OBJECTIVE: To investigate the protective effect of electroacupuncture (EA) at "Zusanli" (ST 36) in pregnant rats on lung dysplasia of newborn rats with intrauterine growth restriction (IUGR) induced by maternal food restriction. METHODS: Twenty-four female SD rats were randomly divided into a control group, a control+EA group, a model group and a model+EA group, 6 rats in each group. From the 10th day into pregnancy to the time of delivery, the rats in the model group and the model+EA group were given with 50% dietary restriction to prepare IUGR model. From the 10th day into pregnancy to the time of delivery, the rats in the control+EA group and the model+EA group were treated with EA at bilateral "Zusanli" (ST 36), once a day. The body weight of offspring rats was measured at birth, and the body weight and lung weight of offspring rats were measured on the 21st day after birth. The lung function was measured by small animal lung function detection system; the lung tissue morphology was observed by HE staining; the content of peroxisome proliferator activated receptor γ (PPARγ) in lung tissue was detected by ELISA. RESULTS: Compared with the control group, the body weight at birth as well as the body weight, lung weight, lung dynamic compliance (Cdyn) and PPARγ at 21 days after birth in the model group were significantly decreased ( CONCLUSION EA at "Zusanli" (ST 36) may protect the lung function and lung histomorphology changes by regulating the level of PPARγ of lung in IUGR rats induced by maternal food restriction.
Acupuncture Points ; Animals ; Electroacupuncture ; Female ; Fetal Growth Retardation/therapy* ; Lung ; Pregnancy ; Rats ; Rats, Sprague-Dawley

Short-term outcome in very low birthweight babies has never been closely examined in Papua New Guinea. A cohort of neonates born over a year at Port Moresby General Hospital was followed from birth to death or discharge. Intrauterine growth retardation was an important contributor to low birthweight. Simple, inexpensive care resulted in respectable survival figures. Improving antenatal surveillance will have much more impact in reducing mortality in this group in the future than trying to emulate sophisticated and costly western neonatal care.
Antibiotic Prophylaxis ; Birth Weight ; Cohort Studies ; Exchange Transfusion, Whole Blood ; Female ; Fetal Growth Retardation - complications ; Respiratory Distress Syndrome, Newborn - therapy

Recent advances in dialysis and a multidisciplinary approach to pregnant patients with advanced chronic kidney disease provide a better outcome. A 38-yr-old female with autosomal dominant polycystic kidney disease (ADPKD) became pregnant. She was undergoing hemodialysis (HD) and her kidneys were massively enlarged, posing a risk of intrauterine fetal growth restriction. By means of intensive HD and optimal management of anemia, pregnancy was successfully maintained until vaginal delivery at 34.5 weeks of gestation. We discuss the special considerations involved in managing our patient with regard to the underlying ADPKD and its influence on pregnancy.
Adult ; Female ; Fetal Growth Retardation/etiology ; Humans ; Kidney Failure, Chronic/therapy ; Polycystic Kidney, Autosomal Dominant/*diagnosis ; Pregnancy ; Renal Dialysis ; Risk Factors ; Tomography, X-Ray Computed

OBJECTIVEAbout 20 - 50% individuals with intrauterine growth retardation (IUGR) could not achieve catch-up growth and remain small in size till adulthood. There are few reports on the relation between intestinal development and body catch-up growth of IUGR. Studies showed that early "nutritional programming" would results in long-term effects on the body growth and organic function, and gastrointestinal development is closely related to the body development as well. The authors aimed to study the effect of early nutritional interventions on serum IGF1, IGFBP3, intestinal development and catch-up growth of pups with IUGR by using diets with different protein and caloric levels during the first four weeks of life.

METHODSAn IUGR rat model was established by maternal nutrition restriction during pregnancy. Thirty-two IUGR female pups were divided randomly into 4 groups (8 pups in each group) and eight normal female pups as control. The groups and interventions were (1) Normal control group (C group); (2) IUGR control group (S group), (3) IUGR low-protein diet group (SL group); (4) IUGR high-protein diet group (SH group); (5) IUGR high-caloric group (SA group). The serum IGF1, IGFBP3, body weight, body length, and intestinal weight, length, intestinal villi height (VH), crypt depth (CD), villi absorbing area (VSA), mucous thickness (MT) were measured at the 4(th) week of life.

RESULTS(1) At the 4(th) week, the serum IGF1 (724.0 +/- 153.5 ng/ml), IGFBP3 (9.69 +/- 3.13 ng/ml), and VH (416.9 +/- 46.3 microm), VSA (115.9 +/- 24.0 x 10(3) microm(2)), MT (583.9 +/- 68.5 microm) in the SH group were significantly higher than those of normal control group (539.4 +/- 198.4 ng/ml, 4.77 +/- 2.98 ng/ml and 322.1 +/- 25.8 microm, 85.8 +/- 17.8 x 10(3) microm(2), 480.0 +/- 61.5 microm) and IUGR control group (P < 0.05). The intestinal weight (1.91 +/- 0.16 g) and length (80.67 +/- 9.47 cm) in the SH group was not significantly different from the normal control group (2.24 +/- 0.22 g and 74.77 +/- 9.06 cm, P > 0.05). The SH group showed the fastest catch-up growth. Their body weights (40.14 +/- 11.03 g) at the 3(rd) week and body lengths (23.61 +/- 0.49 cm) at the 4(th) week of life reached the normal ranges of the control group (44.65 +/- 5.36 g and 23.10 +/- 1.42 cm, P > 0.05). (2) The serum IGF1 (346.7 +/- 85.3 ng/ml), IGFBP3 (1.4 +/- 0.21 ng/ml), body weight (21.41 +/- 3.54 g) and body length (15.96 +/- 1.29 cm) and the most of intestinal indexes in the SL group were markedly lower than other groups at the 4(th) week of life (P < 0.05).

CONCLUSIONThe serum IGF1 was a sensitive marker to reflect the catch-up growth and nutritional status, and IGF1 was positively correlated with the intestinal development and body growth. When given different nutritional interventions during the first four weeks of life, high protein diet is more helpful for the IUGR catch-up growth by promoting the intestinal development and the absorption of nutrition.

Animal Nutritional Physiological Phenomena ; Animals ; Animals, Newborn ; growth & development ; Dietary Proteins ; administration & dosage ; Disease Models, Animal ; Female ; Fetal Growth Retardation ; blood ; diet therapy ; Insulin-Like Growth Factor I ; analysis ; Pregnancy ; Prenatal Nutritional Physiological Phenomena ; Rats

Trisomy 9 mosaicism is a disease characterized not only by intrauterine growth retardation and mental retardation but also congenital heart defects, musculoskeletal, genitourinary and CNS anomalies, as well as craniofacial anomalies such as microcephaly, micrognathia, narrowed temples, prominent occiput, broad-based nose with bulbous tip, low set ears, deeply set eyes, short palpebral fissure and small mouth. This syndrome was first reported back in 1973 by Haslam and others, and has hardly ever been reported since. In Korea, a complete form of trisomy 9 syndrome was first reported in 1998 by Chun and others, but trisomy 9 mosaicism has not been reported yet. We recently experienced a case with a patient who was most likely suspected as diet therapy requiring Smith-Lemli-Opitz Syndrome(SLO), since the patient had unilateral ptosis, hypospadias, micrognathia, simian crease, and low set ears, which are the characteristics not yet reported as trisomy 9 mosaicism, but most similar to Smith-Lemli-Opitz syndrome. Also, the patient did not show the typical characteristics of trisomy 9 mosaicism such as broad nose or enophthalmosis. However, further evaluation was taken in order to make the correct diagnosis, and the serum cholesterol level of the patient was shown to be normal, which implied normal cholesterol metabolism, but the chromosomal studies of the patient confirmed the karyotype of 47,XY,+9/46,XY, which proved that the patient has trisomy 9 mosaicism.
Cholesterol ; Diagnosis ; Diet Therapy ; Ear ; Female ; Fetal Growth Retardation ; Heart Defects, Congenital ; Humans ; Hypospadias ; Intellectual Disability ; Karyotype ; Korea ; Male ; Metabolism ; Microcephaly ; Mosaicism* ; Mouth ; Nose ; Smith-Lemli-Opitz Syndrome* ; Trisomy*

OBJECTIVETo investigate the therapeutic effect of L-arginine (L-Arg) administration on fetus growth retardation (FGR) due to pregnancy-induced hypertension and explore its mechanism.

METHODSSixty-eight pregnant women with pregnancy-induced hypertension and FGR were enrolled in this study, and 25 of them were given L-Arg in addition to routine therapy. Umbilical artery flow parameters and serum NO concentrations in maternal and umbilical blood were measured, and the therapeutic effects were evaluated according to neonatal birth weight.

RESULTSL-Arg therapy markedly decreased the systolic/diastolic value, pulse index and resistant index (P=0.000,0), while increased the fast blood velocity rate(P=0.000,0). NO contents in maternal and umbilical blood were 60.45-/+22.68 and 28.45-/+11.35 micromol/L in L-Arg group, respectively, significantly higher than those in routine treatment group (P=0.000,0 and 0.001,7, respectively) but lower than those in the control group (P=0.000,8 and 0.000,0, respectively). The neonatal birth weights were 2.9-/+0.3 kg in L-Arg group, significantly higher than that in routine treatment group (2.7-/+0.3 kg, P=0.006,8) and similar with that of the control group (3012.9-/+295.9 g, P=0.176,2).

CONCLUSIONL-Arg promote intrauterine growth of the fetus by increasing NO production and improving the umbilical artery flow in pregnant women with pregnancy-induced hypertension and FGR.

Adult ; Arginine ; therapeutic use ; Blood Flow Velocity ; drug effects ; Female ; Fetal Growth Retardation ; physiopathology ; prevention & control ; Humans ; Hypertension, Pregnancy-Induced ; blood ; drug therapy ; physiopathology ; Nitric Oxide ; blood ; Pregnancy ; Umbilical Arteries ; physiopathology

OBJECTIVETo explore the effect of salvia injection (SI) combined with composite amino acid (CAA) in treating fetal growth restriction (FGR).

METHODSA retrospective analysis was conducted on 106 pregnant women with FGR hospitalized from January 2007 to January 2008. Patients were randomized into 2 groups equally, the treated group (53 cases) treated with SI plus CAA, and the control group treated with CAA alone, all for 7 days. The clinical effect and umbilical blood flow (S/D) in patients were observed.

RESULTS(1) The total effective rate in the treated group was 81.13%, it was 88.80% (16/18) for patients in the gestation period of 24+ -28 weeks, 80.00% (12/15) for those of 28+ -32 weeks, and 75.00 (15/20) for 32+ -36 weeks, while in the control group, the corresponding rates were 69.81%, 77.77% (14/18), 66.66% (10/15), and 65.00% (13/20), respectively. The difference between the two groups was significant (P < 0.05). (2) After treatment, S/D significantly lowered in patients of the treated group (P < 0.05, P < 0.01), no matter how long the gestation period was, but it was insignificantly changed in the control group.

CONCLUSIONThe combined treatment with SI and CAA on FGR could improve the condition of the fetus.

Adult ; Amino Acids ; therapeutic use ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Fetal Growth Retardation ; drug therapy ; Gestational Age ; Humans ; Infusions, Intravenous ; Phytotherapy ; Pregnancy ; Retrospective Studies ; Salvia miltiorrhiza ; chemistry ; Young Adult

Interactions of vascular endothelial growth factor (VEGF) with receptors VEGFR1/Flt1 and VEGFR2/Flk1, and those of angiopoietins (Ang-1, Ang-2) with receptor Tie2 play important roles in placental angiogenesis. This study investigated vascular morphology and expression of these angiogenic factors in rat placenta on the day 15, 18, 21 of gestation (D15, D18 and D21). The rats were randomly assigned into 3 groups: normal group, model group [fetal growth restriction (FGR) model], and Bushen Yiqi Huoxue (BYHR) recipe treatment group (BYHR group, the pregnant rats with FGR were treated with BYHR recipe). Morphological analysis indicated that during initial villous formation, fetal nucleated erythrocytes (FNEs) appeared in maternal blood sinus (MBS). Subsequently, FNEs were surrounded by endothelial cells to form fetal capillary (FC) and then by trophoblast cells to form villi. As pregnancy proceeded, FC density increased progressively with increasing endothelial identification staining (EIS) in normal and BYHR groups. Whereas, villous formation was suppressed, normal increase in FC density was impaired and EIS was weakened in model group. Quantitative PCR analysis showed that VEGF and Flk1 mRNA increased over gestation in all groups, indicating that VEGF might play a pivotal role in FC growth during late gestation. VEGF mRNA was increased on D15, while decreased on D21 in model group as compared with normal group and BYHR group. Immunohistochemically, Ang-2 protein was highly expressed in FNEs, gradually disappeared as villi matured, and decreased over gestation in all groups, indicating that Ang-2 might play a pivotal role in villous formation, which was further supported by decreased Ang-2 mRNA and protein expression in model group on D15. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio increased from D15 to D18 in all groups as placenta matured. Ang-1 mRNA, Tie2 mRNA and Ang-1/Ang-2 ratio were decreased on D18 in model group as compared with normal and BYHR groups, indicating delayed maturity of FGR placenta. Alterations in angiogenic factors may result in altered placental vasculature and cause placental insufficiency. BYHR recipe could balance the angiogenic factors to promote the formation and maturation of FGR placental vasculature.
Animals ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fetal Growth Retardation ; etiology ; physiopathology ; therapy ; Male ; Neovascularization, Physiologic ; drug effects ; physiology ; Placenta ; blood supply ; drug effects ; physiopathology ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Tobacco Smoke Pollution ; adverse effects

Objective: To analyze the ultrasonic manifestations, clinical features, high risk factors and key points of pregnancy management in prenatal diagnosis of umbilical artery thrombosis (UAT). Methods: The data of 31 pregnant women of UAT diagnosed by prenatal ultrasonography and confirmed after birth from July 2017 to July 2022 at the Women's Hospital, Zhejiang University School of Medicine were retrospectively analyzed, including the maternal characteristics, pregnancy outcomes and fetal complications. In addition, the baseline data and pregnancy outcomes were compared in 21 patients who continued pregnancy after diagnosis of UAT. Of the 21 UAT cases that continued pregnancy, 10 cases were treated with low molecular weight heparin (LMWH; LMWH treatment group), while the other 11 patients had expectant treatment(expectant treatment group). Results: The age of the 31 pregnant women was (30.2±4.7) years, of which 5 cases (16%,5/31) were advanced age pregnant women. The gestational age at diagnosis was (32.9±4.0) weeks, and the gestational age at termination of pregnancy was (35.6±2.9) weeks. In 31 fetuses with UAT, 15 cases (48%) had fetal distress, 11 cases (35%) had fetal growth restriction, and 3 cases (10%) had intrauterine stillbirth. There were 28 cases of live births, including 26 cases by cesarean section and 2 cases by vaginal delivery. There were also 3 stillbirths, all delivered vaginally. Four neonates had mild asphyxia and two newborns had severe asphyxia. Among the 31 cases, 10 cases were terminated immediately after diagnosis, the gestational age at diagnosis was (35.9±2.9) weeks. Another 21 pregnancies continued, and their gestational age at diagnosis was (31.4±3.7) weeks. The median prolonged gestational age in LMWH treatment group was 7.9 weeks (4.6-9.4 weeks), and all were live births. The median prolonged gestational age in the expectant treatment group was 0.6 weeks (0.0-1.0 weeks), and 2 cases were stillbirths. There was a statistically significant difference in prolonged gestational age (P=0.002). Conclusions: Ultrasound is the preferred method for prenatal detection of UAT. Clinicians need to be vigilant for UAT when a newly identified single umbilical artery is detected by ultrasound in the second or third trimesters. The decision to continue or terminate the pregnancy depends on the gestational age and the condition of fetus. Attention should be paid to fetal movements as the pregnancy continues. The treatment of LMWH as soon as possible after diagnosis of UAT may improve the pregnancy outcome.
Pregnancy ; Infant, Newborn ; Female ; Humans ; Adult ; Infant ; Stillbirth ; Cesarean Section ; Umbilical Arteries/diagnostic imaging* ; Asphyxia ; Retrospective Studies ; Heparin, Low-Molecular-Weight/therapeutic use* ; Pregnancy Outcome ; Fetal Growth Retardation/therapy* ; Ultrasonography, Prenatal/methods* ; Gestational Age

The incidence of acute leukemia in pregnancy is estimated to be about 1 per 75000 pregnancies, and the incidence of lymphocytic leukemia is known to be lower than myelocytic leukemia. Pregnancy dose not affect the course of acute leukemia, but thrombocytopenia, anemia and leukopenia resulting from leukemia may lead to hemorrhage, infection, and insufficient supply of oxygen and nutrition to fetus. The most important factor for chemotherapy is gestational age. Since no evidence on adverse effect of chemotherapeutic agents on fetus when given after the first trimester, aggressive chemotherapy is recommended during pregnancy. However, during chemotherapy, caution regarding risk of spontaneous abortion, intrauterine fetal growth retardation, teratogenicity, intrauterine fetal death, fetal immunosupression and preterm labor should be taken. Acute leukemia in pregnancy is extremely rare, so treatment and management of the pregnant mother bearing viable fetus in her 3rd trimester is not established clearly. We experienced a patient with acute lymphocytic leukemia who was first diagnosed at 27 gestational weeks and immediately started with chemotherapy. But due to preterm labor and impending fetal distress, emergency cesarean section was performed at 28 gestational weeks. We present this patient along with past experiences of acute leukemia in pregnancy.
Abortion, Spontaneous ; Anemia ; Cesarean Section ; Drug Therapy ; Emergencies ; Female ; Fetal Death ; Fetal Distress ; Fetal Growth Retardation ; Fetus ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myeloid ; Leukopenia ; Mothers ; Obstetric Labor, Premature ; Oxygen ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pregnancy Trimester, First ; Pregnancy* ; Thrombocytopenia