losartan-potassium and Fetal-Distress

To study the expression of erythropoietin (EPO) and its receptor (EPOR) in the brain of newborn rats suffering fetal distress.. A model of fetal distress was prepared by ligating bilateral uterine arteries of the rats with full-term pregnancy for 10 minutes before cesarean sections. The expression levels of EPO and EPOR in the brain of newborn rats were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot at 0, 2, 6, 12, 24, 48, 72 hrs and 7 days after birth. Serum EPO levels were measured using ELISA simultaneously. The newborn rats born by cesarean sections which were not subjected to uterine artery ligation were used as the control group.. The expression of EPO protein and mRNA in brain tissues in the fetal distress group increased significantly compared with the control group 2, 6 and 12 hrs after birth (P<0.05). The expression of EPOR protein and mRNA in brain tissues in the fetal distress group increased significantly compared with the control group 2, 6, 12, 24 and 48 hrs, and 3 days after birth (P<0.05). Serum EPO levels in the fetal distress group were significantly higher than in the control group 2 hrs after birth.. The EPO and EPOR levels in the brain increase quickly after birth in newborn rats suffering from fetal distress. The EPOR is high expressed for a longer time than EPO. This can provide a basis for the treatment of neonatal brain damage induced by fetal distress by exogenous EPO.

Topics: Animals; Animals, Newborn; Brain; Erythropoietin; Female; Fetal Distress; Pregnancy; Rats; Rats, Sprague-Dawley; Receptors, Erythropoietin; RNA, Messenger

Umbilical cord blood erythropoietin levels and hematocrit are significantly higher in smoking mothers than those nonsmoking ones. In addition, the incidence of newborns with low birthweight is higher in women who smoke. We conclude that in addition to other parameters, cord blood erythropoietin might be used as a valuable indicator of fetal distress in smokers.

Topics: Adult; Case-Control Studies; Erythropoietin; Female; Fetal Blood; Fetal Distress; Hematocrit; Humans; Infant, Newborn; Male; Pregnancy; Pregnancy Complications; Smoking

The ability of parameters like umbilical arterial pH and Apgar score to predict and/or to reflect fetal distress are limited. It is known that erythropoietin (EPO) increases when partial pressure of oxygen is insufficient for metabolic demand. Therefore we studied the levels of EPO in the cord blood of stressed neonates (n = 75). In addition, reference values for EPO were established in a group of healthy term infants (n = 54) (mean +/- SD: 20.02 +/- [mU/ml]) and in premature infants (n = 77) according to gestational age. A significant increase in EPO concentrations was found in the stressed group: 153.4 +/- 418.8 [mU/ml], p < 0.003 (n = 27) in acute stress; and 102.6 +/- 127.1 [mU/ml], p < 0.002 (n = 48) in chronic stress. However parameters like hemoglobin, hematocrit, umbilical arterial pH and Apgar-score did not correlate with EPO values. A sensitivity of 59% and a specificity of 92% was calculated. We conclude that serum EPO concentrations are capable of detecting acute and chronic stress and could be useful as a screening method. In part EPO concentrations also allow us to grade stress in pregnancies that are complicated by diseases like preeclampsia.

Topics: Apgar Score; Erythropoietin; Female; Fetal Distress; Gestational Age; Hemoglobins; Humans; Infant, Newborn; Monitoring, Physiologic; Pregnancy; Pregnancy Complications; Reference Values

We have investigated the relationship between erythropoietin (Epo) and pH, PaO2 and haematocrit in 100 cord blood samples obtained at Caesarean section prior to labour. Of 82 term (> 37 weeks) infants, 64 were appropriately grown (10th-90th centiles), and their mean cord serum Epo and cord blood Epo was 23 +/- 8 mU/ml (mean +/- SD). Strong inverse correlations were found between cord serum Epo and cord blood pH (r = -0.74; p < 0.0001), and between cord serum Epo and cord blood PaO2 (r = -0.55; p < 0.0001), but not between cord serum Epo and cord haematocrit (r = 0.02; p < 0.9). For the 18 preterm babies (gestation 32.4 +/- 4.1 weeks, birth weight 1,820 +/- 476 g), the Epo level was 36 +/- 8 mU/ml, which was not significantly greater than for the term babies. Strong inverse correlations were again found between Epo and pH (r = -0.87; p < 0.0001) and Epo and PaO2 (r = -0.69; p < 0.002). Babies from complicated pregnancies (intra-uterine growth retardation, pre-eclampsia, antepartum haemorrhage, diabetes mellitus and fetal distress) tended to have higher Epo levels. Thirteen babies had Epo levels > 40 mU/ml, and 11 (85%) of these required neonatal intensive care. Cord serum Epo correlates better with oxygen tension and pH at birth than with fetal growth and haematocrit, which are measures of chronic stress to the fetus.

Topics: Cesarean Section; Cordocentesis; Diabetes Mellitus, Type 1; Erythropoietin; Female; Fetal Blood; Fetal Distress; Fetal Growth Retardation; Fetal Hypoxia; Hematocrit; Humans; Hydrogen-Ion Concentration; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Oxygen; Pre-Eclampsia; Pregnancy; Pregnancy in Diabetics; Uterine Hemorrhage

Serum immunoreactive erythropoietin (siEPO) was determined in cord serum from neonates (n = 97, gestational age 36-43 weeks), in healthy children from birth to adolescence (n = 260) and in children with haematological (n = 30), renal (n = 10) and congenital heart diseases (n = 70). In healthy children siEPO levels decreased after birth (geometric mean cord siEPO 35.6 mU/ml with 95% range of 17-56 mU/ml in eutrophic, nondistressed fetuses) and reached lowest values during the first 2 months (geometric mean siEPO 11.5 mU/ml). Thereafter siEPO levels increased slightly and were constant between 2 months and adolescence. The geometric mean siEPO for healthy children after birth was 18.8 mU/ml with 95% range of 7-47 mU/ml. These estimates were not significantly different from normal adult values. In newborns with fetal distress (n = 15) cord siEPO was significantly elevated (geometric mean 63.0 mU/ml; P less than 0.001). In children with haematological disease, siEPO and Hb concentration were inversely correlated (log siEPO (mU/ml) = 4.1-0.20 x Hb (g/dl); r = -0.62; P less than 0.0005). This relationship was significantly different in children with chronic renal failure (log siEPO (mU/ml) = 0.67 + 0.035 x Hb (g/dl); r = 0.50; P = 0.1). In children with heart disease the geometric mean siEPO was 19.2 mU/ml with 95% range 8-65 mU/ml for cyanotic (SaO2 less than 94%) and 17.7 mU/ml with 95% range of 12-36 mU/ml for acyanotic patients. In this group siEPO values were inversely correlated to the arterial oxygen content (log siEPO (mU/ml) = 1.61-2.04 x oxygen content (l/l); r = -0.28; P less than 0.02).

Topics: Adolescent; Adult; Analysis of Variance; Anemia; Child; Child, Preschool; Erythropoietin; Female; Fetal Distress; Heart Defects, Congenital; Hemoglobins; Humans; Infant; Infant, Newborn; Infant, Small for Gestational Age; Kidney Diseases; Male; Normal Distribution; Oxygen; Pregnancy; Reference Values; Regression Analysis

Repeated amniotic fluid erythropoietin measurements in 23 Rh-immunized pregnancies were done to evaluate erythropoietin levels of amniotic fluid as an indicator of fetal distress (umbilical artery, pH 7.14 or less, or 1-minute Apgar score of 4 or less). Amniotic fluid erythropoietin levels did not vary significantly between 168 and 273 gestational days in the pregnancies without fetal distress. Increasing levels of amniotic fluid erythropoietin predicted highly reliably severe fetal distress at birth. Whether erythropoietin levels of amniotic fluid can also predict fetal distress in other pathologic pregnancies needs further study.

Topics: Amniotic Fluid; Bilirubin; Erythropoietin; Female; Fetal Blood; Fetal Distress; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications, Hematologic; Rh Isoimmunization