Clinical features of fetal growth restriction complicated later by preeclampsia

Mitani, Minoru; Matsuda, Yoshihisa; Makino, Yasuo; Akizawa, Yoshika; Ohta, Hiroaki

doi:10.1111/j.1447-0756.2009.01120.x

Cited by 45 publications

(40 citation statements)

References 22 publications

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“…This premise is further strengthened by the significant overlap in their clinical presentations, with evidence suggesting that 12.8–58.6% of women with severe early onset pre-eclampsia will be further complicated by the presence of fetal growth restriction [10], [11]. Conversely, it has been shown that approximately 15% of women diagnosed with FGR will be diagnosed with superimposed pre-eclampsia later in the pregnancy [12].…”

Section: Introductionmentioning

confidence: 99%

“…Of clinical interest, several studies have proposed that the combination of pre-eclampsia with FGR is associated with a more severe pre-eclamptic phenotype when compared to women with pre-eclampsia and no FGR [12], [13]. Mitani et al [12] examined 133 women between 22 weeks' gestation and term with pre-eclampsia with or without FGR.…”

Section: Introductionmentioning

confidence: 99%

“…Mitani et al [12] examined 133 women between 22 weeks' gestation and term with pre-eclampsia with or without FGR. They found that women with pre-eclampsia and FGR had more severe hypertension and proteinuria, as well as higher rates of complications, such as placental abruption and disseminated intravascular coagulation.…”

Section: Introductionmentioning

confidence: 99%

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Is Fetal Growth Restriction Associated with a More Severe Maternal Phenotype in the Setting of Early Onset Pre-Eclampsia? A Retrospective Study

2011

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BackgroundBoth pre-eclampsia and fetal growth restriction are thought to result from abnormal placental implantation in early pregnancy. Consistent with this shared pathophysiology, it is not uncommon to see growth restriction further confound the course of pre-eclampsia and vice versa. It has been previously suggested that superimposed growth restriction is associated with a more severe pre-eclamptic phenotype, however this has not been a consistent finding. Therefore, we set out to determine whether the presence of fetal growth restriction among women with severe early-onset pre-eclampsia was associated with more severe maternal disease compared to those without a growth-restricted fetus.Methods and FindingsWe undertook a retrospective cohort study of women presenting to a tertiary hospital with severe early-onset pre-eclampsia (<34 weeks' gestation) between 2005–2009. We collected clinical data, including severity of pre-eclampsia, maternal and neonatal outcomes. Of 176 cases of severe pre-eclampsia, 39% (n = 68) were further complicated by fetal growth restriction. However, no significant difference was seen in relation to the severity of pre-eclampsia between those with or without a growth-restricted baby. The presence of concomitant growth restriction was however associated with a significantly increased risk of stillbirth (p = 0.003) and total perinatal mortality (p = 0.02).ConclusionsThe presence of fetal growth restriction among women with severe early-onset pre-eclampsia is not associated with increased severity of maternal disease. However the incidence of stillbirth and perinatal death is significantly increased in this sub-population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is Fetal Growth Restriction Associated with a More Severe Maternal Phenotype in the Setting of Early Onset Pre-Eclampsia? A Retrospective Study

2011

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“…62 In pregnancies in which intrauterine growth restriction due to uteroplacental vascular insufficiency is diagnosed, maternal surveillance for the development of severe preeclampsia with adverse features is warranted. 63,64 Evaluation of placental function by umbilical artery doppler is a clinical standard to distinguish between SGA and FGR. 65,66 …”

Section: Screening and Diagnosismentioning

confidence: 99%

Fetal growth restriction: aetiology, screening, diagnosis and management

Augusthy

2015

Int J Reprod Contracept Obstet Gynecol

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Foetal growth restriction (FGR) is a pathological condition that refers to a foetus that fails to reach his/her genetically predetermined growth potential. FGR remains a leading contributor to perinatal mortality and morbidity and metabolic syndrome in later life. The purpose of this review is to provide the summary statements of the aetiology of FGR and to establish a framework for screening, diagnosis, and management of pregnancies affected with foetal growth restriction. For this study, published literature was retrieved through searches of PubMed (Medline), Highwire, Google Scholar, Scopus, Cochrane Database of Systematic Reviews. Conference/Seminar proceedings, textbooks, previously published systematic reviews, controlled clinical trials, high quality prospective and retrospective observational studies, research articles and unpublished studies were also used for this study. The identification of FGR begins with assessment of maternal, foetal, placental and environmental risk factors and the diagnosis is made by Ultrasound biometry examination. Functional assessment of placental and foetal circulation by Doppler velocimetry and blood flow volume, together with computerized assessment of foetal heart rate variability, are key examinations in early and late FGR to assess severity of the disease and monitor foetal wellbeing. Appropriate timing of delivery in early FGR might change the outcome, and appropriate monitoring in late and term FGR might avoid unnecessary interventions.

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“…Preterm newborns of women who have PE are of great concern because strong evidence shows that they are exposed to increased oxidative stress, which has been implicated in the pathogenesis of serious diseases in neonates [ 53 ]. Thus, an unfavorable outcome could be expected in infants of women who have PE [ 54 ]. Several studies indicate that PE is associated with a higher incidence of newborns with low birth weight [ 55 , 56 ].…”

Section: Low Birth Weight Neonates Born To Preeclamptic/ Eclamptic Momentioning

confidence: 99%

Oxidative Stress in Low Birth Weight Newborns

Negi

Pande

Karki

et al. 2014

Free Radicals in Human Health and Disease

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Free radical damage has been recognized to be a common pathogenic mechanism of many neonatal diseases. An excessive and/or sustained increase in free radical production associated with diminished effi cacy of the antioxidant defense systems results in oxidative stress, which occurs in many pathologic processes and contributes signifi cantly to disease and can be the key link between size at birth and increased morbidity later in life. Low birth weight is closely associated with fetal and neonatal mortality and morbidity, inhibited growth and cognitive development, and chronic diseases later in life. Low birth weight is considered the primary factor associated with a poor perinatal outcome of maternal preeclampsia/ eclampsia and premature birth. High oxidative stress and low level of enzymatic antioxidants and antioxidant nutrients such as vitamins A, E, and C, zinc, copper, and selenium and antioxidant status might be increasing the risk of pathogenesis of major complications in low birth weight newborns.

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Clinical features of fetal growth restriction complicated later by preeclampsia

Cited by 45 publications

References 22 publications

Is Fetal Growth Restriction Associated with a More Severe Maternal Phenotype in the Setting of Early Onset Pre-Eclampsia? A Retrospective Study

Is Fetal Growth Restriction Associated with a More Severe Maternal Phenotype in the Setting of Early Onset Pre-Eclampsia? A Retrospective Study

Fetal growth restriction: aetiology, screening, diagnosis and management

Oxidative Stress in Low Birth Weight Newborns

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