Fetal Growth and Body Proportion during Pre-Eclamptic Pregnancy

Abstract

Purpose: To evaluate the effects of mild and severe PE on fetal growth and body proportion, measurement at serial ultrasound (US) examinations. Five to 7% of all pregnancies are complicated by preeclampsia (PE). Some forms of intrauterine growth restriction (IUGR) have been etiologically linked to PE, based on similar placental disease-abnormal implantation. Materials and Methods:Women (n=400) who had singleton pregnancies and underwent two or more second-and third-trimester obstetric US examinations were included in our study. The women were divided in three groups: 300 normotensive pregnancies (controls), 67 pregnancies with mild PE (MP) and 33 pregnancies with severe PE (SP). Inadequate fetal growth was defined as growth at or below 10 th percentile. We calculated US measurements between fetuses from normotensive and PE pregnancies (MP and SP). Results:In newborns of women with PE, mean birth weight and length were lower than in births without PE. Fetuses in PE pregnancies from 26 week of gestation (wg) with US scan had lower biometric parameters vs. then of normotensive pregnancies, especially values of abdominal circumference and femur length. In PE pregnancies, there could be faster aging of placenta and oligohydramnion. This is time before clinical onset of PE. Conclusion:Our results support the hypothesis that PE is a heterogeneous disorder which involving placental dysfunction and IUGR, often with asymmetric fetal body proportion and reduced fetal length. The results suggest that US measurements of fetal size are important predictors for PE and birth outcomes. IntroductionPreeclampsia is a multi-system disorder of unknown etiology. Women with preeclampsia usually develop raised blood pressure and proteinuria. Preeclampsia is also associated with abnormalities of coagulation system, disturbed liver function, renal failure and cerebral ischemia [1]. PE is characterized by vasospasm, increased peripheral vascular resistance, and thus reduced organ perfusion [1,2]. Also, it's well known that PE is associated with reduced fetal size. Fetal growth is dependent on genetic, placental and maternal factors. Intrauterine growth restriction (IUGR) refers to a condition in which a fetus is unable to achieve its genetically determined potential size. The most widely used definition of IUGR is a fetus whose estimated weight is below 10 th percentile for its gestational age [3][4][5].IUGR occurs when gas exchange and nutrient delivery to the fetus are not sufficient to allow it to thrive in utero. This process can occur primarily because of maternal disease causing decreased oxygen-carrying capacity, a dysfunctional oxygen delivery system secondary to maternal vascular disease, or placental damage resulting from maternal disease [4][5][6][7][8].Ultrasound (US) fetal biometry is the most widespread method used to establish gestational age, estimate fetal size and monitor its growth. US fetal biometry is gold standard for assessing fetal growth. The most commonly used measurements are the biparietal diameter, he...

Evaluation of Management of Pre-Eclamptic Cases Admitted to Elshatby Maternity University Hospital

“…In agreement with our study also, Siveska, and Jasovic, [21] conducted a prospective study upon 400 pregnant women. They were divided in three groups: 300 normo-tensive pregnancies (controls), 67 pregnancies with mild PET and 33 pregnancies with severe PET.…”

Comparison of Head Circumference and Abdominal Circumference Ratio in Normotensive and patients with Pregnancy Induced Hypertensive Disorders after 28 weeks of gestation

“…At 36 weeks (p >0.05), at 38 weeks (p < 0.05), at 40 weeks (p> 0.05). 23 Jasovic-Savisca & Jasovic (2008) performed a study on 67 preeclamptic patients and 129 normotensive pregnancies. At 36 weeks 21.31% had asymmetric IUGR (p<0.01), at 38 weeks 25.29% had IUGR (p<0.01) and at 40 weeks 31.82% of Hypertensive pregnancies had IUGR (p<0.01).…”

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“…Вагітні з затримкою розвитку плода часто народжують достроково, тоді як з нормальним розвитком плода частіше народжують у термін. Результати свідчать про те, що вимірювання розмірів плода є важливим предиктором для визначення розвитку ПЕ [70].…”