Document Detail


Fetal renal artery impedance as assessed by Doppler ultrasound in pregnancies complicated by intraamniotic inflammation and preterm birth.
MedLine Citation:
PMID:  19185102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  200     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-02-20     Revised Date:  2009-03-20    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203.e1-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
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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