Intrauterine growth retardation (upavishataka garbhavyapad) and it’s ayurved and modern management – review of literatures.

2020 ◽  
Vol 8 (02) ◽  
Author(s):  
Snehal Snehal
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Intrauterine Growth Retardation ◽  
Modern Science ◽  
Neonatal Morbidity ◽  
Signs And Symptoms ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Basic Principles ◽  
Intrauterine Growth

According to modern science , intrauterine Growth Restriction (IUGR) is an important causes of fetal and neonatal morbidity and mortality.    In IUGR development and maturity of foetus delayed or impaired . Fetal growth restriction is said to be present in those babies whose birth weight is below the 10th percentile of the average for the gestational age. Growth restriction can occure in preterm , term, or post term babies.(1)  Placental insufficiency or utero placental insufficiency is most imp. Cause of intrauterine growth restriction.    The signs and   symptoms of IUGR and Upavishtaka are same .In Ayurveda Upavishtak is described under Garbhavyapads.In ayurvedic literature , there are many natural formulations ,various drugs have been described  for treatment is based upon basic principles such as rasa , guna ,veerya,vipak of drugs.Hence to study the consept of IUGR (upavishtaka) according to modern and Ayurveda; this topic has been selected for study.

scholarly journals Intrauterine Growth Restriction: Antenatal and Postnatal Aspects

2016 ◽  
Vol 10 ◽  
pp. CMPed.S40070 ◽  
Author(s):  
Deepak Sharma ◽  
Sweta Shastri ◽  
Pradeep Sharma
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Perinatal Asphyxia ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Growth Potential ◽  
Intrauterine Growth ◽  
Health And Disease ◽  
Neonatal Problems

Intrauterine growth restriction (IUGR), a condition that occurs due to various reasons, is an important cause of fetal and neonatal morbidity and mortality. It has been defined as a rate of fetal growth that is less than normal in light of the growth potential of that specific infant. Usually, IUGR and small for gestational age (SGA) are used interchangeably in literature, even though there exist minute differences between them. SGA has been defined as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycemia, and polycythemia. The likely long-term complications that are prone to develop when IUGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps, and developmental origin of health and disease. In this review, we have covered various antenatal and postnatal aspects of IUGR.

scholarly journals Does an abnormally elevated maternal alkaline phosphatase pose problems for the fetus?

2019 ◽  
Vol 12 (4) ◽  
pp. e229109 ◽  
Author(s):  
Sarah McErlean ◽  
Chris King
Keyword(s):  
Alkaline Phosphatase ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Delivery ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Potential Association

We report a potential association between an abnormally raised pregnancy level of alkaline phosphatase (ALP) and intrauterine growth restriction (IUGR). There are few reports of women with abnormally high ALP during pregnancy. However, there is work to suggest an association with placental insufficiency, low birth weight and preterm delivery. In conjunction with a rising ALP, fetal IUGR and intermittent absence of umbilical artery end diastolic flow had evolved. A greatly elevated ALP may be a marker for placental insufficiency and IUGR.

scholarly journals A retrospective interventional study for evaluation of efficacy and safety of sildenafil citrate in improving intrauterine growth restriction and oligohydramnios using ultrasound Doppler velocimetry

2019 ◽  
Vol 8 (12) ◽  
pp. 2736
Author(s):  
Kedar N. Ganla ◽  
Rana A. Choudhary ◽  
Kavita N. Desai ◽  
Santoshi B. Kadam ◽  
Krutika Arunachalam
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Morbidity And Mortality ◽  
Sildenafil Citrate ◽  
Common Finding ◽  
Interventional Study ◽  
Intrauterine Growth

Background: Intrauterine growth restriction (IUGR) is one of the major reasons for neonatal morbidity and mortality. Oligohydramnios is a common finding in IUGR. In majority of these cases diminished utero-placental blood flow is observed. However, in spite of this understanding and identification of high-risk patients, the management options are limited. Sildenafil citrate, a phosphodiesterase type-5 inhibitor improves utero-placental perfusion.Methods: We present a retrospective interventional study involving 50 adult pregnant women diagnosed with early-onset IUGR (n=38) and oligohydramnios (n=12). Vaginal sildenafil citrate 25 mg t.i.d. was started from the day of diagnosis till delivery. Primary efficacy endpoints included changes in Doppler parameters i.e., amniotic fluid index (AFI), uterine artery (UA)- pulsatility index (PI), resistance index (RI) and systolic diastolic ratio (S/D ratio). Secondary endpoints included live birth, birth weight, Apgar score at birth, neonatal survival to hospital discharge and adverse maternal side effects.Results: There was a statistically significant improvement in UA-PI, RI and S/D ratios (p<0.0001) in all cases. In oligohydramnios cases, treatment showed a statistical significant increase in AFI score (2.86±1.33 cm). The mean birth weight on delivery was 2200 gm with good Apgar scores. No major adverse effects were reported by women using sildenafil citrate vaginally.Conclusions: Sildenafil citrate, by increasing utero-placental perfusion, improves uterine artery Doppler patterns, AFI, fetal weight and overall better neonatal survival rates by reducing neonatal morbidity and mortality. Sildenafil citrate may hold a promising treatment strategy for management of IUGR and oligohydramnios.

scholarly journals Intrauterine Growth Restriction: Cytokine Profiles of Trophoblast Antigen-Stimulated Maternal Lymphocytes

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Raj Raghupathy ◽  
Majedah Al-Azemi ◽  
Fawaz Azizieh
Keyword(s):  
Inflammatory Cytokines ◽  
Peripheral Blood ◽  
Intrauterine Growth Restriction ◽  
Mononuclear Cells ◽  
Normal Pregnancy ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Anti Inflammatory ◽  
Ifnγ And Tnfα

Intrauterine growth restriction (IUGR) is an important perinatal syndrome that poses several serious short- and long-term effects. We studied cytokine production by maternal peripheral blood lymphocytes stimulated by trophoblast antigens. 36 women with a diagnosis of IUGR and 22 healthy women with normal fetal growth were inducted. Peripheral blood mononuclear cells were stimulated with trophoblast antigens and levels of the proinflammatory cytokines IL-6, IL-8, IL-12, IL-23, IFNγ, and TNFα and the anti-inflammatory cytokines IL-4, IL-10, and IL-13 were measured in culture supernatants by ELISA. IL-8 was produced at higher levels by blood cells of the IUGR group than normal pregnant women, while IL-13 was produced at lower levels. IL-8, IFNγ, and TNFα were higher in IUGR with placental insufficiency than in normal pregnancy. IL-12 levels were higher and IL-10 levels were lower in IUGR with placental insufficiency than in IUGR without placental insufficiency. We suggest that a stronger pro-inflammatory bias exists in IUGR as compared to normal pregnancy and in IUGR with placental insufficiency when compared to IUGR without placental insufficiency. Several ratios of proinflammatory to anti-inflammatory cytokines also support the existence of an inflammatory bias in IUGR.

scholarly journals Physical activity during pregnancy and fetal outcomes: a case-control study

2010 ◽  
Vol 44 (1) ◽  
pp. 90-101 ◽  
Author(s):  
Monica Yuri Takito ◽  
Maria Helena D'Aquino Benício
Keyword(s):  
Physical Activity ◽  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Case Control Study ◽  
Growth Restriction ◽  
P Value ◽  
Intrauterine Growth ◽  
Control Study

OBJECTIVE: To investigate the relationship between physical activity during the second trimester pregnancy and low birth weight, preterm birth, and intrauterine growth restriction. METHODS: Case-control study including 273 low birth weight newborns and 546 controls carried out in the city of São Paulo, Southeastern Brazil, in 2005. Low birth weight cases were grouped into two subsamples: preterm birth (n=117) and intrauterine growth restriction (n=134), with their related controls. Information was collected by means of interviews with mothers shortly after birth and transcription of medical records. Data were analyzed using conditional multiple and hierarchical logistic regression. RESULTS: Light physical activity for over 7 hours per day was shown to be protective against low birth weight (adjusted OR=0.61; 95% CI 0.39-0.94) with a dose-response relationship (p-value for trend=0.026). A similar trend was found for intrauterine growth restriction (adjusted OR=0.51; 95% CI 0.26-0.97). Homemaking activities were associated as a protective factor for both low birth weight and preterm birth (p-value for trend=0.013 and 0.035, respectively). Leisure-time walking was found to be protective against preterm birth. CONCLUSIONS: Mild physical activity during the second trimester of pregnancy such as walking has an independent protective effect on low birth weight, preterm birth, and intrauterine growth restriction.

Civil unrest linked to intrauterine growth restriction in western Kenya

2014 ◽  
Vol 5 (5) ◽  
pp. 370-373
Author(s):  
E. Dybjer ◽  
J. Linvik ◽  
P. M. Nilsson
Keyword(s):  
Birth Weight ◽  
Intrauterine Growth Restriction ◽  
Epidemiological Data ◽  
Control Area ◽  
Growth Restriction ◽  
Western Kenya ◽  
Civil Unrest ◽  
Intrauterine Growth ◽  
Control Hospital ◽  
Mount Elgon

Risk factors associated with intrauterine growth restriction (IUGR) have previously been identified, but few studies have described the relationship between IUGR and maternal stress caused by exposure to civil unrest. Here, we investigate this relationship during the Mount Elgon crisis in western Kenya between 2006 and 2008, following a period of violence. Birth weight data were compared between three hospitals in an exposed area, Mount Elgon (n=570), and one hospital in a control area, Kimilili (n=530). In a sub-analysis, the most stress exposed hospital, Bungoma West (n=211), was compared with the control hospital in Kimilili. Adjustments were made for offspring sex, gestational age and parity. The difference in mean birth weight between the most stress-exposed hospital (Bungoma West) and the control hospital (Kimilili) was 91 g after full adjustment (P=0.041). In conclusion, epidemiological data suggest a significant relationship between exposure to civil unrest and IUGR causing lower birth weight.

scholarly journals Consequences in Infants That Were Intrauterine Growth Restricted

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Erich Cosmi ◽  
Tiziana Fanelli ◽  
Silvia Visentin ◽  
Daniele Trevisanuto ◽  
Vincenzo Zanardo
Keyword(s):  
Intrauterine Growth Restriction ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Growth Potential ◽  
Intrauterine Growth ◽  
Cardiovascular Abnormalities ◽  
Short And Long Term

Intrauterine growth restriction is a condition fetus does not reach its growth potential and associated with perinatal mobility and mortality. Intrauterine growth restriction is caused by placental insufficiency, which determines cardiovascular abnormalities in the fetus. This condition, moreover, should prompt intensive antenatal surveillance of the fetus as well as follow-up of infants that had intrauterine growth restriction as short and long-term sequele should be considered.

Abstract 15515: Sexual Dimorphism in Cardiac Response to Intrauterine Growth Restriction (IUGR)

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Alina Maloyan ◽  
Sribalasubashini Muralimanoharan ◽  
Mark Nijland ◽  
Peter W Nathanielsz
Keyword(s):  
Birth Weight ◽  
Sexual Dimorphism ◽  
Mirna Expression ◽  
Intrauterine Growth Restriction ◽  
Left Ventricular ◽  
Growth Restriction ◽  
Cardiac Response ◽  
Heart Weight ◽  
Reverse Correlation ◽  
Intrauterine Growth

Background: Poor fetal nutrient availability predisposes to adult cardiovascular disease (CVD). We have developed a fetal baboon model of maternal undernutrition resulting in Intrauterine Growth Restriction (IUGR) in both male and female fetuses (Li, et al, J Endocrinol, 2013). MicroRNAs are small non-coding RNAs that regulate gene expression through mRNA degradation and translational repression. Hypothesis: We hypothesized that IUGR is accompanied by cardiac dysfunction and dysregulation of cardiac miRNAs. Methods: Six control pregnant baboons ate ad libitum, and six nutrient restricted pregnant baboons ate a globally reduced diet (70% of control feed) from 0.16 gestation (G) through pregnancy resulting in fetal IUGR compared to controls (p<0.05). No differences in heart weight were observed. Fetuses (3 males and 3 females per group) were euthanized at C-section at 0.9G. Cardiac sections were studied for morphological changes and fibrosis using H&E and Masson’s trichrome staining respectively. Total left ventricular RNA was isolated and miRNA array was performed. Results: While no differences in myofiber orientation were observed, IUGR male but not female fetuses showed a reverse correlation between birth weight and accumulation of fibrotic tissue in the heart (r=-0.831, p=0.01). We next investigated the expression of the extracellular matrix proteins thrombospondin-1 (TSP-1) and connective tissue growth factor (CTGF). A reverse correlation between birth weight and cardiac TSP-1 levels (r=-0.77, p=0.03) was found in male but not female fetuses. No changes in CTGF were observed. Sexual dimorphism was observed in fetal cardiac miRNA expression within both IUGR and control groups. In male IUGR group, the increase in levels of TSP-1 was associated with more than 50% reduction in expression of its targeting miRNA-19a, reduction in which has been implicated in CVD. Other CVD-related and differentially expressed miRNAs in male IUGR included miRNA-23b, 27b, 99b, 143, 181a, and 378-3p. Summary: IUGR resulting from decreased maternal nutrition is associated with sexual dimorphism in cardiac structure and miRNA expression. If the changes observed in male IUGR fetuses persists postnatally they may program offspring for higher CVD risk later in life.

scholarly journals Catecholamines Mediate Multiple Fetal Adaptations during Placental Insufficiency That Contribute to Intrauterine Growth Restriction: Lessons from Hyperthermic Sheep

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
D. T. Yates ◽  
A. S. Green ◽  
S. W. Limesand
Keyword(s):  
Intrauterine Growth Restriction ◽  
Somatic Growth ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Postnatal Life ◽  
Adaptive Responses ◽  
Hepatic Gluconeogenesis ◽  
Intrauterine Growth ◽  
Metabolic Adaptations ◽  
Insulin Dependent

Placental insufficiency (PI) prevents adequate delivery of nutrients to the developing fetus and creates a chronic state of hypoxemia and hypoglycemia. In response, the malnourished fetus develops a series of stress hormone-mediated metabolic adaptations to preserve glucose for vital tissues at the expense of somatic growth. Catecholamines suppress insulin secretion to promote glucose sparing for insulin-independent tissues (brain, nerves) over insulin-dependent tissues (skeletal muscle, liver, and adipose). Likewise, premature induction of hepatic gluconeogenesis helps maintain fetal glucose and appears to be stimulated by both norepinephrine and glucagon. Reduced glucose oxidation rate in PI fetuses creates a surplus of glycolysis-derived lactate that serves as substrate for hepatic gluconeogenesis. These adrenergically influenced adaptive responses promotein uterosurvival but also cause asymmetric intrauterine growth restriction and small-for-gestational-age infants that are at greater risk for serious metabolic disorders throughout postnatal life, including obesity and type II diabetes.

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