共查询到20条相似文献,搜索用时 15 毫秒
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C M Salafia A M Vintzileos L Silberman K F Bantham C A Vogel 《American journal of perinatology》1992,9(3):179-184
Placental examination was carried out in 128 consecutive cases of idiopathic intrauterine growth retardation (IUGR) at term and the findings were compared with those of 179 gestational age-matched cases with normal growth. Mean pregnancy weight and mean maternal weight gain during pregnancy of IUGR cases were both significantly lower than for non-IUGR cases. There was a higher frequency of a history of previous growth-retarded infants between IUGR cases (18 of 128, or 14%) compared with non-IUGR cases (7 of 179, or 3.9%). The studied placental lesions were placental infarction, chronic villitis, hemorrhagic endovasculitis, and placental vascular thromboses. One or more of these lesions were present in 71 of 128 (55%) of IUGR cases, and 58/179 (32%) of non-IUGR cases. Thirty-eight of 72 (53%) cases with chronic villitis were IUGR (30% of all IUGR cases). Thirty-one of 49 cases (63%) with placental infarction were IUGR cases (24% of all IUGR cases). Nineteen of 32 cases (59%) with hemorrhagic endovasculitis were IUGR cases (15% of all IUGR cases). Twelve of 17 cases (71% with placental vascular thromboses were IUGR (9% of all IUGR cases). Relationships of all placental lesions to IUGR were independent of each other. IUGR infants more frequently had multiple types of lesions in their placentas. Chronic villitis and hemorrhagic endovasculitis tended to occur in the same placentas. There were no significant relationships between maternal characteristics and placental lesions, except for an association between low pregravid weight and increased incidence of placental infarction. Decreased birth length was associated only with placental infarction (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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Among 246 term patients undergoing ultrasonic evaluation within 1 week of delivery, a grade-three placenta was found in 39.4%. Advanced placental maturity was not associated with altered fetal growth rates or an increase in small- or large-for-gestational infants. At term, advanced placental maturity is not associated with aberrant fetal growth. 相似文献
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Zollner U Rehn M Girschick G Dietl J 《Zeitschrift für Geburtshilfe und Neonatologie》2011,215(2):49-59
Intrauterine growth restriction (IGUR) can have different etiologies, but placental insufficiency is the clinically most relevant. Fetuses with IUGR have a significantly higher morbidity and mortality than normally grown fetuses of the same gestational age. It is important to distinguish a growth restricted fetus from a normal, small fetus and from a fetus being small because of a disease, e.g., an aneuploidy. This differentiation requires the knowledge of the gestational age and the use of multiple imaging modalities. Serial assessments of fetal growth by ultrasound are necessary to recognize declining growth. Doppler sonography can detect changes in the uteroplacentar and the fetal perfusion. Blood vessels of clinical relevance are the uterine arteries, the umbilical artery, the middle cerebral artery and the ductus venosus. When no fetal anomalies can be detected, fetal growth is parallel to the percentiles and Doppler sonography measurements are normal, IUGR is unlikely. In most IUGR fetuses, a typical sequence of circulatory changes and ultrasound findings can be observed. As there is no evidence-based treatment option for IUGR until now, obstetric management consists in defining the optimal time of delivery. This means weighing the risks of prematurity against the risks of a potentially hostile intrauterine environment. 相似文献
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We set out to compare neonatal morbidity between disproportionate intrauterine growth retarded newborn infants and proportionate retarded ones at term, based on ponderal index. This is a prospective study of 185 single pregnancies with evidence of intrauterine growth retardation at term. Sixty three cases (34%) were disproportionate and 122 (66%) proportionate in terms of ponderal index. All were born in the University Hospital 'Principe de Asturias' of Alcala de Henares, Madrid, Spain. Proportionate or disproportionate intrauterine growth retardation diagnosis was established using the ponderal index (weight/length3). The following outcomes of neonatal morbidity were investigated: (1) perinatal asphyxia (meconium-stained amniotic fluid, abnormal fetal heart rates, newborn acidosis or low Apgar score 7 at 5 minutes) and/or (2) early neonatal medical complications. Disproportionate intrauterine growth retardated newborn infants presented higher rates of perinatal asphyxia (54% vs. 32%, P 0.01), with higher abnormal fetal heart rates (37% vs. 15%, P 0.01), higher frequency of arterial pH 7.20 (31% vs. 16%, P 0.05); and also higher rates of early neonatal medical complications (40% vs. 11%, P 0.001), mainly hypoglycaemia (25% vs. 4%, P 0.01). Morbidity among disproportionate intrauterine growth retardated Aconates is significantly higher compared with proportionate ones, demonstrating the heterogeneity of the intrauterine growth retardation population. Proportionate and disproportionate intrauterine growth retardation should be diagnosed as early as possible, since the majority of the morbidity is intimately related to this difference. 相似文献
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Severi FM Rizzo G Bocchi C D'Antona D Verzuri MS Arduini D 《Fetal diagnosis and therapy》2000,15(1):8-19
Intrauterine growth retardation is a pathology which is found in 3-10% of all pregnancies and it is associated with around 20-25% of all fetal intrauterine deaths and with long-term neurologic sequelae. It presents an increased risk of distress during labor and delivery and a greater risk of perinatal mortality. The causes of IUGR and the cardiac and venous Doppler in normal fetuses are analyzed, and the hemodynamic cardiac modifications in IUGR fetus are discussed. The fetal cardiac function in intrauterine growth retardation shows a redistribution of the fetal cardiac output, which tends to favor the left ventricle as the mechanism to compensate for the uteroplacental insufficiency. The Doppler velocity indices are modified as the fetal condition progressively deteriorates and they represent an important tool for the management of the complicated pregnancy. 相似文献
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GIORGIO PARDI ANNAMARIA MARCONI ENRICO FERRAZZI 《BJOG : an international journal of obstetrics and gynaecology》1986,93(3):250-254
Summary. Electrocardiographs from 68 fetuses with ultrasound evidence of growth retardation were recorded from the maternal abdomen; QRS duration was measured and compared to normal standards previously obtained in our Institute. Of these fetuses, 54 were small-for-gestational-age at birth and 44 exhibited QRS duration values below -2SD for their gestational age. All but one of the 14 normal fetuses showed normal QRS values (positive predictive value = 98%; negative predictive value = 57%). Of 11 fetuses with QRS duration values below -4SD, nine were particularly small, below the 2nd centile of weight for gestation. QRS duration measurements may represent a sensitive method for identifying fetal growth-retardation. The QRS duration also seems to provide a reliable prognosis of perinatal outcome. Normal values are a reassuring factor: abnormal cardiotocographic records were observed in only 2 out of 23 cases and no low Apgar scores or perinatal deaths occurred. QRS values below -4 SD proved to be associated with abnormal cardiotocographic records (7/13), low Apgar scores (5/15) and perinatal deaths (3/15). 相似文献
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Electrocardiographs from 68 fetuses with ultrasound evidence of growth retardation were recorded from the maternal abdomen; QRS duration was measured and compared to normal standards previously obtained in our Institute. Of these fetuses, 54 were small-for-gestational-age at birth and 44 exhibited QRS duration values below -2 SD for their gestational age. All but one of the 14 normal fetuses showed normal QRS values (positive predictive value = 98%; negative predictive value = 57%). Of 11 fetuses with QRS duration values below -4 SD, nine were particularly small, below the 2nd centile of weight for gestation. QRS duration measurements may represent a sensitive method for identifying fetal growth-retardation. The QRS duration also seems to provide a reliable prognosis of perinatal outcome. Normal values are a reassuring factor: abnormal cardiotocographic records were observed in only 2 out of 23 cases and no low Apgar scores or perinatal deaths occurred. QRS values below -4 SD proved to be associated with abnormal cardiotocographic records (7/13), low Apgar scores (5/15) and perinatal deaths (3/15). 相似文献
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S. D. Mahajan R. Aalinkeel S. Singh P. Shah N. Gupta N. Kochupillai 《The journal of maternal-fetal & neonatal medicine》2013,26(10):615-623
Objective. The ponderal index (PI) is a widely accepted measure of disproportionate growth or asymmetrical growth retardation by pediatricians worldwide. Identification of disproportionately grown small for gestational age (SGA) neonates by using the ponderal index as a measure of the nutritional status at birth, is important because they constitute a high-risk group among SGA neonates. Poor nutritional status of the mother could have a direct effect on the organs of the developing fetus and/or affect the endocrine milieu in the maternal feto-placental unit resulting in an increased incidence of intrauterine growth-retarded (IUGR)/SGA births. IUGR is a significant risk factor for adult disease. In this study, we have investigated the endocrine adaptation by the fetus to overcome the growth disadvantage caused due to poor nutritional status of the mother.Materials and methods. We examined the quantitative variations in hormonal and growth factor profiles in paired maternal and cord blood samples obtained from mothers and their neonates who were classified based on their growth status into SGA and appropriate for gestational age (AGA).Results. (1) A total of 24.7% neonates had a PI < 2, indicating a high incidence of asymmetric IUGR in the population studied. (2) Anthropometric parameters measured in the mothers indicate that the mothers giving birth to neonates with a PI < 2 had poor nutritional status, both prior to and during pregnancy. (3) We observed increased levels of placental lactogen and prolactin and decreased levels of insulin in the cord blood of neonates with PI < 2, while lower levels of insulin-like growth factor 1 (IGF-1) and higher levels of epidermal growth factor (EGF) were observed in their mothers.Conclusion. Poor maternal nutritional status results in fetal adaptation to a growth restricted environment via the modulation of the pituitary–thyroid axis thereby altering the endocrine milieu, thus affecting fetal growth. 相似文献
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Non-pregnant maternal plasma volume and fetal growth retardation 总被引:1,自引:0,他引:1
The hypothesis that low maternal blood volume is an aetiological factor in fetal growth retardation was considered. It was found that a high proportion of women who had repeatedly given birth to small-for-dates babies had a low non-pregnant plasma volume. 相似文献
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Dihydroergotamine causes fetal growth retardation in guinea pigs 总被引:1,自引:0,他引:1
Summary Dihydroergotamine is a vasoactive drug which enhances venous tone, central blood volume and cardiac output but has variable
effects on arterial tone. Its effect on the uterine arterial circulation is unstudied and yet dihydroergotamine is widely
used to treat postural hypotension in pregnant and nonpregnant women. For this reason we undertook studies to determine if
its chronic use had any adverse effect on the placental arterial circulation and fetal growth in an animal model. We administered
dihydroergotamine (14 μg/kg/day) to pregnant guinea pigs with 2–4 fetuses from day 30–60 of pregnancy. At term under light
ketamine anaesthesia, we measured maternal arterial blood pressure and blood flow to myometrium, placenta, skin and skeletal
muscle using left ventricular injection and standard sampling techniques. Vascular resistance was calculated from arterial
blood pressure and blood flow. When controlled for litter size, both fetal weight and the fetal weight/placental weight ratio
were significantly less (P<0.001) in the dihydroergotamine group (−21% and −11% respectively). Placental blood flow was decreased by 51% (P<0.01) whereas myometrial blood flow, skin blood flow and muscle blood flow were not significantly altered. There was no significant
difference in mean arterial blood pressure but placental vascular resistance was increased (+45%,P<0.05) while it was unchanged in myometrium and skin and decreased in skeletal muscle (−51%,P<0.05). Chronic administration of dihydroergotamine at a clinical dosage level has a constrictive effect on the placental
vasculature of guinea pigs with a subsequent adverse effect on flow and fetal growth. 相似文献