%) and concordant MC twins (6/71, 8%). BWD MC twins had a 6-fold higher risk of cerebral palsy compared to DC twins (5/26, 19% vs. 1/40, 3%, p < 0.05). Another article described a linear relationship between birth weight and verbal IQ scores, demonstrating a 13-point difference for a 1000 gram BWD between the twins, with a disadvantage for the smaller twin (p < 0.0001). Three articles analyzing within-pair differences showed that the smaller twin more frequently demonstrated mild NDI (6/80, 8% vs. 1/111, 1%) and lower developmental test scores (up to 5.3 points) as opposed to its larger co-twin. Although these results suggest that MC twins with sFGR/BWD are at increased risk of long-term NDI as compared to BWD DC or concordant MC twins, with a within-pair disadvantage for the smaller twin, the overall level of evidence is of moderate quality. As only five articles with a high degree of heterogeneity were available, our review mainly demonstrates the current lack of knowledge of the long-term outcomes of MC twins with sFGR/BWD. Insight into long-term outcomes will lead to improved prognostics, which are essential in parent counseling and crucial in the process of forming a management protocol specifically for twins with sFGR to optimally monitor and support their development.


Placenta ◽  
2019 ◽  
Vol 83 ◽  
pp. 57-62
Author(s):  
Zhiyong Zou ◽  
Zhiming He ◽  
Jian Cai ◽  
Linhuan Huang ◽  
Hui Zhu ◽  
...  

2018 ◽  
pp. 184-195
Author(s):  
Minh Son Pham ◽  
Vu Quoc Huy Nguyen ◽  
Dinh Vinh Tran

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)


2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Samantha C. Lean ◽  
Alexander E. P. Heazell ◽  
Mark R. Dilworth ◽  
Tracey A. Mills ◽  
Rebecca L. Jones

Author(s):  
Sri Sulistyawati ◽  
Didon M Trimulya ◽  
Supriyadi H Respati ◽  
Soetrisno Soetrisno

Objective: To determine the role of HLA-C and NK cell expressions in fetal growth restriction (FGR). Methods: A cross sectional study design was used. This study was conducted at the Obstetrics and Gynecology Department of Dr. Moewardi General Hospital, Surakarta, its affiliated hospitals, and at the Pathological Anatomy Laboratory of the Faculty of Medicine, University of Sebelas Maret Surakarta. A total of 40 samples were included in this study. The samples consisted of 20 normal pregnancies and 20 pregnancies with FGR. HLA-C expression in the trophoblast and NK cells in decidua of the subjects who met the inclusion and exclusion criteria were examined using immunohistochemical method and statistical analysis with T test. Results: The mean expression of HLA-C in the trophoblast in the pregnant group with FGR was 9.021.30, normal pregnancy was 7.96 ± 0.97, p=0.01 (p<0.05). The mean expression of NK cells in decidua of pregnancy with FGR was 10.59 ± 2.11, normal pregnancy was 0.91 ± 8.18, with p=0.00 (p<0.05). Conclusion: The expressions of HLA-C in trophoblast and NK cells in decidua of pregnancy with FGR were higher compared with those of normal pregnancy. [Indones J Obstet Gynecol 2017; 5-3: 142-148] Keywords: fetal growth restriction, HLA-C, NK cells


2021 ◽  
Vol 20 (5) ◽  
pp. 76-86
Author(s):  
N.M. Podzolkova ◽  
◽  
Yu.V. Denisova ◽  
M.Yu. Skvortsova ◽  
T.V. Denisova ◽  
...  

Fetal growth restriction (FGR) refers to pregnancy complications associated with an increased risk of perinatal morbidity and mortality and is defined in the Russian-language literature as the fetal size and weight retardation in relation to the norm for a given gestational age, and in the English-language literature – as the inability of the fetus to realize its genetically determined growth potential. FGR is the cause of 43% of stillbirths of unspecified etiology, and some cases remain undiagnosed even in high-risk populations due to the lack of universal diagnostic standards for this pathology. The review presents a critical analysis of the existing definitions of FGR, the latest data on risk factors, an assessment of diagnostic methods for its early and late forms, the prospects of using biomarkers and instrumental methods of examination in predicting adverse perinatal outcomes, and an algorithm for the management of pregnancy complicated by FGR. For a more complete coverage of the literature and deeper understanding of the nosology, attention is focused on FGR that is not accompanied by preeclampsia and other hypertensive disorders, which occur in about 30% of cases. Key words: placental insufficiency, fetometry, percentile, pulsatility index, fetal growth restriction For citation: Podzolkova N.M., Denisova Yu.V., Skvortsova M.Yu., Denisova T.V., Shovgenova D.S. Fetal growth restriction: unresolved issues of risk stratification, early diagnosis, and obstetric management. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2021; 20(5): 76–86. (In Russian). DOI: 10.20953/1726-1678-2021-5-76-86


2007 ◽  
Vol 197 (6) ◽  
pp. S209
Author(s):  
Silvia Malberti ◽  
Maddalena Incerti ◽  
Anna Locatelli ◽  
Sara Consonni ◽  
Massimiliano Greco ◽  
...  

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