Procedure related risk of premature delivery and fetal growth reduction following amniocentesis, transcervical and transabdominal chorionic villus sampling: a retrospective study

2019 ◽  
Vol 47 (8) ◽  
pp. 811-816
Author(s):  
Julia Zimmer ◽  
Ralf Schmitz ◽  
Mareike Möllers ◽  
Kerstin Hammer ◽  
Maria K. Falkenberg ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Chorionic Villus ◽  
Prenatal Testing ◽  
Invasive Procedure ◽  
Normal Karyotype ◽  
Growth Restriction ◽  
Premature Delivery ◽  
Control Group ◽  
Chorionic Villus Sampling

Abstract Background The aim of this study was to compare transabdominal and transcervical chorionic villus sampling (CVS) as well as amniocentesis (AC) with respect to their rates of premature delivery and fetal growth restriction. Methods We retrospectively evaluated the mentioned procedures of invasive prenatal testing performed in a single center between 2001 and 2016. Seven hundred and ninety-nine cases of AC and 719 cases of CVS were included, of which 400 were performed transvaginally. Only singleton pregnancies with a normal karyotype and delivery after 24 + 0 weeks of gestation were included. Fetal growth restriction was defined as birth weight below the 10th percentile. Premature delivery was defined as delivery before 37 + 0 weeks of gestation. Data were compared to a control group without an invasive procedure. Results The frequency of premature delivery was 8.5% after transabdominal CVS, 6.3% after transcervical CVS and 10.5% after AC as compared to 10.8% in the control group. The frequency of fetal growth restriction was 8.2% after transabdominal CVS 6.8% after transcervical CVS and 8.4% after AC as compared to 9.7% in the control group. Conclusion Our study supports that the three different methods of invasive prenatal testing do not lead to a higher risk of either premature delivery or fetal growth restriction when compared to controls. We found no difference in risk profile among the three techniques.

scholarly journals CD68+ M1 MACROPHAGES IS ASSOCIATED WITH PLACENTAL INSUFFICIENCY UNDER FETAL GROWTH RESTRICTION

2021 ◽  
Vol 74 (2) ◽  
pp. 213-219
Author(s):  
Varvara A. Berezhna ◽  
Tetiana V. Mamontova ◽  
Antonina M. Gromova
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Preterm Births ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Immunohistochemical Method ◽  
Control Group ◽  
Stromal Component ◽  
Term Births

The aim: To elucidate the possible involvement of M1 and M2 macrophages in the placentas of women, whose pregnancies were complicated by fetal growth restriction (FGR) and resulted in term births after 37 weeks of gestation and preterm births up to 37 weeks of gestation. Materials and methods: CD68+ and CD163+ macrophages were studied by immunohistochemical method, placental morphology in the placentas of 16 women whose pregnancies were complicated by FGR and resulted in term births at a gestational age after 37 weeks (1-st group, n = 7) or resulted in preterm births at a gestational age up to 37 weeks (2-nd group, n = 9). The control group consisted of 10 placentas of women with physiological pregnancies and births. Results: Women 2-nd group showed significantly low weight of the placenta, a short gestation period at the time of delivery, and a prolonged labor period than women of the control group (p <0.001; p <0.001; p <0.05, respectively). The level of CD68+ and CD163+ macrophages in the placentas of women 2-nd group was significantly higher than in woman 1-st group (p <0.001, p <0.001, respectively). A significant correlation was found between the expression level of CD68+ monocytes in the intervillous space and the weight of a newborn (r = – 0.765; p = 0.016) in women 2-nd group. Conclusions: These studies suggest that in the placentas of women whose pregnancies were complicated by FGR and resulted in preterm births, the increased activation of CD68+ macrophages of the pro-inflammatory pool may be associated with disorders of the vascular and stromal component of the villous chorion with the development of involutive and dystrophic changes. In general, this fact probably determines the progress of chronic placental insufficiency and aggravates the development of fetal growth restriction.

scholarly journals miR-16-5p, miR-103-3p, and miR-27b-3p as Early Peripheral Biomarkers of Fetal Growth Restriction

2021 ◽  
Vol 9 ◽  
Author(s):  
Salvatore Tagliaferri ◽  
Pasquale Cepparulo ◽  
Antonio Vinciguerra ◽  
Marta Campanile ◽  
Giuseppina Esposito ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Late Onset ◽  
Maternal Blood ◽  
Growth Restriction ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Fetal Hypoxia ◽  
Blood Samples

Current tests available to diagnose fetal hypoxia in-utero lack sensitivity thus failing to identify many fetuses at risk. Emerging evidence suggests that microRNAs derived from the placenta circulate in the maternal blood during pregnancy and may be used as non-invasive biomarkers for pregnancy complications. With the intent to identify putative markers of fetal growth restriction (FGR) and new therapeutic druggable targets, we examined, in maternal blood samples, the expression of a group of microRNAs, known to be regulated by hypoxia. The expression of microRNAs was evaluated in maternal plasma samples collected from (1) women carrying a preterm FGR fetus (FGR group) or (2) women with an appropriately grown fetus matched at the same gestational age (Control group). To discriminate between early- and late-onset FGR, the study population was divided into two subgroups according to the gestational age at delivery. Four microRNAs were identified as possible candidates for the diagnosis of FGR: miR-16-5p, miR-103-3p, miR-107-3p, and miR-27b-3p. All four selected miRNAs, measured by RT-PCR, resulted upregulated in FGR blood samples before the 32nd week of gestation. By contrast, miRNA103-3p and miRNA107-3p, analyzed between the 32nd and 37th week of gestation, showed lower expression in the FGR group compared to aged matched controls. Our results showed that measurement of miRNAs in maternal blood may form the basis for a future diagnostic test to determine the degree of fetal hypoxia in FGR, thus allowing the start of appropriate therapeutic interventions to alleviate the burden of this disease.

Evaluating the Effect of Pravastatin in Early-Onset Fetal Growth Restriction: A Nonrandomized and Historically Controlled Pilot Study

2020 ◽  
Author(s):  
Manel Mendoza ◽  
Raquel Ferrer-Oliveras ◽  
Erika Bonacina ◽  
Pablo Garcia-Manau ◽  
Carlota Rodo ◽  
...  
Keyword(s):  
Pilot Study ◽  
Fetal Growth ◽  
Pregnancy Outcomes ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Maternal Serum ◽  
Angiogenic Factors ◽  
Interquartile Range ◽  
Growth Restriction ◽  
Control Group

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

scholarly journals Intrauterine Gardnerella vaginalis Infection Results in Fetal Growth Restriction and Alveolar Septal Hypertrophy in a Rabbit Model

2021 ◽  
Vol 8 ◽  
Author(s):  
Fook-Choe Cheah ◽  
Chee Hoe Lai ◽  
Geok Chin Tan ◽  
Anushia Swaminathan ◽  
Kon Ken Wong ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Ureaplasma Urealyticum ◽  
Rabbit Model ◽  
Fetal Lung ◽  
Growth Restriction ◽  
Gardnerella Vaginalis ◽  
Control Group ◽  
Lung Weight ◽  
Septal Hypertrophy

Background:Gardnerella vaginalis (GV) is most frequently associated with bacterial vaginosis and is the second most common etiology causing intrauterine infection after Ureaplasma urealyticum. Intrauterine GV infection adversely affects pregnancy outcomes, resulting in preterm birth, fetal growth restriction, and neonatal pneumonia. The knowledge of how GV exerts its effects is limited. We developed an in vivo animal model to study its effects on fetal development.Materials and Methods: A survival mini-laparotomy was conducted on New Zealand rabbits on gestational day 21 (28 weeks of human pregnancy). In each dam, fetuses in the right uterine horn received intra-amniotic 0.5 × 102 colony-forming units of GV injections each, while their littermate controls in the left horn received sterile saline injections. A second laparotomy was performed seven days later. Assessment of the fetal pups, histopathology of the placenta and histomorphometric examination of the fetal lung tissues was done.Results: Three dams with a combined total of 12 fetuses were exposed to intra-amniotic GV, and 9 fetuses were unexposed. The weights of fetuses, placenta, and fetal lung were significantly lower in the GV group than the saline-inoculated control group [mean gross weight, GV (19.8 ± 3.8 g) vs. control (27.9 ± 1.7 g), p &lt; 0.001; mean placenta weight, GV (5.5 ± 1.0 g) vs. control (6.5 ± 0.7 g), p = 0.027; mean fetal lung weight, GV (0.59 ± 0.11 g) vs. control (0.91 ± 0.08 g), p = 0.002. There was a two-fold increase in the multinucleated syncytiotrophoblasts in the placenta of the GV group than their littermate controls (82.9 ± 14.9 vs. 41.6 ± 13.4, p &lt; 0.001). The mean alveolar septae of GV fetuses was significantly thicker than the control (14.8 ± 2.8 μm vs. 12.4 ± 3.8 μm, p = 0.007). Correspondingly, the proliferative index in the interalveolar septum was 1.8-fold higher in the GV group than controls (24.9 ± 6.6% vs. 14.2 ± 2.9%, p = 0.011). The number of alveoli and alveolar surface area did not vary between groups.Discussion: Low-dose intra-amniotic GV injection induces fetal growth restriction, increased placental multinucleated syncytiotrophoblasts and fetal lung re-modeling characterized by alveolar septal hypertrophy with cellular proliferative changes.Conclusion: This intra-amniotic model could be utilized in future studies to elucidate the acute and chronic effects of GV intrauterine infections.

scholarly journals Genetic Background of Fetal Growth Restriction

2021 ◽  
Vol 23 (1) ◽  
pp. 36
Author(s):  
Beata Anna Nowakowska ◽  
Katarzyna Pankiewicz ◽  
Urszula Nowacka ◽  
Magdalena Niemiec ◽  
Szymon Kozłowski ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Metabolic Diseases ◽  
Prenatal Testing ◽  
Growth Restriction ◽  
Chromosomal Microarray ◽  
Third Trimester ◽  
Noninvasive Prenatal Testing ◽  
Current State

Fetal growth restriction (FGR) is one of the most formidable challenges in present-day antenatal care. Pathological fetal growth is a well-known factor of not only in utero demise in the third trimester, but also postnatal morbidity and unfavorable developmental outcomes, including long-term sequalae such as metabolic diseases, diabetic mellitus or hypertension. In this review, the authors present the current state of knowledge about the genetic disturbances responsible for FGR diagnosis, divided into fetal, placental and maternal causes (including preeclampsia), as well as their impact on prenatal diagnostics, with particular attention on chromosomal microarray (CMA) and noninvasive prenatal testing technique (NIPT).

Can Inflammatory Hematological Parameters be a Guide to Late-onset Fetal Growth Restriction?

2020 ◽  
Author(s):  
Demet Aydogan kırmızı ◽  
Emre Baser ◽  
Taylan Onat ◽  
Melike Demir Caltekin ◽  
Mustafa Kara ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Late Onset ◽  
Hematological Parameters ◽  
Growth Restriction ◽  
Control Group ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference

Abstract Purpose To compare the rates obtained from hematological parameters in cases of late-onset idiopathic fetal growth restriction (FGR) with healthy pregnancies and to evaluate the effect on neonatal outcomes. Methods The study group consisted of 63 pregnant women with late-onset idiopathic FGR and the control group consisted of 91 healthy pregnant women. The determined rates were calculated from the control hemograms of patients at 28 weeks. Both groups were compared for neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and other parameters. Results NLR, leukocyte and neutrophil levels were significantly higher in the FGR group (p<0.05). There was no significant difference in PLR, platelet and lymphocyte levels between the groups (p>0.05). To predict FGR, the best cut-off value of NLR was determined to be 4.11 with 56% sensitivity and 88% specificity values. Conclusion Neutrophil, lymphocyte and platelet interactions have an important role in FGR development. Inflammation can be involved in the etiopathogenesis in late-onset FGR.

scholarly journals Hemolysis, Elevated Liver Enzymes, and Low Platelets, Severe Fetal Growth Restriction, Postpartum Subarachnoid Hemorrhage, and Craniotomy: A Rare Case Report and Systematic Review

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Shadi Rezai ◽  
Justin Faye ◽  
Alexander Hughes ◽  
Mon-Lai Cheung ◽  
Joel R. Cohen ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Growth Restriction ◽  
Premature Delivery ◽  
Management Approach ◽  
Chronic Hypertension ◽  
Elevated Liver Enzymes

Introduction. Hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome is a relatively uncommon but traumatic condition occurring in the later stage of pregnancy as a complication of severe preeclampsia or eclampsia. Prompt brain computed tomography (CT) or magnetic resonance imaging (MRI) and a multidisciplinary management approach are required to improve perinatal outcome. Case. A 37-year-old, Gravida 6, Para 1-0-4-1, Hispanic female with a history of chronic hypertension presented at 26 weeks and 6 days of gestational age. She was noted to have hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome accompanied by fetal growth restriction (FGR), during ultrasound evaluation, warranting premature delivery. The infant was delivered in stable condition suffering no permanent neurological deficit. Conclusion. HELLP syndrome is an uncommon and traumatic obstetric event which can lead to neurological deficits if not managed in a responsive and rapid manner. The central aggravating factor seems to be hypertension induced preeclamptic or eclamptic episode and complications thereof. The syndrome itself is manifested by hemolytic anemia, increased liver enzymes, and decreasing platelet counts with a majority of neurological defects resulting from hemorrhagic stroke or subarachnoid hemorrhage (SAH). To minimize adverse perinatal outcomes, obstetric management of this medical complication must include rapid clinical assessment, diagnostic examination, and neurosurgery consultation.

scholarly journals Ultrasound Doppler fetal heart rate detection algorithm analyzesthe correlation between twin selective fetal growth restriction and cord blood SFass fasL level

2021 ◽  
Vol 37 (6-WIT) ◽  
Author(s):  
Qiaohong Cao ◽  
Cong Ma ◽  
Junbiao Zhu
Keyword(s):  
Heart Rate ◽  
Cord Blood ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Detection Algorithm ◽  
Growth Restriction ◽  
Control Group ◽  
Ultrasound Doppler

Objective: The paper uses ultrasound Doppler fetal heart rate detection algorithm to explore the placental characteristics of monochorionic twin pregnancy with selective fetal growth restriction, and discuss the correlation between selective fetal growth restriction and cord blood SFass FasL level.  Methods: From June 1, 2019 to June 1, 2020 in our hospital, 23 cases of selective fetal growth restriction and 32 cases of uncomplicated cases were included in the monochorionic twin pregnancies whose pregnancy was terminated in our hospital (control group) research. Perfusion was completed within 24 hours after delivery of the placenta. The umbilical arteries and veins of the two fetuses were respectively perfused with four different colors of pigments. The type of anastomoses was judged according to the color of the blood vessels on the placenta surface.  Results: The selective fetal growth restriction group was higher than the control group. In the selective fetal growth restriction group and the control group, the number of anastomoses of the placental superficial arterial artery, arterial vein and venous vein were 1.0 and 1.0, 3.0 and 2.0, 0.0 and 0.0, respectively; the placental superficial arterial artery, arterial vein and venous vein. The total diameters of the anastomosed blood vessels were 2.7 and 2.2, 4.0 and 3.4, 0.0 and 0.0 mm, respectively; the total number of superficial placental anastomosed blood vessels in the selective fetal growth restriction group and the control group were 3.5 and 3.5, respectively.The total diameters were 6.9 and 6.9, respectively 5.9mm.  Conclusion: Uneven placental share and non-central attachment of the umbilical cord may be risk factors for selective fetal growth restriction in monochorionic twin pregnancy. doi: https://doi.org/10.12669/pjms.37.6-WIT.4881 How to cite this:Cao Q, Ma C, Zhu J. Ultrasound Doppler fetal heart rate detection algorithm analyzes the correlation between twin selective fetal growth restriction and cord blood SFass fasL level. Pak J Med Sci. 2021;37(6):1672-1676.   doi: https://doi.org/10.12669/pjms.37.6-WIT.4881 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The use of folates for the prevention of fetal growth restriction during pregnancy

2018 ◽  
pp. 65-67
Author(s):  
N. E. Kan ◽  
Z. V. Khachatryan ◽  
V. L. Tyutyunnik ◽  
N. A. Lomova ◽  
A. E. Donnikov
Keyword(s):  
Risk Factors ◽  
Folic Acid ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Clinical Risk Factors ◽  
Control Group ◽  
Mthfr Polymorphism ◽  
Clinical Risk ◽  
Group I

Purpose of the study: Rational for the use of folates for the prevention of fetal growth restriction on the basis of the identification of a MTHFR polymorphism.Material and methods: 200 patients (case-control) were enrolled in the study. The (main) group I included 100 patients with fetal growth restriction (FGR), the (control) group II included 100 conditionally healthy patients. The features of the anamnesis, the initial clinical characteristics, the course of pregnancy, childbirth and the postpartum period in patients with placental insufficiency were studied in detail, and the features of the early neonatal period were analysed comprehensively. At the second stage, the polymorphism of the MMP2, MMP3, MMP9, and MTHFR genes was studied and their dependence with the development of the FGR was established. Statistical processing of the results was carried out on a personal computer using the SPSS Statistics 17.0 for Windows software package.Results:The clinical risk factors for the development of FGR include: chronic pyelonephritis, medium degree myopia, varicose veins, threat of abortion, ultrasound-detected subchorionic hemorrhage in the I trimester of gestation, anemia. Along with clinical risk factors for ZRP, the carriage of MTGFR (677 C> T) polymorphism is also considered, which justifies its identification in patients at risk.Conclusion: The data obtained make it possible to use the identification of MTHFR polymorphism as a predictor of placental abnormalities during pregnancy and to start taking folic acid supplements at the preconception stage in good time. Femibion 1 vitaminmineral complex has proved to be an effective product that is suitable for women in the period of preparation for pregnancy and in the first trimester of gestation, reducing the risk of fetal malformations and endothelial dysfunction caused by a violation of folic acid metabolism. 

scholarly journals Hepatitis E, Schistosomiasis and Echinococcosis–Prevalence in a Cohort of Pregnant Migrants in Germany and Their Influence on Fetal Growth Restriction

Pathogens ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 58
Author(s):  
Janine Zöllkau ◽  
Juliane Ankert ◽  
Mathias W. Pletz ◽  
Sasmita Mishra ◽  
Gregor Seliger ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Hepatitis E ◽  
Growth Restriction ◽  
Premature Delivery ◽  
Delivery Methods ◽  
Increased Risk ◽  
History Of ◽  
Adverse Pregnancy ◽  
History Of Migration

Background: Infections, as well as adverse birth outcomes, may be more frequent in migrant women. Schistosomiasis, echinococcosis, and hepatitis E virus (HEV) seropositivity are associated with the adverse pregnancy outcomes of fetal growth restriction and premature delivery. Methods: A cohort study of 82 pregnant women with a history of migration and corresponding delivery of newborns in Germany was conducted. Results: Overall, 9% of sera tested positive for anti-HEV IgG. None of the patients tested positive for anti-HEV IgM, schistosomiasis, or echinococcus serology. Birth weights were below the 10th percentile for gestational age in 8.5% of the neonates. No association between HEV serology and fetal growth restriction (FGR) frequency was found. Conclusions: In comparison to German baseline data, no increased risk for HEV exposure or serological signs of exposure against schistosomiasis or echinococcosis could be observed in pregnant migrants. An influence of the anti-HEV serology status on fetal growth restriction could not be found.

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