| Fetal renal artery impedance as assessed by Doppler ultrasound in pregnancies complicated by intraamniotic inflammation and preterm birth. | |
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MedLine Citation:
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PMID: 19185102 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of the study was to evaluate the fetal renal artery impedance in the context of inflammation-associated preterm birth. STUDY DESIGN: We conducted a prospective Doppler assessment of the fetal renal artery impedance in 70 singleton fetuses. The study group consisted of 56 premature fetuses (median, 28.1 [interquartile range, 25.3-30.6] weeks at enrollment). Gestational age (GA) reference ranges were generated based on fetuses with uncomplicated pregnancies (n = 14). Doppler studies included renal artery pulsatility index (PI), resistance index (RI), systolic/diastolic (S/D) ratio, and presence or absence of end-diastolic blood flow. Proteomic profiling (surface-enhanced laser desorption ionization time-of-flight) was used for assessment of intraamniotic inflammation and biomarker peak corresponding to beta2-microglubin. Data were interpreted in relationship to amniotic fluid index (AFI), cord blood interleukin (IL)-6 and erythropoietin (EPO) levels. The cardiovascular and metabolic profiles of the neonates were investigated in the first 24 hours of life. RESULTS: Fetuses delivered by mothers with intraamniotic inflammation had higher cord blood IL-6 but not EPO levels. Fetal inflammation did not affect either renal artery PI, RI, S/D ratio, or end-diastolic blood flow. Neonates delivered in the context of intraamniotic inflammation had higher serum blood urea nitrogen levels, which correlated significantly with AF IL-6 levels. The renal artery RI and SD ratio were inversely correlated with the AFI independent of GA, cord blood IL-6, and status of the membranes. CONCLUSION: The fetus is capable of sustaining normal renal artery impedance despite inflammation. Resistance in the renal vascular bed affects urine output independent of inflammation. |
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Authors:
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Humberto Azpurua; Antonette T Dulay; Irina A Buhimschi; Mert O Bahtiyar; Edmund Funai; Sonya S Abdel-Razeq; Guoyang Luo; Vineet Bhandari; Joshua A Copel; Catalin S Buhimschi |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: American journal of obstetrics and gynecology Volume: 200 ISSN: 1097-6868 ISO Abbreviation: Am. J. Obstet. Gynecol. Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-02-02 Completed Date: 2009-02-20 Revised Date: 2009-03-20 |
Medline Journal Info:
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Nlm Unique ID: 0370476 Medline TA: Am J Obstet Gynecol Country: United States |
Other Details:
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Languages: eng Pagination: 203.e1-11 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniocentesis Amniotic Fluid / immunology* Female Fetal Membranes, Premature Rupture / immunology Fetus Hemodynamics Humans Infant, Newborn Infant, Premature Obstetric Labor, Premature / immunology Pregnancy Premature Birth / immunology Prospective Studies Renal Artery / immunology, ultrasonography* Ultrasonography, Doppler Vascular Resistance / immunology* Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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R01 HD 047321/HD/NICHD NIH HHS; R01 HD047321-01/HD/NICHD NIH HHS; R01 HD047321-02/HD/NICHD NIH HHS; R01 HD047321-03/HD/NICHD NIH HHS; R01 HD047321-04/HD/NICHD NIH HHS; R01 HD047321-05/HD/NICHD NIH HHS; R03 HD 50249/HD/NICHD NIH HHS |
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