Umbilical artery N-terminal peptide of proatrial natriuretic peptide in hypertensive pregnancies and fetal acidemia during labor

Abstract

In groups 1-3, N-terminal peptide of proatrial natriuretic peptide concentrations were higher (P <.001) than in the control group. In group 1, neonates with abnormal umbilical artery blood velocity pattern had higher N-terminal peptide of proatrial natriuretic peptide concentrations than neonates with normal umbilical artery Doppler findings (P <.006). N-terminal peptide of proatrial natriuretic peptide concentrations were higher in group 2 (P <.002) than in groups 1 and 3. CONCLUSIONS Maternal hypertensive disorder and fetal acidemia during labor stimulate fetal atrial natriuretic peptide production, which was greatest in fetuses with severe placental insufficiency and signs of congestive heart failure.

Plasma natriuretic peptide levels in fetuses with congenital heart defect and/or arrhythmia

“…showed that umbilical‐cord ANP level was inversely related to UA pH. Maternal hypertensive disorder and fetal acidemia during labor have been reported to stimulate fetal ANP production. We found that a UA pH of < 7.15 is correlated independently with high NP levels, which is consistent with the findings of these previous studies.…”

Human fetal cardiovascular profile score and neonatal outcome in intrauterine growth restriction

“…1626 (402-9574) pmol/L, P = 0.0001). NT-proANP values of all neonates with a CVP score ≤ 6 were above the 95 th percentile NT-proANP value of normal pregnancies, while 42 of 67 (63%) fetuses with CVP > 6 had NT-proANP concentrations above the 95 th percentile value in normal pregnancies 13 . The fetuses with umbilical venous pulsations had higher umbilical artery mean (SD) NT-proANP values than had fetuses with a normal nonpulsatile umbilical venous blood flow profile (6580 (5833) pmol/L vs. 2131 (1671) pmol/L, P < 0.0001).…”

Ultrasonographic and Biochemical Markers of Human Fetal Cardiac Dysfunction in Placental Insufficiency

“…29 There is no significant transplacental passage of NT-proANP, and mode of delivery does not influence UA plasma ANP concentrations. 4,30 In addition, atrial natriuretic factor concentrations do not change with gestation. 31 Gestational age at delivery and mode of delivery do not affect newborn cTnT levels, at least after 27 weeks' gestation.…”

“…Concentrations of fetal NT-proANP and cTnT (Enzymum-Test Troponin-T, Boehringer Mannheim Diagnostics) were determined. 4,5 We previously found that in neonates born after uncomplicated pregnancy and labor, the ϩ2 SD level of NT-proANP was 1145 pmol/L 4 , which was chosen to represent the cut-off level. A clinically significant cTnT concentration was set at 0.10 ng/mL 5 .…”

“…2 In placental insufficiency, abnormalities in the fetal venous circulation detected by Doppler ultrasonography have been proposed to indicate the need for delivery. 3 We have shown that in placental insufficiency, fetuses with a normal umbilical vein blood flow profile have increased atrial natriuretic peptide (ANP) production, 4 whereas an abnormal umbilical vein blood flow pattern is associated with fetal myocardial cell damage. 5 In this study, we tested the hypothesis that there exists a relationship between ultrasonographic and biochemical markers of fetal cardiac dysfunction and myocardial cell damage in pregnancies complicated by placental insufficiency.…”