endothelin-1 and Fetal-Distress

To compare venous cord plasma concentrations of 4 vasoactive peptide precursors: carboxy-terminal proarginine vasopressin, CT-prondothelin (ET)-1, midregional proadrenomedullin, and MR-proatrial natriuretic peptide, between fetuses with intrauterine growth restriction and appropriate for gestational age controls.. Matched-pair analysis of 12 fetuses with significant intrauterine growth restriction and 42 healthy appropriate for gestational age control fetuses. All infants were singletons, delivered by elective section after 34 weeks and without chromosomal abnormalities.. Umbilical cord plasma copeptin levels (median [range]) were 4-fold higher in intrauterine growth restriction infants than in matched appropriate for gestational age controls: 23.2 (6.7-449) vs 5.1 (2.5-53) pmol/L (P < .001). Multivariate regression analysis revealed an association between copeptin and umbilical artery resistance index z-score (P = .034). The 3 other precursor peptides showed no changes.. High copeptin concentrations in the cord blood of intrauterine growth restriction newborns reflect a fetal stress response and support the fetal programming hypothesis.

Topics: Adult; Arginine Vasopressin; Atrial Natriuretic Factor; Biomarkers; Case-Control Studies; Endothelin-1; Female; Fetal Blood; Fetal Distress; Fetal Growth Retardation; Glycopeptides; Humans; Middle Aged; Peptide Fragments; Young Adult

To evaluate plasma endothelin-1 (ET-1) and fetuin-A concentrations in women with intrahepatic cholestasis of pregnancy (ICP) and to determine whether there is any association between these parameters and fetal asphyxia.. We carried out a prospective case-control study consisting of 32 women with ICP at third trimester of pregnancy and 32 pregnant women without ICP. Blood samples from maternal peripheral venous circulation were collected and ET-1 and fetuin-A levels were determined from the plasma samples. Pulse-wave Doppler and Apgar scores were also recorded.. ET-1 concentrations were significantly higher in ICP patients. No difference was observed in fetuin-A levels between the two groups. Six newborns were declared as asphyctic (APGAR score at the 5 min <7). Maternal ET-1 levels did not correlate with the APGAR score at 5 min, total bile acid (TBA) and umbilical artery systolic/diastolic ratio with ICP patients. TBA levels were positively correlated with umbilical artery systolic/diastolic ratio negatively correlated with APGAR score at the 1' and 5'-Apgar score in all subjects. Plasma ET-1 concentration was higher in the preterm neonates of mothers with ICP compared with normal term neonates of mothers.. Although these data did not show evidence that maternal ET-1 would be associated with fetal distress, we can speculate that maternal ET-1 may be playing a role in the underlying pathology regarding microvascular dysfunction especially in the preterm neonates of mothers with ICP. Elevated TBA levels may increase the risk of asphyxia whereas fetuin-a (as an anti-inflammation marker) does not seem to have effect in women with ICP.

Topics: Adolescent; Adult; alpha-2-HS-Glycoprotein; Apgar Score; Asphyxia Neonatorum; Blood Proteins; Case-Control Studies; Cholestasis, Intrahepatic; Endothelin-1; Female; Fetal Distress; Humans; Infant, Newborn; Laser-Doppler Flowmetry; Pregnancy; Pregnancy Complications; Premature Birth; Prospective Studies; Umbilical Arteries; Young Adult

To investigate the changes of umbilical cord and the vasoactive substance in umbilical vein in intrahepatic cholestasis of pregnancy.. By HE staining method we analyzed the pathologic change of umbilical cord of 25 women with intrahepatic cholestasis of pregnancy (ICP) and fetal distress (ICP fetal distress group), 25 ICP women without fetal distress group (ICP control group) and 27 normal pregnancies (control group). The nitric oxide synthase (NOS) and endothelin-1 (ET-1) were detected in human umbilical vein endothelial cells (HUVEC) by immunohistochemistry method. Umbilical vein total bile acid (TBA) and NOS and ET-1 were measured.. (1) A remarkable high TBA level was found in umbilical vein in ICP, and it was higher in ICP fetal distress group (19.0 +/- 2.3) micromol/L than in ICP control group (9.0 +/- 1.7) micromol/L (P < 0.05); it was higher in ICP control group than the control group (4.4 +/- 1.5) micromol/L (P < 0.05). (2) A significant difference was found in the endotheliocytes of umbilical vein in ICP fetal distress group compared with ICP control group. The ratio of cells with pathological changes in ICP fetal distress group (92%, 23/25) was higher than ICP control group (68%, 17/25; P < 0.05). The occurrence of the pathological changes was associated with TBA. (3) The expression of eNOS in ICP fetal distress group 0.09 +/- 0.06 was lower than in ICP control group 0.21 +/- 0.08 (P < 0.05), and it was lower in ICP control group than in control group 0.47 +/- 0.07 (P < 0.05). In contrast, the expression of ET-1 in ICP fetal distress group 0.49 +/- 0.08 was higher than in ICP control group 0.32 +/- 0.07 (P < 0.05), and it was higher in ICP control group than control group 0.14 +/- 0.06 (P < 0.05). The expression of inducible nitric oxide synthase (iNOS) in ICP fetal distress group 0.20 +/- 0.04 and ICP control group 0.21 +/- 0.05 was lower than in control group 0.26 +/- 0.04 (P < 0.05), but no significant difference was found in ICP fetal distress group and ICP control group (P > 0.05). (4) The expression of eNOS, iNOS and ET-1 was correlated with umbilical vein TBA in ICP (r1 = -0.88, r2 = -0.45, r3 = 0.9; P < 0.01), respectively.. High level of TBA in ICP is harmful to the umbilical vein endothelium, which is correlated with the raised expression of ET-1, and the decreased expression of eNOS,and iNOS in human umbilical cord endothelium cells. All these changes of umbilical vein may be associated with the occurrence of fetal distress in ICP.

Topics: Adult; Bile Acids and Salts; Cholestasis, Intrahepatic; Endothelial Cells; Endothelin-1; Female; Fetal Distress; Humans; Immunohistochemistry; Nitric Oxide Synthase; Pregnancy; Pregnancy Complications; Umbilical Cord; Umbilical Veins