Document Detail


Respiratory outcome in preterm small for gestational age fetuses with or without abnormal umbilical artery Doppler and/or maternal hypertension.
MedLine Citation:
PMID:  17674279     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study respiratory outcome in preterm small for gestational age (SGA) fetuses with or without signs of intrauterine growth restriction due to placental insufficiency, and with or without maternal hypertension. METHODS: This was a retrospective study of 187 neonates with birth weight <10(th) percentile and gestational age <34 weeks. Results from umbilical artery Doppler velocimetry were used to identify the abnormal Doppler subgroup. RESULTS: No significant difference in respiratory outcome between SGA fetuses with normal (SGA-N) or abnormal (SGA-A) umbilical artery Doppler examination was found. Within the SGA-A group, the respiratory distress syndrome (RDS) incidence (OR 5.6, 95% CI 1.7-18.3), RDS grade (OR 6.7, 95% CI 1.2-38.5), and need for surfactant (OR 5.3, 95% CI 1.1-24.4) were higher in infants of women with hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome as compared to those of normotensive mothers. CONCLUSIONS: Lung maturation is not accelerated with placental insufficiency. SGA-A fetuses of mothers with HELLP syndrome have a significantly poorer respiratory outcome than those with healthy mothers. Possibly, fetuses of mothers with HELLP syndrome are subjected to 'oxidative stress' causing lung damage rather than lung maturation.
Authors:
Helen L Torrance; Eduard J H Mulder; Hens A A Brouwers; Frank van Bel; Gerard H A Visser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  20     ISSN:  1476-7058     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-03     Completed Date:  2007-10-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  613-21     Citation Subset:  IM    
Affiliation:
Perinatal Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. H.Torrance@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Blood Flow Velocity / physiology
Drug Utilization
Female
Glucocorticoids / therapeutic use
HELLP Syndrome / physiopathology*
Humans
Infant Mortality
Infant, Newborn
Infant, Premature*
Infant, Small for Gestational Age*
Male
Outcome Assessment (Health Care)*
Pregnancy
Pulmonary Surfactants / therapeutic use
Respiration, Artificial
Respiratory Distress Syndrome, Newborn / physiopathology*,  therapy
Retrospective Studies
Severity of Illness Index
Ultrasonography, Doppler
Umbilical Arteries / ultrasonography*
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Pulmonary Surfactants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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