scholarly journals Intrauterine Growth Retardation in Pregnant Women with Long QT Syndrome Treated with Beta-Receptor Blockers

Neonatology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Tatjana Welzel ◽  
Birgit Donner ◽  
Johannes N. van den Anker
Keyword(s):  
Pregnant Women ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Receptor Blocker ◽  
Prenatally Exposed ◽  
Long Qt ◽  
Intrauterine Growth ◽  
Receptor Blockers ◽  
Qt Syndrome ◽  
Β Receptor

Pregnant women with inherited long QT syndrome (iLQTS) are at an increased risk for preterm delivery and intrauterine growth retardation (IUGR) due to their underlying disease. Additionally, they are at a risk of arrhythmogenic events, particularly during the postpartum period because of physiological changes and increased emotional/physical stress. β-receptor blockers can effectively prevent life-threatening Torsades de Pointes ventricular tachycardia and they are the treatment of choice in iLQTS. Use of β-receptor blockers in pregnancy is recommended, although IUGR is commonly reported for prenatally exposed infants. IUGR, particularly in preterm infants, can result in adverse neonatal outcomes. This review was performed to support clinicians in their selection of β-receptor blocker treatment for their pregnant iLQTS women by (i) summarizing the available literature addressing the impact of different β-receptor blockers on IUGR and (ii) reporting additional aspects which might influence the β-receptor blocker selection. In general, experts recommend to use nonselective β-receptor blockers, such as nadolol and propranolol, for iLQTS management as these drugs seem to be superior in effectiveness. However, β-1-selective receptor blockers, such as bisoprolol or metoprolol, seem to affect less likely uterine contraction, peripheral vasodilation, and are associated with lower IUGR rates and fetal hypoglycemia. They are therefore recommended, except atenolol, as first-line therapy for pregnant women. Additionally, maternal factors such as iLQTS genotype, other underlying comorbidities (e.g., diabetes mellitus type 1, asthma bronchiale), and uteroplacental dysfunction or fetal factors have to be taken into account. Therefore, each woman with iLQTS who wants to become pregnant should be well-advised for a personalized β-receptor blocker therapy according to the individual risk-benefit evaluation by a multidisciplinary team of cardiologists, gynecologists, pediatric cardiologists, neonatologists, and clinical pharmacologists. During pregnancy, a close monitoring of IUGR and, after birth, monitoring of bradycardia, hypoglycemia, and respiratory depression in the neonate is mandatory. This review summarizes available data on β-receptor blocker-related risk for IUGR in prenatally exposed infants and illustrates which factors might influence β-receptor blocker selection with the aim to support clinicians in their pharmacological management of their pregnant iLQTS patients.

UNCONJUGATED OESTETROL IN PLASMA IN RESPONSE TO AN INTRAVENOUS LOAD OF DEHYDROEPIANDROSTERONE SULPHATE (DHAS) IN UNCOMPLICATED AND COMPLICATED HUMAN PREGNANCY

1978 ◽  
Vol 89 (4) ◽  
pp. 753-762 ◽  
Author(s):  
Ove Axelsson
Keyword(s):  
Pregnant Women ◽  
Intravenous Injection ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
High Specificity ◽  
Intrauterine Growth ◽  
Before And After ◽  
Patients With Diabetes ◽  
The Individual ◽  
Plasma Oestradiol

ABSTRACT A non-chromatographic radioimmunoassay for estimation of unconjugated oestetrol in plasma from pregnant women is described. The antiserum has a high specificity to oestetrol. The technical procedure is simple and rapid. Only small amounts of plasma (0.2–0.4 ml) are needed for the analysis. The method has been applied to the measurement of oestetrol in plasma from pregnant women before and after an intravenous injection of 50 mg DHAS. In women with uncomplicated pregnancies a rise of plasma oestetrol was found 60 min after the injection. From 120 to 360 min there was a plateau level, at 600 min a decrease from this level was observed. No changes in the oestetrol response were found with advancing gestational age from the 33rd to the 40th week of pregnancy. A great spread in the individual responses were recorded. Patients with pre-eclampsia and intrauterine growth retardation had a tendency to a lower increase and patients with diabetes a tendency to a higher increase of plasma oestetrol after the DHAS administration. From the data obtained it is concluded that the increase of plasma oestetrol after an intravenous injection of DHAS in most cases is secondary to the increase of plasma oestradiol. The results suggest that measurement of unconjugated oestetrol in plasma after an intravenous load of DHAS is no safe way to assess foetal wellbeing. In women with intrauterine growth retardation (IUGR) the simultaneous measurement of plasma oestradiol and oestetrol after an injection of DHAS indicates a possibility to distinguish placental from foetal causes of this syndrome.

scholarly journals Blood Lead and Zinc in Pregnant Women and their Offspring in Intrauterine Growth Retardation Cases

2001 ◽  
Vol 25 (6) ◽  
pp. 461-465 ◽  
Author(s):  
S. Srivastava ◽  
P. K. Mehrotra ◽  
S. P. Srivastava ◽  
I. Tandon ◽  
M. K. J. Siddiqui
Keyword(s):  
Pregnant Women ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Blood Lead ◽  
Intrauterine Growth ◽  
Lead And Zinc

Pregnancy Anemia as a Favorable Factor of Premature Birth

2018 ◽  
Vol 69 (7) ◽  
pp. 1886-1888
Author(s):  
Alexandru Oancea ◽  
Casiana Stanescu ◽  
Diana Maria Anastasiu Popov ◽  
Radu Neamtu ◽  
Doru Anastasiu ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Growth Retardation ◽  
Premature Birth ◽  
Intrauterine Growth Retardation ◽  
Preterm Births ◽  
Premature Births ◽  
Intrauterine Growth ◽  
Economic Context ◽  
Hb Concentration ◽  
In Pregnancy

Hematological physiological changes during gestation are intended to compensate and support pregnancy-related changes in the woman�s body. In pregnancy there is a dilution of the known Hb concentration known as gestational hemodilution or physiological pregnancy anemia. On a group of 300 pregnant women with different forms of anemia, we followed its implications on the evolution of pregnancy, its role in the determinism of premature labor, and its role in the apparition of intrauterine growth retardation. In 46 cases (15.33%) we reported premature births, in 23 (7.66%) of the cases we considered that anemia was the main (unique) cause of premature birth, in other cases (84.67%) anemia associated with other etiologic factors of premature birth. Comparing the incidence of preterm birth with a group of 300 pregnant women without anemia revealed the incidence of premature birth is 3 times less and is represented by 12 cases (4%) and 2 times less for intrauterine growth retardation represented by 16 cases (5.33%). Pregnancy anemia can cause a frequent pathology with major consequences in pregnancy development during birth and fetal development involving 15.33% of preterm births and 12.35% of cases of intrauterine growth retardation. In the current social and economic context, it is necessary to prophylactically administer iron for pregnant women from 20 weeks of gestation, at least 30mg / day for prophylaxis of pathology due to iron deficiency.

Arginine and аrginase levels in the blood serum of pregnant women with intrauterine growth retardation

2016 ◽  
pp. 97-99
Author(s):  
A.V. Basystyi ◽  
Keyword(s):  
Blood Serum ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Main Group ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Intrauterine Growth ◽  
Group I

The objective: to determine arginine and arginase levels in the blood serum of pregnant women with intrauterine growth retardation of different severity. Patients and methods. The study included 100 pregnant women (from 23 to 40 weeks of gestation). The main group consisted of 80 pregnant women with intrauterine growth retardation. The control group consisted of 20 women with physiological course of pregnancy. The patients of the main group were divided into three clinical groups regarding intrauterine growth retardation staging. Group I included 38 pregnant women with stage I IUGR, 22 pregnant women with stage II IUGR were in group II and 20 pregnant women with stage III IUGR – in group III. L-arginine concentration was determined in the blood serum by the method of T.L. Aleinikova et al [1], arginase activity – by the method of J.W. Geyer, D. Dabich [4]. The statistical analysis was performed by using standard computer programs: STATISTICA 6.0, Microsoft Excel, ANOVA. Statistically significant difference was considered at p<0.05. Results. In the study the reduced level of free arginine in the main group of pregnant women with intrauterine growth retardation of different severity was determined if compared with the control group. Fetomaternal gradient of arginine is reduced significantly due to increasing activity of the enzyme arginase, which competitively uses amino acid. Conclusions. The level of reduced free arginine in the blood serum of pregnant women with intrauterine growth retardation is directly proportional to the severity of fetal growth retardation: the more severe fetal growth retardation, the more marked arginine deficiency. For correcting metabolic disorders in pregnant women with intrauterine growth retardation it is recommended to administer L-arginine containing drugs. Key words: L-arginin, arginase, blood serum, pregnant women with intrauterine growth retardation.

scholarly journals Prevalence of overt and subclinical thyroid dysfunction among women and its effects on maternal and fetal outcome

2018 ◽  
Vol 7 (6) ◽  
pp. 2123
Author(s):  
Puja Kumari ◽  
Sadhana Singh
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Pregnant Women ◽  
Growth Retardation ◽  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Intrauterine Growth Retardation ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Intrauterine Growth

Background: Objective of present study was to determine the current prevalence of thyroid dysfunction in normal pregnant women and to study the impact of thyroid dysfunction on maternal and fetal outcome.Methods: 400 pregnant women between 13 and 26 weeks of gestation were registered for the study. Apart from routine obstetrical investigations, TSH tests were done. Free T4 and anti-TPO antibody tests were done in patients with deranged TSH. Patients were followed up till delivery. Their obstetrical and perinatal outcomes were noted.Results: The prevalence of hypothyroidism and hyperthyroidism was and 1.25%, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (16.6 vs. 7.8%) and placental abruption (16.6 vs. 0.8%). Subclinical hypothyroidism was associated with preeclampsia (22.3 vs. 7.8%) as compared to the euthyroid patients. Adverse fetal outcome in overt hypothyroidism  included spontaneous abortion (16.6 vs. 2.39%), preterm birth (33.3 vs. 5.8%), low birth weight (50 vs. 12.11%), intrauterine growth retardation (25 vs. 4.9%), and fetal death (16.6 vs.7%) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (5.5 vs. 2.39%), preterm delivery (11.2 vs. 5.8%), low birth weight (25 vs. 12.11%), and intrauterine growth retardation (8.4 vs. 4.9%) as compared to the euthyroid women.Conclusions: The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.

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