Document Detail

Lung maturation in small for gestational age fetuses from pregnancies complicated by placental insufficiency or maternal hypertension.
MedLine Citation:
PMID:  18249076     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Clinical studies suggest that respiratory outcome of infants born preterm may be influenced by placental insufficiency and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome. If so, one could expect to see differences in lung maturation indices (lecithin/sphingomyelin (L/S) ratio and lamellar body count (LBC)) in the amniotic fluid. The present study investigates lung maturation indices of preterm small for gestational age (SGA) fetuses with or without abnormal Doppler ultrasound examination and with or without maternal hypertension/HELLP syndrome. STUDY DESIGN: Retrospective cohort study of 76 neonates born in our center between 1997 and 2003 with gestational age (GA) <34 weeks, birth weight <p10 for GA and available results from amniocentesis. All analyses were corrected for potential confounders. RESULTS: The L/S ratio was significantly higher in the abnormal Doppler group as compared to the normal Doppler group (p=0.02). The L/S ratio was significantly lower in hypertensive pregnancies as compared to normotensive pregnancies (p=0.02). Subdivision of the maternal hypertension group showed a significantly lower L/S ratio in the HELLP syndrome group as compared to the normotension group (p=0.04). CONCLUSION: The L/S ratio of SGA fetuses is significantly higher in cases with presumed placental insufficiency and significantly lower when pregnancies are complicated by HELLP syndrome. These observations are in line with the hypothesis that placental insufficiency accelerates lung maturation and with recent reports of poorer respiratory outcome in infants from mothers with HELLP syndrome.
H L Torrance; H A M Voorbij; L D Wijnberger; F van Bel; G H A Visser
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Publication Detail:
Type:  Journal Article     Date:  2008-01-30
Journal Detail:
Title:  Early human development     Volume:  84     ISSN:  0378-3782     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-13     Completed Date:  2008-09-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  465-9     Citation Subset:  IM    
Perinatal Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherlands.
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MeSH Terms
Amniotic Fluid / chemistry,  cytology
Cohort Studies
Fetal Growth Retardation / diagnosis,  physiopathology*
Fetal Organ Maturity / physiology*
Gestational Age
HELLP Syndrome* / physiopathology
Health Status Indicators
Infant, Newborn
Infant, Small for Gestational Age
Lecithins / analysis
Lung / embryology*,  physiology
Placental Insufficiency* / physiopathology
Pulmonary Surfactants / analysis
Retrospective Studies
Sphingomyelins / analysis
Reg. No./Substance:
0/Lecithins; 0/Pulmonary Surfactants; 0/Sphingomyelins

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