Fetal development Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2004;26(9):691-695
DOI 10.1590/S0100-72032004000900003
PURPOSE: to evaluate the importance of circulating maternal and fetal leptin in the healthy gestation, using its association with maternal, placental and fetal anthropometric variables, obtained at birth, and the relationship between the evaluated compartments. METHODS: in a transversal study a population of 33 single, healthy and term gestations was studied. The evaluated variables were maternal age, maternal weight, body mass index (BMF), weight of the newborn, placental weight, and placental index. Samples of maternal blood were immediately obtained before birth and from fetal umbilical cord blood at birth. Determination of serum leptin was performed using conventional radioimmunoassay. The relationships between serum leptin concentrations in maternal blood, umbilical artery and vein and the studied variables were assessed through linear regression. RESULTS: leptin levels were detected in the blood of all 33 pregnant women and their respective newborns, with maternal blood concentration (17.1±1.77 ng/mL) higher than that of umbilical vessels (vein: 9.0±1.16 ng/mL; artery: 8.23±1.02 ng/mL), p<0.0001. Leptin concentrations in the maternal blood were correlated with leptin concentrations in fetal blood (artery: coef. 0.63, p=0.037; vein: coef. 0.72, p=0.006). Regarding the anthropometric variables, leptin measured in the maternal blood was associated with initial and final maternal BMF (coef. 1.13; p=0.002; coef. 1,18, p=0.001) and cord leptin levels were correlated with the fetal weight at birth (vein: coef. 0.007, p=0.02; artery: coef. 0.006, p=0.02). CONCLUSION: there was a correlation between maternal and fetal leptin production and probably by the action of similar stimuli during gestation. Serum leptin was associated with the weight of the compartment where it circulates.
Summary
Rev Bras Ginecol Obstet. 2004;26(9):691-695
DOI 10.1590/S0100-72032004000900003
PURPOSE: to evaluate the importance of circulating maternal and fetal leptin in the healthy gestation, using its association with maternal, placental and fetal anthropometric variables, obtained at birth, and the relationship between the evaluated compartments. METHODS: in a transversal study a population of 33 single, healthy and term gestations was studied. The evaluated variables were maternal age, maternal weight, body mass index (BMF), weight of the newborn, placental weight, and placental index. Samples of maternal blood were immediately obtained before birth and from fetal umbilical cord blood at birth. Determination of serum leptin was performed using conventional radioimmunoassay. The relationships between serum leptin concentrations in maternal blood, umbilical artery and vein and the studied variables were assessed through linear regression. RESULTS: leptin levels were detected in the blood of all 33 pregnant women and their respective newborns, with maternal blood concentration (17.1±1.77 ng/mL) higher than that of umbilical vessels (vein: 9.0±1.16 ng/mL; artery: 8.23±1.02 ng/mL), p<0.0001. Leptin concentrations in the maternal blood were correlated with leptin concentrations in fetal blood (artery: coef. 0.63, p=0.037; vein: coef. 0.72, p=0.006). Regarding the anthropometric variables, leptin measured in the maternal blood was associated with initial and final maternal BMF (coef. 1.13; p=0.002; coef. 1,18, p=0.001) and cord leptin levels were correlated with the fetal weight at birth (vein: coef. 0.007, p=0.02; artery: coef. 0.006, p=0.02). CONCLUSION: there was a correlation between maternal and fetal leptin production and probably by the action of similar stimuli during gestation. Serum leptin was associated with the weight of the compartment where it circulates.
Summary
Rev Bras Ginecol Obstet. 2004;26(5):383-389
DOI 10.1590/S0100-72032004000500007
OBJECTIVE: to evaluate the measurement of uterine height in order to predict fetal growth restriction (FGR), according to a local curve. METHODS: from July 2000 to February 2003, 238 high-risk pregnant women were submitted to uterine height measurements between the 20th and the 42nd week of gestation. The gestational age of all the women was well known, confirmed by early ultrasound. Fifty (21%) women gave birth to infants considered small for their gestational age. The measures were performed by a single observer, who took 1617 uterine height measurements, from the upper border of the symphysis pubis to the fundus uteri, using tape measurement. The diagnosis of FGR was confirmed after birth according to the Ramos's curve. The women were divided into two groups according to their infant's birth weight and the data were statistically analyzed by the Fisher's exact test or Kruskal-Wallis's test. The sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were calculated. The test for two proportions with normal approximation was performed to analyze the continuous variables. RESULTS: one measurement below the 10th percentile, according to gestational age, resulted in SE = 78.0%, SP = 77.1%, PPV = 47.6%, and NPV = 88.8% for the identification of FGR. If one measurement was below the 5th percentile, the SE, SP, PPV, and NPV were 64.0, 89.9, 62.7 and 90.4%, respectively. CONCLUSIONS: one measurement below the 10th percentile for the gestational age, according to the local curve, proved to be a good predictor of FGR.
Summary
Rev Bras Ginecol Obstet. 2004;26(5):383-389
DOI 10.1590/S0100-72032004000500007
OBJECTIVE: to evaluate the measurement of uterine height in order to predict fetal growth restriction (FGR), according to a local curve. METHODS: from July 2000 to February 2003, 238 high-risk pregnant women were submitted to uterine height measurements between the 20th and the 42nd week of gestation. The gestational age of all the women was well known, confirmed by early ultrasound. Fifty (21%) women gave birth to infants considered small for their gestational age. The measures were performed by a single observer, who took 1617 uterine height measurements, from the upper border of the symphysis pubis to the fundus uteri, using tape measurement. The diagnosis of FGR was confirmed after birth according to the Ramos's curve. The women were divided into two groups according to their infant's birth weight and the data were statistically analyzed by the Fisher's exact test or Kruskal-Wallis's test. The sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) were calculated. The test for two proportions with normal approximation was performed to analyze the continuous variables. RESULTS: one measurement below the 10th percentile, according to gestational age, resulted in SE = 78.0%, SP = 77.1%, PPV = 47.6%, and NPV = 88.8% for the identification of FGR. If one measurement was below the 5th percentile, the SE, SP, PPV, and NPV were 64.0, 89.9, 62.7 and 90.4%, respectively. CONCLUSIONS: one measurement below the 10th percentile for the gestational age, according to the local curve, proved to be a good predictor of FGR.
Summary
Rev Bras Ginecol Obstet. 2001;23(4):235-241
DOI 10.1590/S0100-72032001000400006
Purpose: to create a uterine height growth curve, according to gestational age, to verify differences among the existing curves and to evaluate the influence of color, parity and maternal weight on the variation of uterine height. Methods: during the period from July 1997 to July 1999, 100 normal pregnant women were submitted to uterine height measurements between the 20th and 42nd week of gestation. All the pregnant women had ultrasonically confirmed gestational age. A total of 726 measurements of uterine height were carried out by the same examiner, using a metric tape from the upper border of the symphysis pubis to the fundus uteri. Results: curves and tables of uterine height according to gestational age were obtained. The average uterine height growth was 0.7 cm/week. The study revealed different average uterine height values in relation to other uterine height growth curves. No statistically significant variations were found between the distributions of uterine heights according to color, parity and weight. Conclusion: the construction of a methodologically accepted uterine height growth curve aimed to detect, as a clinical method, the fetal growth disturbances. This should be analyzed in a posterior study.
Summary
Rev Bras Ginecol Obstet. 2001;23(4):235-241
DOI 10.1590/S0100-72032001000400006
Purpose: to create a uterine height growth curve, according to gestational age, to verify differences among the existing curves and to evaluate the influence of color, parity and maternal weight on the variation of uterine height. Methods: during the period from July 1997 to July 1999, 100 normal pregnant women were submitted to uterine height measurements between the 20th and 42nd week of gestation. All the pregnant women had ultrasonically confirmed gestational age. A total of 726 measurements of uterine height were carried out by the same examiner, using a metric tape from the upper border of the symphysis pubis to the fundus uteri. Results: curves and tables of uterine height according to gestational age were obtained. The average uterine height growth was 0.7 cm/week. The study revealed different average uterine height values in relation to other uterine height growth curves. No statistically significant variations were found between the distributions of uterine heights according to color, parity and weight. Conclusion: the construction of a methodologically accepted uterine height growth curve aimed to detect, as a clinical method, the fetal growth disturbances. This should be analyzed in a posterior study.
