Adrenomedullin is increased in the fetoplacental circulation in intrauterine growth restriction with abnormal umbilical artery waveforms.
OBJECTIVE
To examine whether adrenomedullin, a novel vasoactive peptide produced by the placenta, participates in the uteroplacental hemodynamic alterations in intrauterine growth restriction, we studied the correlation between adrenomedullin levels and fetoplacental blood flow.


METHODS
Maternal and umbilical blood samples were collected in pregnancies complicated by intrauterine growth restriction with abnormal umbilical artery Doppler findings and in control pregnancies. Adrenomedullin levels were measured by means of a specific radioimmunoassay, and flow velocimetry waveforms were recorded from uterine, umbilical, and fetal middle cerebral arteries.


RESULTS
Mean adrenomedullin values in umbilical plasma were higher (P <.05) in patients with intrauterine growth restriction (63.7 +/- 34.2 pg/mL; n = 16) than in control subjects (38.1 +/- 14.8 pg/mL; n = 16). A significant correlation was found between maternal adrenomedullin levels and umbilical artery pulsatility index. Moreover, fetal adrenomedullin concentrations correlated negatively with middle cerebral artery pulsatility index and positively with umbilical artery pulsatility index/middle cerebral artery pulsatility index ratio.


CONCLUSIONS
This study provides evidence that adrenomedullin is increased in fetuses with intrauterine growth restriction in response to reduced uteroplacental blood flow and suggests that it may participate in the fetal hemodynamic modifications.
Di Iorio
R
R
Laboratory of Perinatal Medicine and Molecular Biology, 2nd Institute of Obstetrics and Gynecology, and the Department of Internal Medicine, University "La Sapienza," Rome, Italy.
Marinoni
E
E
Letizia
C
C
Gazzolo
D
D
Lucchini
C
C
Cosmi
E V
EV
D053607:Adrenomedullin; D000328:Adult; D001724:Birth Weight; D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D010455:Peptides / Q000097:blood*; D010927:Placental Insufficiency / Q000097:blood; D011247:Pregnancy; D016216:Ultrasonography, Prenatal
D010455:Peptides; D053607:Adrenomedullin