Metabolomics in normal and pathologic pregnancies
Moshe Hod, Vincenzo Berghella, Mary E. D'Alton, Gian Carlo Di Renzo, Eduard Gratacós, Vassilios Fanos in New Technologies and Perinatal Medicine, 2019
Intrauterine growth retardation (IUGR) is characterized by a fetus that does not reach its growth potential, with birth weight and BMI below normal for gestational age (33). The incidence of IUGR ranges between 4% and 8% of newborns in industrialized countries and 6% and 30% in developing countries (34). Etiology may depend on genetic abnormalities, congenital infections, and maternal and placental pathologies. The intrauterine environment is the main factor that influences fetal growth and development. Metabolomics analyses looked for biomarkers in maternal plasma, amniotic fluid, urine, cervicovaginal secretions, placenta, and umbilical cord blood, and provided information on the transfer of placental nutrients (35). Some studies evaluated an increase in different metabolites (sphingolipids, phospholipids, carnitines, and fatty acids) in maternal plasma and a decrease in umbilical cord blood in underdeveloped fetuses, demonstrating a failure of placental transfer to the fetus of these nutrients (36).
Diabetes
Judy Bothamley, Maureen Boyle in Medical Conditions Affecting Pregnancy and Childbirth, 2020
Microvascular injury to the kidney will damage the glomerular membrane, and protein will leak into the urine. As kidney function deteriorates, the loss of protein will cause fluid retention, and the kidneys will be less efficient at removing waste products such as creatinine. This is known as diabetic nephropathy and will contribute to complications in pregnancy including pre-eclampsia, hypertension, low birthweight and pre-term delivery. Strict glycaemic control, low dose aspirin and antihypertensive treatment is advocated. Assessment of renal function (see blood tests for renal function, Chapter 4), blood pressure and urinary protein is required21. Women with this condition may be admitted to hospital for close monitoring of their condition and that of the fetus. Intrauterine growth restriction (IUGR) is a common complicating factor. It can be difficult to distinguish between renal disease and pre-eclampsia as both conditions share similar features.
The Use of Magnetic Resonance Imaging in Intrauterine Growth Retardation
Asim Kurjak, John M. Beazley in Fetal Growth Retardation: Diagnosis and Treatment, 2020
The diagnosis of intrauterine growth retardation (IUGR) is traditionally made on clinical examination, in combination with ultrasound. However, the detection rate by measurement of symphysis-fundal height (SFH) is only 76%, and screening, with both SFH and ultrasound measurement of fetal abdominal circumference, has a sensitivity of 93%, a specificity of 67%, and a positive predictive value of only 32%.14 Underdiagnosing the condition results in poor fetal surveillance and is associated with a higher perinatal mortality. Overdiagnosing produces unnecessary intervention, which is costly, and causes increased anxiety for the mother. Good tissue resolution, and the ability to visualize fetal fat clearly, which appears bright with MRI, suggests that MRI is a potentially useful tool in the diagnosis and management of IUGR. In addition, the presence of oligohydramnios may limit fetal movement and thus improve visualization.
Intrauterine Growth Retardation is a Risk Factor for Anthracycline Toxicity
Published in Pediatric Hematology and Oncology, 2021
Nilgun Eroglu, Tamer Yoldas, Burcak Bilgin, Sule Yesil, Ali Fettah, Gurses Sahin
Intrauterine growth restriction (IUGR) is defined as delayed fetal growth and development during pregnancy, often increasing the susceptibility to several diseases.1 The primary mechanism of IUGR is abnormal and/or defective placentation, which is correlated with increased free oxygen radicals, apoptosis, and dysregulation of enzyme activity, and defective transcription and signal transduction pathways.2 Mitochondria play an essential function in maintaining the homeostasis of energy metabolism and formation of the placenta. In addition, mitochondrial DNA (mtDNA) codes for 13 subunits of the respiratory chain complexes, which produce most of the cellular energy, indicating that a healthy placental mitochondrial function is important for proper fetal growth and development.
Maternal and Placental Zinc and Copper Status in Intra-Uterine Growth Restriction
Published in Fetal and Pediatric Pathology, 2022
Özge Yücel Çelik, Sevginur Akdas, Aykan Yucel, Burcu Kesikli, Nuray Yazihan, Dilek Uygur
Intrauterine growth restriction (IUGR) is considered a pathological condition that occurs in approximately 710% of all pregnancies [1]. Due to the uncertainty of the cause of IUGR development, it has become an important problem in the field of birth and pediatrics [2,3]. Factors causing the development of IUGR can be grouped under 3 headings; placental factors, fetal factors, and maternal factors. Maternal factors include maternal age, maternal hypoxia status, socioeconomic status and nutritional deficiency, very high or low body mass index, hypertension, and chronic diseases, and maternal infections. Fetal factors include chromosomal anomalies, genetic syndromes, congenital anomalies, multiple gestations, congenital infections, and metabolic diseases [4]. Placental factors include weight (too large or small), abnormal uteroplacental vascularity, placental dysfunction, or reduced expression of enzymes that provide redox regulation [4,5].
First trimester 3D ultrasound placental volume for predicting preeclampsia and/or intrauterine growth restriction
Published in Journal of Obstetrics and Gynaecology, 2019
Adjima Soongsatitanon, Vorapong Phupong
Preeclampsia is a common obstetric complication which causes both a maternal and foetal morbidity and mortality (Khan et al. 2006). Preeclampsia also increases the risk of developing long-term cardiovascular and cerebrovascular diseases (Bellamy et al. 2007). Intrauterine growth restriction (IUGR), another obstetric complication, is associated with a high perinatal mortality and morbidity (ACOG 2013a). The exact aetiology of both conditions are still unknown, but they are associated with a failure of the trophoblastic invasion of the spiral arteries, which may be associated with an increased vascular resistance of the uterine artery and a decreased perfusion of the placenta (Khong et al. 1986; Lin et al. 1995). An early detection of the risk of these complications can improve the outcome by increasing the patient’s surveillance or by initiating an appropriate therapeutic intervention (Phupong et al. 2003).
Related Knowledge Centers
- Chromosome Abnormality
- Low Birth Weight
- Percentile
- Placental Insufficiency
- Umbilical Cord
- Embryo
- Hypoxia
- Subcutaneous Tissue
- Gestational Age
- Small For Gestational Age