Hypertriglyceridemia and hypoxemia in small-for-gestational-age fetuses

Article Abstract:

A genetic disorder of lipoprotein metabolism can cause increased levels of lipoproteins in the blood to affect family members. In a study examining fetal umbilical cord blood to detect the genetic disorder, an increase in triglycerides (a type of fat) was found to be associated with complications of pregnancy. The complications included high blood pressure in the mother, long labor, umbilical cord around the fetus' neck, and unusually long pregnancy. It is thought that these may be the result of a decreased oxygen supply to the fetus. To see if measuring triglycerides in the umbilical cord blood is useful in predicting fetal distress, the oxygen content and triglyceride concentration were measured in umbilical cord blood. Blood samples were taken between the 18th and 36th week of pregnancy from cords of 35 small-for-gestational-age fetuses (SGA, fetuses smaller than expected for that fetal age) and 54 normal-sized fetuses. As the pregnancy advanced, normal fetuses had a decrease in blood triglycerides. The average triglyceride concentration was 68 percent higher in the SGA fetuses than in the normal fetuses. In addition, the extent of triglyceride increase was related to the degree of decrease in oxygen content in the fetal blood. It is unclear whether the increased triglycerides were the result of low oxygen concentration or related to an inefficient placenta (the organ of fetal nutrition). Further studies are needed to determine the cause of the higher fetal blood triglycerides. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Triglycerides, Fetal anoxia, Hyperlipoproteinemia

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Plasma amino acids in appropriate- and small-for-gestational-age fetuses

Article Abstract:

Amino acids are needed for the formation of proteins in the body. Essential amino acids are obtained by dietary sources and nonessential amino acids are produced by the body itself. During pregnancy, amino acids, as well as oxygen, pass from the mother through the placenta to the fetus. The concentration of essential amino acids in the umbilical cord blood of growth-retarded fetuses appears to be low, while the nonessential amino acid concentration is increased. Growth retardation may be the result of poor blood flow through the placenta. Cordocentesis, a process of removing blood from the fetal umbilical cord during pregnancy, was performed on 28 small-for-gestational-age (SGA) and 62 appropriate-for-gestational-age (AGA) fetuses. The amino acid concentrations of fetal and maternal blood were compared. Amino acid concentrations were higher in AGA fetal blood than in the maternal blood. The amino acid concentrations of SGA fetuses were lower than the concentrations found in maternal blood. The low amino acid concentration was related to decreased oxygen concentration in the fetal blood. The amount of nonessential amino acids varied. The ratio of essential and nonessential amino acids was increased with hypoxemia, inadequate oxygen supply to the fetus, while the absolute concentrations of essential and nonessential amino acids in the mother were increased. These results indicate that the amino acids were transported by the placenta and that fetal starvation is due to an inadequately functioning placenta.

Usage, Maternal-fetal exchange, Complications and side effects, Physiological aspects, Amino acids, Placental diseases, Placenta diseases, Cordocentesis

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Blood gases, pH, and lactate in appropriate- and small-for- gestational-age fetuses

Article Abstract:

The blood from the umbilical cord of the fetus can be tested for amount of circulating oxygen (PO/.sub.2~), carbon dioxide (PCO/.sub.2~), pH level, an indicator of relative acidity, and lactate, a product of metabolism. Studies of fetuses that are the appropriate size for the particular point in the pregnancy, appropriate-for-gestational-age (AGA), have shown that PO/.sub.2~ decreases and PCO/.sub.2~ increases as the pregnancy continues towards term. The cord blood obtained from 196 small-for-gestational-age fetuses (SGA) was analyzed and compared with that from 208 AGA fetuses. The AGA fetuses had decreasing pH and PO/.sub.2~ and increasing PCO/.sub.2~, and maintained lactate as the pregnancy progressed. The SGA fetuses had lower PO/.sub.2~, higher PCO/.sub.2~, higher lactate and more acidic (lower pH) blood. It is suggested that the biochemical exchange of oxygen and carbon dioxide is compromised because of slowed circulation through the placenta, which controls the percentages of lactate and pH found in the cord blood. These values are good indicators of placental functioning.

Blood gases, Blood gas analysis

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