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Circulating N-Terminal Pro-B-Type Natriuretic Peptide in Fetal Anemia Before and After Treatment.
MedLine Citation:
PMID:  22546865     Owner:  NLM     Status:  Publisher    
Background:N-terminal pro-B-type natriuretic peptide (nt-proBNP) is an established marker of heart failure in adult cardiology. We analyzed nt-proBNP in the circulation of fetuses with increased volume load secondary to anemia and investigated the effect of treatment on nt-proBNP concentration.Methods:Fetuses undergoing intrauterine transfusion (IUT) were examined. Nt-proBNP was measured before IUT and correlated with hemoglobin concentrations, ultrasonographic findings and Doppler measurements of the peak systolic velocity of the middle cerebral artery (MCA-PSV).Results:27 patients (seven with hydrops) and 78 controls were examined. Nt-proBNP was markedly elevated in anemia (p < 0.001). Concentrations were highest in hydropic fetuses (p < 0.03); no difference was present in hemoglobin and MCA-PSV values between hydropic and non-hydropic cases. In fetuses undergoing multiple IUTs nt-proBNP normalized after the third IUT, whereas hemoglobin and MCA-PSV remained abnormal.Conclusions:Levels of circulating nt-proBNP correlate well with the degree of myocardial work load in the hyperdynamic state of fetal anaemia. We hypothesize that normalization of nt-proBNP after serial transfusions is an indicator of myocardial adjustment to chronic anemia. Nt-proBNP measurement may be useful in the management of fetal anaemia, particularly in cases at risk of hydrops and fetuses requiring multiple transfusions.
Waltraut M Merz; Kirsten Kübler; Rolf Fimmers; Birgit Stoffel-Wagner; Annegret Geipel; Ulrich Gembruch
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-30
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-5-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Obstetrics and Prenatal Medicine, University of Bonn Medical School, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany.
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