Mending a growth-restricted fetal heart: should we use glucocorticoids?
Summary of "Mending a growth-restricted fetal heart: should we use glucocorticoids?"
Clinical and experimental studies suggest that the growth-restricted fetus at increased risk of impaired cardiovascular function that likely contributes to both increased mortality rate and in survivors, to cardiovascular dysfunction apparent in childhood and later life. Fetal growth restriction is also associated with a high risk of preterm birth. Accordingly, the growth-restricted fetus is more likely than average to receive antenatal glucocorticoids to accelerate lung maturation in preparation for birth. However, glucocorticoids are powerful regulators of vascular tone and antenatal glucocorticoid administration to the intrauterine growth restriction (IUGR) fetus results in systemic cardiovascular changes that are not observed in the healthy normal grown fetus. These responses to glucocorticoids may disturb the IUGR fetus' ability to appropriately compensate to placental insufficiency. Indeed is it possible that in the setting of severe IUGR exogenous glucocorticoids are detrimental rather than beneficial to the fetus?
Affiliation
Maternal Fetal Medicine, Monash Medical Centre , Southern Health, Victoria , Australia.
Journal Details
This article was published in the following journal.
Name: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the
ISSN: 1476-4954
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22764774
- DOI: http://dx.doi.org/10.3109/14767058.2012.697940
Medical and Biotech [MESH] Definitions
Fetal Distress
A nonreassuring fetal status (NRFS) indicating that the FETUS is compromised (American College of Obstetricians and Gynecologists 1988). It can be identified by sub-optimal values in FETAL HEART RATE; oxygenation of FETAL BLOOD; and other parameters.
Nuchal Cord
A complication of pregnancy in which the UMBILICAL CORD wraps around the fetal neck once or multiple times. In some cases, cord entanglement around fetal neck may not affect pregnancy outcome significantly. In others, the nuchal cord may lead to restricted fetal blood flow, oxygen transport, fetal development, fetal movement, and complicated delivery at birth.
Fetal Heart
The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (HEART/embryology) only on the basis of time.
Endocardial Cushions
A fetal heart structure that is the bulging areas in the cardiac septum between the HEART ATRIA and the HEART VENTRICLES. During development, growth and fusion of endocardial cushions at midline forms the two atrioventricular canals, the sites for future TRICUSPID VALVE and BICUSPID VALVE.
Fetal Growth Retardation
The failure of a FETUS to attain its expected FETAL GROWTH at any GESTATIONAL AGE.
PubMed Articles
Objective: To evaluate changes in central and peripheral circulation, including new and standard parameters of the fetal brain and heart in fetuses with intrauterine growth restriction (IUGR) in relat...
Glucocorticoids and the regulation of growth hormone secretion.
Glucocorticoids modulate the secretion of growth hormone (GH) by various and competing effects on the hypothalamus and pituitary gland. The final effects of this modulation depend on hormone concentra...
Arginine nutrition and fetal brown adipose tissue development in nutrient-restricted sheep.
Intrauterine growth restriction is a significant problem worldwide, resulting in increased rates of neonatal morbidity and mortality, as well as increased risks for metabolic and cardiovascular diseas...
Venous Doppler evaluation of the growth-restricted fetus.
Evaluation of venous Doppler parameters has significantly contributed to the understanding of the vascular mechanisms that lead to fetal growth restriction (FGR) and subsequent fetal deterioration in...
Congenital heart block develops in fetuses of anti-Ro52 Ab-positive women. A recurrence rate of 20%, despite the persistence of maternal autoantibodies, indicates that there are additional, yet uniden...
Clinical Trials
We are interested in determining if we can measure the blood flow in the descending aorta (large blood vessel in the abdomen) of healthy fetuses and fetuses with growth restriction. An inc...
The primary objective of the study is to compare the efficacy of glucocorticoids on Cardiovascular mortality in the 30 days following randomization and renal function in hospitalization.
Fetal ST Segment and T Wave Analysis in Labor
The purpose of this research is to test a new instrument, called a fetal STAN monitor, that may be used during labor to monitor the electrical activity of the baby's heart. This new instr...
LMWH to Prevent Preeclampsia and Fetal Growth Restriction
The objective of this trial will be to determine whether prophylactic low-molecular weight heparin therapy in pregnant women with the heterozygous Factor V Leiden and G20210A prothrombin...
The National Standard for Normal Fetal Growth
Background: - Normal fetal growth is a critical component of a healthy pregnancy and the long-term health of the offspring. Pivotal to understanding the dynamics of human fetal gr...
