Treatment of Growth-Restricted Human Fetuses with Amino Acids and Glucose Supplementation through a Chronic Fetal Intravascular Perinatal Port System

Abstract

Objective: Intrauterine growth restriction (IUGR) carries an increased risk of mortality and morbidity. The accepted procedure to treat IUGR fetuses is premature delivery, which may increase neonatal mortality and morbidity and retards neonatal brain development. Material and Methods: We report here on intravascular supplementation with amino acids and glucose of an IUGR human fetus at 33 weeks of gestation with oligohydramnios and placental insufficiency using the port system (Norfolk Medical Products, Skokie, Ill., USA). The catheter was implanted into the umbilical vein (UV) by cordocentesis, and was then connected to a subcutaneously implanted port system. The treatment course included daily infusions of amino acid solution and 10% glucose into the UV. Results: Daily intravascular fetal nutrition significantly improved both fetal condition and fetal weight gain. No complications were seen. The patient was delivered by cesarean section in the 38th week of gestation. The female newborn weighed 2,130 g and was 47 cm long. Blood sampling from the UV after delivery showed no deviations of amino acids in comparison to standardized curves. In one-year follow-up the child’s development and weight gain was like that of children without IUGR in the anamnesis. Conclusion: This is the first report of the successful use of a subcutaneously implanted intravascular perinatal port system in IUGR human fetuses for long-term administration of nutriments into the UV of a fetus.

Impaired cerebral development in fetuses with congenital cardiovascular malformations: Is it the result of inadequate glucose supply?

“…This should not be recommended until more information is available regarding glucose and oxygen supply in fetuses with specific congenital cardiovascular malformations. Recently, glucose has been infused over an extended period in a fetus with intrauterine growth retardation to improve growth (24). Glucose infusion into fetuses with specific cardiac malformations to promote brain growth could possibly be recommended.…”

A study of morbidity and drug utilization pattern in indoor patients of high risk pregnancy at tertiary care hospital

“…Daily intravascular foetal nutrition may significantly improve both foetal condition and foetal weight gain in oligohydramnios. 28 Cost of total duration of drug therapy per patient was 303.2 (±30.96) INR (Indian Rupees). As less (32%) number of drugs prescribed from hospital supply, average cost of therapy is high.…”

Impact of chronic hypoxemia on blood flow to the brain, heart, and adrenal gland in the late-gestation IUGR sheep fetus

“…Placental insufficiency is a consequence of a decrease in either placental size and/or placental transfer capacity and is the most common cause of IUGR, defined as a birth weight below the 10th percentile for any given gestational age (24,49,78,81). Ultrasound studies in human fetuses suggest that a redistribution of blood flow toward the brain occurs as a fetal adaptation to chronic hypoxemia (19,76).…”