P13.23: Case of Seckel Syndrome: diagnosis and monitoring

Abstract

Objectives: to investigate the relationships between immune system and endothelial dysfunction in IUGR mother-child couple. Methods: 170 pregnant patients were included in the study . Adiponectin, leptin, tumor necrosis factor α (TNFα), interleukin-6 (IL-6) and C reactive protein (CRP) in IUGR, small for gestational age (SGA) and appropriate for gestational age (AGA) mother-child couple at delivery were assessed. Fetal aorta intima media thickness (aIMT) was evaluated in the same fetal groups. IUGR fetuses were defined as fetuses whose estimated fetal weight (EFW) was below 10th percentile for gestational age with umbilical artery (UA) Doppler abnormalities. SGA fetuses were defined as fetuses whose EFW was below 10th percentile for gestational age with normal fetal velocimetry. Results: There were 37 IUGR mother-child couple, 33 SGA and 70 AGA ones. Maternal adiponectin concentration presented the same distribution among the three groups (p 0.137), while leptin, TNFα, IL-6 and CRP serum levels were higher in IUGR mothers than SGA and AGA pregnant patients (p 0.04, p 0.008, p 0.06 and p 0.04, respectively). If adiponectin levels were significantly reduced in IUGR fetuses than SGA and AGA ones, leptin (p < 0.05), TNFα (p 0.05) and IL-6 (p 0.05) levels conversely were higher in the former group, such as aIMT (<0.05). Moreover, fetal aIMT was significantly greater in IUGR group than SGA (p 0.0003) and AGA ones (p 0.0002), and SGA fetuses had a higher aIMT than AGA group (p 0.05). Finally, in IUGR fetuses there were a negative correlation between aIMT and adiponectin/leptin ratio (A/L ratio) (p < 0.05) and between adiponectin and IL-6 levels than SGA and AGA group (p < 0.05). Conclusions: In IUGR fetuses a higher fetal aIMT associated with decreased blood adiponectin levels and increased adipocytokines concentrations might relate to a greater risk of endothelial damage and insulin resistance. P13.22Intrauterine growth restriction, cerebellar hematoma and PMD C. Martínez-Payo, R. Alvarez Bernabéu, I. Salas Villar, E. Iglesias Obstetricia y Ginecologia, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, SpainPlacental mesenchymal dysplasia (PMD) is a rare vascular disease associated with intrauterine growth restriction, fetal demise as well as with Beckwick-Wiedemann syndrome. Some neonates present hematologic abnormalities possibly related to consumptive coagulopathy and hemolytic anemia in the placental circulation.A 31 year old pregnant woman on 21st week of pregnancy, the scan showed a fetus smaller than the gestational age, placentomegaly with hypoechoic areas, severe oligoamnios, a hyperechogenic intestine and hemorrhagic damage in the left hemisphere of the cerebellum.The middle cerebral artery speed was higher than average 1.5 MoM for the gestational age. The Karyotype was 46 XX. aCGH analysis revealed no genomic imbalance in the amniocytes. Higher than average concentrations of alfaprotein levels were foun in the amniotic fluid. The TORCH study revealed no abnormalities. Threee weeks later, the...