Abstract
It has been postulated that both idiopatic fetal growth retardation (FGR) and FGR associated with pre-eclampsia (PE) share common pathophysiologic alterations (Wallenburg, 1988).The aim of this study was to investigate the cause of FGR in both diseases. We determined plasma volume (PV), plasma renin activity (PRA), aldosterone (ALDO), estradiol (E2) and progesterone (Prog) levels in 30 normotensive (NT) and 12 PE (Am College Obstet Gynecol Criteria) nulliparous women with FGR between 32-38 wks of gestation. Mean blood pressure (NT=82±1.4; PE=107±2.4 mmHg; p <0.001) and maternal weight (NT= 63±1.2; PE= 69±2.5 kg? p < .0.02) were higher in PE group; no differences were observed in heart rate, hematocrit and creatinine clearance. PV was similar and significantly lower in both groups when compared with PV levels of control pregnant women (NT=2976± 76; PE=2795±111ml). PE group had lower PRA (NT=10.6±1.4; PE=5.5 ± 1.3 ng/ml/h; p < 0.05); however, no differences were observed in Aldo (NT=414±46.7; PE=318±92 pg/ml). Prog was significantly higher in PE group NT=159±10.5; PE=243±33 ng/ml; p<0.01), whereas Aldo/ Prog ratio was lower NT=2.9±0.4; PE=1.4±0.3; p < 0.03). E2 levels were similar in both groups NT=19.7±1.8: PE=17.5±2.2 ng/ml). Gestational age at delivery was higher in NT mothers NT=38±0.3; PE= 36±0.6 sem; p < 0.01; this may explain the observed differences in newborn weight NT=2477±66; PE=2089±152 g;p<0.01). Newborn of PE mothers had significantly lower ponderal index (NT=2.4±0.05; PE= 2.2±0.04; p<0.03). These data indicate that could be the reduction in maternal plasma the inmediate cause of both idiopatic. FGR and of FGR associated to PE volume. However, the differences obser ved in PRA, Prog and Aldo/Prog ratio between both groups suggest that the mechanisms of inadequate plasma volume expansion may be different. Partially supported by FONDECYT 91-0734.
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Salas, S., Rosso, P. IDIOPATIC FETAL GROWTH RETARDATION AND PREECLAMPSIA: A COMMON MECHANISM?. Pediatr Res 32, 737 (1992). https://doi.org/10.1203/00006450-199212000-00025
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DOI: https://doi.org/10.1203/00006450-199212000-00025