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WS17‐08Fetal biochemical markers in severe placental insufficiency – comparison with fetal Doppler findings
Author(s) -
Räsänen J.,
Mäkikallio K.,
Vuolteenaho O.,
Jouppila P.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00009-1-116.x
Subject(s) - medicine , umbilical artery , atrial natriuretic peptide , placental insufficiency , fetus , cardiology , natriuretic peptide , diastole , umbilical vein , pregnancy , blood pressure , endocrinology , placenta , heart failure , biochemistry , genetics , chemistry , in vitro , biology
Background The aims of this study were to assess the activity of the human fetal atrial natriuretic peptide system in hypertensive pregnancies with and without signs of increased fetal systemic venous pressure and to investigate the association between severe placental insufficiency and fetal myocardial cell destruction. Method Control group consisted of 50 newborns with uncomplicated pregnancy and labor. In group 1, 22 newborns after hypertensive pregnancies were included. Doppler ultrasonography revealed abnormal umbilical artery (UA) blood velocity waveform in five cases, and normal nonpulsatile umbilical vein (UV) blood velocity profile in every case. Group 2 consisted of five newborns after pregnancies complicated by maternal hypertensive disorder. Atrial pulsations in the UV and retrograde diastolic blood velocity pattern in the UA were detected in every case. Immediately after birth blood samples were collected from the UA and plasma N‐terminal peptide of proatrial natriuretic peptide (NT‐proANP) and serum cardiac specific troponin‐T concentrations were measured. Results In group 1, nt‐proANP concentrations were higher ( P < 0.001) than in the control group. In group 1, newborns with abnormal UA blood velocity pattern had higher ( P < 0.006) NT‐proANP concentrations than newborns with normal UA Doppler findings. Troponin‐T concentrations in group 1 did not differ from the control group. In group 2, NT‐proANP ( P < 0.002) and troponin‐T ( P < 0.0001) concentrations were higher than in the control group and study group 1. Conclusion Maternal hypertensive disorder stimulates fetal atrial natriuretic peptide production, being greatest in fetuses with severe placental insufficiency and a rise in systemic venous pressure. These fetuses also have evidence of myocardial cell destruction.