作者: John C. P. Kingdom , James McQueen , John M. C. Connell , Martin J. Whittle
DOI: 10.1111/J.1471-0528.1993.TB15276.X
关键词: Fetus 、 Endocrinology 、 Angiotensin II 、 Gestational age 、 Angiotensin receptor 、 Medicine 、 Internal medicine 、 Severe intrauterine growth retardation 、 Angiotensin II receptor type 1 、 Umbilical artery 、 Vascular resistance
摘要: Objective To investigate the status of fetal renin-angiotensin system (RAS) in pregnancies complicated by severe intrauterine growth retardation (IUGR), and its possible relationship to elevated fetoplacental vascular resistance as indicated abnormal umbilical artery Doppler flow velocity waveforms (FVW). Design Prospective survey falling into predefined categories presenting at Queen Mothers Hospital, Glasgow, over study period. Subjects Effects mode delivery gestational age were investigated using uncomplicated term delivered vaginally (SVD group, n= 15) or elective caesarean section (ECS 9), normal with spontaneous preterm onset labour (PREM 6; birthweight for (31 weeks)). These groups used controls 13 IUGR cases weeks) interest. Main outcomes measures Umbilical FVW, birthweight, cord venous angiotensin II concentration ([cv ANG II]), receptor concentration. Results Cord was similar maternal values ECS group (31–101 pmol/1, 95% CI), but (81–288 pmol/l, P= 0.03) after vaginal delivery. The receptors (type AT1, dissociation equilibrium constant, 1.27 nmol/l) placental primary/secondary stem tissue lower SVD (18–44 fmol/mg membrane protein, compared (29–122 fmol/mg, consistent acute down-regulation levels. No effect on number demonstrable (P= 0.13, PREM (premature delivery) vs group). In [cv II] (94–378 pmol/l) markedly 0.001) (28–84 fmol/mg) not significantly altered 0.13). relationships between FVW could be identified. changes affinity observed. Conclusion results indicate activation RAS suggest that responsiveness vasculature peptide is diminished would expected from plasma may contribute increased observed this disorder, does apparently account a proportion cases.