Severely impaired fetal growth is preceded by maternal hemodynamic maladaptation in very early pregnancy

Abstract

Maternal hemodynamic adaptation in the first weeks of pregnancy is defective in IUGR pregnancies, presumably associated with a concomitant inadequacy of the vascular filling state.

Maternal cardiac function in fetal growth‐restricted and non‐growth‐restricted small‐for‐gestational age pregnancies

“…In pregnancies with IUGR, compared to those with normal fetal growth, the maternal cardiac output is lower 5 . Duvekot et al 6 examined 10 women, early in the first trimester, who subsequently had normal pregnancies and four women who subsequently developed IUGR. They found a suboptimal increase in cardiac output and smaller left atrial diameter, an index of preload and thus plasma volume expansion in pregnancies that subsequently developed fetal growth restriction 6 .…”

Association between maternal exposure to ambient air pollutants during pregnancy and fetal growth restriction

“…Intrauterine growth restriction (IUGR) is an important predictor of neonatal morbidity and mortality (Vorherr, 1982;Kramer, 1987). Severely growth restricted fetuses are at increased risk of stillbirth, and those born alive are at increased risk of neonatal death as well as short-term morbidity from hypoglycemia, hypocalcemia, and polycythemia (Kramer, 1987;Duvekot et al, 1995;Kramer, 2003). Over a longer term, IUGR infants tend to have small but permanent deficits in growth and neurocognitive development.…”

“…Over a longer term, IUGR infants tend to have small but permanent deficits in growth and neurocognitive development. Recent studies have demonstrated a relationship between impaired growth in the prenatal and early postnatal period and serious disease risks, including noninsulindependent diabetes, hypertension, and coronary heart disease (Duvekot et al, 1995;Kramer, 2003).…”

Influência das Alterações Hemodinâmicas Maternas sobre o Desenvolvimento Fetal

“…Seguindo esse raciocínio, alguns autores encontraram aumento da resistência periférica em gestantes com fetos com restrição de crescimento intra-uterino 2,11 . Em nosso estudo, os comportamentos da resistência periférica e da pressão arterial média foram diferentes, quando a gestação resultou em recém-nascido PIG ou AIG.…”

“…A hipervolemia fisiológica da gravidez garante o suporte de oxigênio e nutrientes para o feto e protege a mãe contra os efeitos danosos da diminuição do retorno venoso, decorrente da compressão uterina durante a gestação e da perda sangüínea no parto. Duvekot et al 2 demonstraram que gestantes com volemia inalterada ou pouco aumentada, no período da embriogênese, têm fetos com restrição de crescimento intra-útero. Em gestantes normais e em portadoras de hipertensão arterial crônica há nítida correlação entre a expansão do volume plasmático e o peso fetal 3 .…”