Anna Girsen

Cardiovascular hemodynamics and umbilical artery N-terminal peptide of proB-type natriuretic peptide in human fetuses with growth restriction.

To test our hypothesis that human fetal N‐terminal peptide of proB‐type natriuretic peptide (NT‐proBNP) secretion is increased in proportion to the severity of fetal cardiovascular compromise in intrauterine growth restriction.

Comprehensive maternal serum proteomic profiles of preclinical and clinical preeclampsia

We systematically characterized maternal serum proteome in women with clinical preeclampsia (PE) and asymptomatic women in early pregnancy that subsequently developed PE. Clinical PE cohort comprised 30 patients with mild PE, 30 with severe PE, and 58 normotensive women. Preclinical PE cohort included 149 women whose serum samples were collected at 8-14 gestational weeks and in whom 30 women later developed mild and 40 severe PE. Serum proteome was analyzed and enzyme-linked immunosorbent assays were used for protein quantification. In Clinical PE, fibronectin, pappalysin-2, choriogonadotropin-beta, apolipoprotein C-III, cystatin-C, vascular endothelial growth factor receptor-1, and endoglin were more abundant compared to normotensive women. In preclinical PE, differently expressed proteins included placental, vascular, transport, matrix, and acute phase proteins. Angiogenic and antiangiogenic proteins were not significant. We conclude that placental and antiangiogenic proteins are abundant in clinical PE. In preclinical PE, proteomic profile is distinct and different from that in clinical PE.

Increased fetal cardiac natriuretic peptide secretion in type-1 diabetic pregnancies

Background. We hypothesised that human fetal cardiac natriuretic peptide secretion is increased in type‐1 diabetic pregnancies with normal placental hemodynamics, and this increase is related to the first trimester maternal glycemic control. Methods. Thirty‐two neonates of type‐1 diabetic mothers and 60 neonates born after uncomplicated pregnancy and labour (control group) were included in this study. Diabetic pregnancies were divided into two subgroups based on the first trimester HbA1c value. Group 1 pregnancies (n =22) had a good glycemic control (HbA1c <7.5%) and Group 2 pregnancies (n =10) had a poor glycemic control (HbA1c ≥7.5%). At delivery, an umbilical artery (UA) blood sample was obtained for assessment of N‐terminal peptide of proatrial (NT‐proANP) and proB‐type (NT‐proBNP) natriuretic peptide levels. In diabetic pregnancies, each fetus had normal UA Doppler velocimetry for gestational age. Results. The newborn UA NT‐proANP and NT‐proBNP concentrations were significantly higher in type‐1 diabetic pregnancies than in the control group. Group 2 fetuses with poor glycemic control showed significantly higher UA NT‐proANP levels than Group 1 fetuses. UA NT‐proANP levels correlated significantly with maternal HbA1c values in the first, second and third trimesters, while UA NT‐proBNP levels did not correlate with maternal HbA1c values. Conclusions. In type‐1 diabetic pregnancies, fetal cardiac natriuretic peptide secretion is increased, even in the presence of good glycemic control and normal placental hemodynamics. In addition, fetal NT‐proANP levels are already related to maternal glycemic control in the first trimester of pregnancy.

P05.08: Human fetal cardiovascular hemodynamics and umbilical artery N‐terminal peptide of proB‐type natriuretic peptide in placental insufficiency

magnesium and vasodilatans were administered to patient and fetal monitoring by cardiotocography was performed twice per day. At 35 weeks’ gestation the occurrence of repetitive early decelerations was considered as an indication for induction of the labour. Labour, delivery, postpartal analysis of the umbilical blood gases, puerperium, postpartal and neonatal outcomes were normal. Up to 8% of fetuses with IUGR and AEDV may have an abnormal karyotype. Its rapid adquisition by fetal blood sampling is indicated to avoid unnecessary interventions. In the cases of normal karyotype a simultaneous assessment of the fetal umbilical blood analysis is very useful for these fetuses. This kind of examination is very significant and independent to the interval between cordocentesis and the onset of cardiotocographic pathology. This interval may be utilized for intrauterine treatment, exact monitoring of the fetal being and to optimize obstetric management.