title: Hematological changes in severe early onset growth-restricted fetuses with absent and reversed end-diastolic flow in the umbilical artery.
abstract: BACKGROUND
  Erythropoietin seems to play an important role in the regulation of fetal hypoxemia. The present prospective study was designed to determine if changes in erythropoietin levels can be found in fetuses with severe early-onset growth restriction and hemodynamic compromise.
  
  
  RESULTS
  Erythropoietin, hemoglobin, hematocrit, platelet counts, normoblasts, lacate, arterial and venous blood gasses in the umbilical cord were determined in 42 fetuses with fetal growth restriction (IUGR) with absent (zero-flow) and 26 IUGR fetuses with retrograde end-diastolic flow (reverse-flow) in the umbilical artery. Color Doppler measurements were performed on the middle cerebral artery (PI) and ductus venosus [(S-a)/D and (S-a)/Vmean]. Erythropoietin concentrations were significantly lower in the zero-flow group (median: 128.0 mU/mL; range: 60.3-213 mU/mL) compared with the reverse-flow group (median: 202.5 mU/mL; range: 166-1182 mU/mL). Significant differences in median lactate concentrations were observed between the zero-flow group: 3.28 mmol/L (range; 2.3-4.7 mmol/L), and reverse-flow group: 5.6 mmol/L (range: 3.8-7.5 mmol/L). Fetuses with reverse-flow had significantly lower median platelet counts than fetuses with zero-flow (74 vs. 155/μL) and significantly lower normoblast counts (63 vs. 342/100 WBC).
  
  
  CONCLUSIONS
  Fetuses with severe IUGR due to chronic placental insufficiency and absent or reversed flow in the umbilical artery show increased erythropoietin levels.
authors: Department of Obstetrics and Gynecology, Bürgerhospital Frankfurt.
authors: Franz
authors: F
authors: Bahlmann
authors: Department of Obstetrics and Gynecology, Bürgerhospital Frankfurt.
authors: Ammar
authors: A
authors: Al Naimi
authors: Center of Laboratory Medicine, Klinikum Darmstadt, Darmstadt.
authors: Manfred
authors: M
authors: Ossendorf
authors: Department of Obstetrics and Gynecology, Bürgerhospital Frankfurt.
authors: Monica
authors: M
authors: Schmidt-Fittschen
authors: Department of Obstetrics and Gynecology, University of Bonn, Bonn.
authors: Arne
authors: A
authors: Willruth
mesh_terms: D001783:Blood Flow Velocity; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000503:physiopathology; D000860:Hypoxia / Q000097:blood / Q000503:physiopathology; D010976:Platelet Count; D011247:Pregnancy; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000097:blood / Q000503:physiopathology; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*
chemical_list: C554270:EPO protein, human; D004921:Erythropoietin
keywords: IUGR; absent and reversed end-diastolic flow; erythropoietin; umbilical artery