Blood levels of vasoactive intestinal polypeptide in normal and growth retarded fetuses: relationship with acid-base and haemodynamic status.
The objectives of this study were (1) to detect vasoactive intestinal polypeptide in fetal blood obtained by cordocentesis (2) to examine possible changes in growth retarded fetuses and to establish relationships between its levels and fetal blood acid-base status as well as fetal haemodynamics as assessed by Doppler ultrasonography. Vasoactive intestinal polypeptide was measured in umbilical vein blood obtained at cordocentesis in 12 growth retarded fetuses and in 13 control fetuses. Umbilical vein pH and PO2 values were determined in all the cases. Before the procedure, Doppler indices were calculated from umbilical artery, middle cerebral artery, renal artery, cardiac outflow tracts and inferior vena cava. Simple and multiple stepwise regression analysis were performed to examine the relationships between Doppler indices, acid-base status and vasoactive intestinal polypeptide levels. In control fetuses, vasoactive intestinal polypeptide was always detectable in cord blood and its levels did not change with gestational age. In growth retarded fetuses, vasoactive intestinal polypeptide levels were higher and significantly related to umbilical vein PO2 levels, Pulsatility Index in umbilical artery, middle cerebral artery and renal artery, while no relationship was found with umbilical vein pH, cardiac and venous Doppler indices. Stepwise multiple regression demonstrated middle cerebral artery Pulsatility Index to be the best explanatory variable for vasoactive intestinal polypeptide levels. In conclusion, vasoactive intestinal polypeptide blood levels are increased in growth retarded fetuses and this increase is inversely related to the Doppler measured impedance to flow in middle cerebral artery.
Rizzo
G
G
Department of Obstetrics and Gynecology, Università di Roma Tor Vergata, Policlinico Nuovo S. Eugenio, Italy.
Montuschi
P
P
Capponi
A
A
Romanini
C
C
D000136:Acid-Base Equilibrium; D000328:Adult; D001158:Arteries / Q000196:embryology / Q000503:physiopathology; D001783:Blood Flow Velocity; D017218:Cordocentesis; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000503:physiopathology; D005865:Gestational Age; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D017078:Laser-Doppler Flowmetry; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D014471:Umbilical Veins; D014660:Vasoactive Intestinal Peptide / Q000097:blood*
D014660:Vasoactive Intestinal Peptide; D010100:Oxygen