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Early fetal growth restriction

Katie M Groom, Lesley M Mccowan, Laura K Mackay, Arier C Lee, Glenn Gardener, Julia Unterscheider, Renuka Sekar, Jan E Dickinson, Peter Muller, Rosemary A Reid, David Watson, Alec Welsh, Jay Marlow, Susan P Walker, Jon Hyett, Jonathan Morris, Peter R Stone, Philip N Baker
OBJECTIVE: To assess the effect of maternal sildenafil therapy on fetal growth in pregnancies with early-onset fetal growth restriction. DESIGN: A randomised placebo-controlled trial. SETTING: Thirteen maternal-fetal medicine units across New Zealand and Australia. POPULATION: Women with singleton pregnancies affected by fetal growth restriction at 22+0 to 29+6 weeks. METHODS: Women were randomised to oral 25mg sildenafil citrate or visually matching placebo three times daily until 32+0 weeks, birth or fetal death (whichever occurred first)...
February 19, 2019: BJOG: An International Journal of Obstetrics and Gynaecology
F Fuchs, P Borrego, C Amouroux, B Antoine, M Ollivier, J M Faure, C Lopez, D Forgues, A Faure, T Merrot, P Boulot, C Jeandel, P Philibert, L Gaspari, C Sultan, F Paris, N Kalfa
OBJECTIVES: 1-To report the clinical spectrum of genital defects diagnosed before birth, 2- to identify predictive factors for severe phenotypes at birth 3- to determine the rate of associated malformations. METHODS: A retrospective study (2008-2017) of 4580 fetuses identified prenatally with abnormalities evaluated by our Reference Center for Fetal Medicine included cases with fetal sonographic finding of abnormal genitalia or uncertainty of fetal sex determination...
February 18, 2019: BJU International
Patrycja A Jazwiec, Xinglin Li, Brad Matushewski, Bryan S Richardson, Deborah M Sloboda
BACKGROUND: The mechanisms mediating the impacts of fetal growth restriction (FGR) on follicular development are commonly studied in mouse/rat models, where ovarian development occurs largely during the early postnatal period. These models have shown that FGR is associated with premature follicle loss, early pubertal onset, and accelerated ovarian aging. Whether the same occurs in precocious species is unknown. OBJECTIVE: Since guinea pig follicle development occurs in utero in a manner consistent with human ovarian development, we sought to determine whether FGR had similar impacts on guinea pig ovarian development...
February 11, 2019: Reproductive Sciences
Ilona Hromadnikova, Katerina Kotlabova, Lenka Dvorakova, Ladislav Krofta, Jan Sirc
Children descending from pregnancies complicated by gestational hypertension (GH), preeclampsia (PE) or fetal growth restriction (FGR) have a lifelong cardiovascular risk. The aim of the study was to verify if pregnancy complications induce postnatal alterations in gene expression of microRNAs associated with cardiovascular/cerebrovascular diseases. Twenty-nine microRNAs were assessed in peripheral blood, compared between groups, and analyzed in relation to both aspects, the current presence of cardiovascular risk factors and cardiovascular complications and the previous occurrence of pregnancy complications with regard to the clinical signs, dates of delivery, and Doppler ultrasound examination...
February 2, 2019: International Journal of Molecular Sciences
A Pels, N A Mensing van Charante, C A Vollgraff Heidweiller-Schreurs, J Limpens, H Wolf, M A de Boer, W Ganzevoort
OBJECTIVE: Cardiotocography (CTG) is an important tool for fetal surveillance in severe early-onset fetal growth restriction (FGR). Assessment of the CTG is usually performed visually (vCTG). However, it is suggested that computerized analysis of the CTG (cCTG) including short term variability (STV) could more accurately detect fetal compromise. The objective of this study was to systematically review the literature on the association between cCTG and perinatal outcome and the comparison of cCTG with vCTG...
January 22, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Ce Guo, Yang Yang, Meng-Xing Shi, Bo Wang, Ji-Jie Liu, De-Xiang Xu, Xiu-Hong Meng
Fenvalerate (FEN), a representative type II pyrethroid, is a widely used pyrethroid insecticide and a potential environmental contaminant. Several studies demonstrated that gestational FEN exposure induced intrauterine growth restriction (IUGR). However, the critical time window of FEN-induced fetal IUGR remains obscure. The present study aimed to identify the critical window of FEN-induced fetal IUGR. Pregnant mice were administered corn oil or FEN (20 mg/kg) by gavage daily at the early gestational stage (GD0-GD6), middle gestational stage (GD7-GD12) or late gestational stage (GD13-GD17)...
January 29, 2019: Ecotoxicology and Environmental Safety
Lucy C Chappell, Marcus Green, Neil Marlow, Jane Sandall, Rachael Hunter, Stephen Robson, Ursula Bowler, Virginia Chiocchia, Pollyanna Hardy, Edmund Juszczak, Louise Linsell, Anna Placzek, Peter Brocklehurst, Andrew Shennan
BACKGROUND: Pre-eclampsia is a pregnancy disorder, characterised by hypertension and multisystem complications in the mother. The adverse outcomes of pre-eclampsia include severe hypertension, stroke, renal and hepatic injury, haemorrhage, fetal growth restriction and even death. The optimal time to instigate delivery to prevent morbidity when pre-eclampsia occurs between 34 and 37 weeks' gestation, without increasing problems related to infant immaturity or complications, remains unclear...
January 28, 2019: Trials
Christopher M Novak, Ernest M Graham
Childhood brain development begins before birth, and obstetric management, tests, and technologies designed to diagnose and treat fetal conditions can have an impact on development. Preconception counseling for maternal diabetes and hypertension affect the risk of fetal congenital anomalies and growth restriction. Patients with risk factors for pre-existing maternal diabetes are offered early diabetic screening because earlier diagnosis and treatment can decrease the risk of fetal and neonatal complications...
January 28, 2019: Developmental Medicine and Child Neurology
Alan Leviton, Elizabeth N Allred, Raina N Fichorova, Deborah K VanderVeen, T Michael O'Shea, Karl Kuban, Olaf Dammann
OBJECTIVE:  To evaluate to what extent indicators of placenta insufficiency are associated with low concentrations of insulin-like growth factor 1 (IGF-1) and IGF-1-binding protein-1 (IGFBP-1) in neonatal blood, and to what extent the concentrations of these growth factors are associated with concentrations of proteins with inflammatory, neurotrophic, or angiogenic properties. DESIGN:  Using multiplex immunoassays, we measured the concentrations of IGF-1 and IGFBP-1, as well as 25 other proteins in blood spots collected weekly from ≥ 880 infants born before the 28th week of gestation, and sought correlates of concentrations in the top and bottom quartiles for gestational age and day the specimen was collected...
January 27, 2019: American Journal of Perinatology
Violeta Stojanovska, Dorieke J Dijkstra, Rebekka Vogtmann, Alexandra Gellhaus, Sicco A Scherjon, Torsten Plösch
Preeclampsia is a multifactorial pregnancy-associated disorder characterized by angiogenic dysbalance and systemic inflammation, however, animal models which combine these two pathophysiological conditions are missing. Here we introduce a novel double-hit preeclampsia mouse model which mimics the complex multifactorial conditions that are present during preeclampsia, and allows for the investigation of early consequences for the fetus. Adenoviral overexpression of soluble fms-like tyrosine kinase (sFlt-1) and lipopolysaccharide (LPS) administration at mid-gestation in pregnant mice resulted in hypertension and albuminuria comparable to that of the manifestation in humans...
January 25, 2019: Disease Models & Mechanisms
Maria Gloria Dominguez-Bello, Filipa Godoy-Vitorino, Rob Knight, Martin J Blaser
The host-microbiome supraorganism appears to have coevolved and the unperturbed microbial component of the dyad renders host health sustainable. This coevolution has likely shaped evolving phenotypes in all life forms on this predominantly microbial planet. The microbiota seems to exert effects on the next generation from gestation, via maternal microbiota and immune responses. The microbiota ecosystems develop, restricted to their epithelial niches by the host immune system, concomitantly with the host chronological development, providing early modulation of physiological host development and functions for nutrition, immunity and resistance to pathogens at all ages...
January 22, 2019: Gut
Kirsty L Brain, Beth J Allison, Youguo Niu, Christine M Cross, Nozomi Itani, Andrew D Kane, Emilio A Herrera, Katie L Skeffington, Kimberley J Botting, Dino A Giussani
Evidence derived from human clinical studies and experimental animal models shows a causal relationship between adverse pregnancy and increased cardiovascular disease in the adult offspring. However, translational studies isolating mechanisms to design intervention are lacking. Sheep and humans share similar precocial developmental milestones in cardiovascular anatomy and physiology. We tested the hypothesis in sheep that maternal treatment with antioxidants protects against fetal growth restriction and programmed hypertension in adulthood in gestation complicated by chronic fetal hypoxia, the most common adverse consequence in human pregnancy...
January 2019: PLoS Biology
Mohamed Ibrahem Eid, Mohamed Sayed Abdelhafez, Waleed El-Refaie, Ahmed A El-Zayadi, Khaled Samir, Mahmoud Mohamed Abdelrazik, Mahmoud Thabet, Alaa Wageh, Emad Ahmed Fyala, Yasser Abdeldayem, Ahmed Badawy
Objective: We aimed to evaluate the effect of different timing of initiation of low-molecular-weight heparin (LMWH) administration on the pregnancy outcomes in women with antiphospholipid syndrome (APS). Materials and methods: A randomized controlled study was conducted on women with obstetrical APS. All participants were randomly divided at documentation of positive pregnancy test into two groups; early initiation group in which LMWH therapy was started once positive pregnancy test was established (in the fifth week of gestation), and later initiation group in which LMWH therapy was started after sonographic confirmation of fetal cardiac pulsation (in the seventh week of gestation)...
2019: International Journal of Women's Health
A Pels, O C Knaven, B J Wijnberg-Williams, M J C Eijsermans, S M Mulder-de Tollenaer, C S H Aarnoudse-Moens, C Koopman-Esseboom, J van Eyck, J B Derks, W Ganzevoort, A G van Wassenaer-Leemhuis
OBJECTIVE: The objective of this study is to explore developmental outcomes at five years after early-onset fetal growth restriction (FGR). STUDY DESIGN: Retrospective data analysis of prospective follow-up of patients of three Dutch centres, who participated in a twenty centre European randomized controlled trial on timing of delivery in early-onset FGR. Developmental outcome of very preterm infants born after extreme FGR is assessed at (corrected) age of five...
January 11, 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Marcus R Orzabal, Emilie R Lunde-Young, Josue I Ramirez, Selene Y F Howe, Vishal D Naik, Jehoon Lee, Cristine L Heaps, David W Threadgill, Jayanth Ramadoss
Increasing popularity of electronic cigarettes (e-cigs), including among women of reproductive age, is attributed to its perceived safety compared to conventional tobacco. However, there is a major knowledge gap surrounding the effects of e-cig aerosols on pregnancy and fetal development. We aimed to evaluate the effects of vaping e-cigs during gestation on offspring growth and to asses if growth deficits are accompanied by altered maternal and fetal vascular hemodynamics. Sprague-Dawley dams were assigned to Pair-Fed Control, Pair-Fed Juice, or Juice+Nicotine groups, and then underwent either a prenatal or prenatal+postnatal exposure paradigm in a custom-engineered vaping system...
January 7, 2019: Translational Research: the Journal of Laboratory and Clinical Medicine
Matthew S Crouse, Nathaniel P Greseth, Kyle J McLean, Mellissa R Crosswhite, Nicolas Negrin Pereira, Alison K Ward, Lawrence P Reynolds, Carl R Dahlen, Bryan W Neville, Pawel P Borowicz, Joel S Caton
We examined the hypothesis that maternal nutrition and day of gestation would affect the concentrations of amino acids (AA) and hexoses in bovine utero-placental fluids and maternal serum from d 16 to 50 of gestation. Forty-nine cross-bred Angus heifers were bred via artificial insemination and fed a control diet (CON = 100% of requirements for growth) or a restricted diet (RES = 60% of CON) and ovariohysterectomized on d 16, 34, or 50 of gestation; non-pregnant (NP) controls were not bred and ovariohysterectomized on d 16 of the synchronized estrous cycle...
January 10, 2019: Journal of Animal Science
Valentina Pampanini, Kirsi Jahnukainen, Lena Sahlin, Daniela Germani, Antonella Puglianiello, Stefano Cianfarani, Olle Söder
BACKGROUND: A low oxygen supply to the fetus causes intrauterine growth restriction and can affect gonadal development of the offspring, having a potential impact on fertility. We investigated histology and gene expression in the postnatal rat ovary after fetal hypoxia induced by uterine artery ligation. METHODS: Sprague-Dawley rats underwent uterine artery ligation at day 19 of gestation. Offspring were sacrificed at 5, 20 and 40 days post-partum. Follicles were counted and classified in hematoxylin-eosin stained sections...
January 10, 2019: Reproductive Biology and Endocrinology: RB&E
Asma Khalil, James M N Duffy, Helen Perry, Wessel Ganzevoort, Keith Reed, Ahmet A Baschat, Jan Deprest, Eduardo Gratacos, Kurt Hecher, Liesbeth Lewi, Enrico Lopriore, Dick Oepkes, Aris Papageorghiou, Sanne J Gordijn
BACKGROUND: Selective fetal growth restriction in monochorionic twin pregnancies is associated with an increased risk of perinatal mortality and morbidity and represents a clinical dilemma. Interventions include expectant management with early preterm delivery if there are signs of fetal compromise, selective termination of the compromised twin, fetoscopic laser coagulation of the communicating placental vessels or termination of the whole pregnancy. Previous studies evaluating interventions have reported many different outcomes and outcome measures...
January 9, 2019: Trials
R Abi Nahed, D Reynaud, A J Borg, W Traboulsi, A Wetzel, V Sapin, S Brouillet, M N Dieudonné, M Dakouane-Giudicelli, M Benharouga, P Murthi, Nadia Alfaidy
Fetal growth restriction (FGR) the leading cause of perinatal mortality and morbidity is highly related to abnormal placental development, and placentas from FGR pregnancies are often characterized by increased inflammation. However, the mechanisms of FGR-associated inflammation are far from being understood. NLRP7, a member of a family of receptors involved in the innate immune responses, has been shown to be associated with gestational trophoblastic diseases. Here, we characterized the expression and the functional role of NLRP7 in the placenta and investigated its involvement in the pathogenesis of FGR...
January 8, 2019: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
Shigeo Iijima
Pheochromocytoma during pregnancy is rare but potentially harmful to the mother and fetus. Fetal risks are mainly determined by the vasoconstrictive effects of maternal catecholamine on uteroplacental circulation, because the fetus is protected from the direct effects of high catecholamine levels at the placental interface. Uteroplacental insufficiency may lead to spontaneous abortion, fetal growth restriction, premature delivery, and fetal hypoxia, followed by fetal distress and/or birth asphyxia. Adrenalectomy is recommended during the second trimester...
January 6, 2019: Gynecological Endocrinology
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