Adrenomedullin is increased in the fetoplacental circulation in intrauterine growth restriction with abnormal umbilical artery waveforms

To examine whether adrenomedullin, a novel vasoactive peptide produced by the placenta, participates in the uteroplacental hemodynamic alterations in intrauterine growth restriction, we studied the correlation between adrenomedullin levels and fetoplacental blood flow. Maternal and umbilical blood s...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2000-03, Vol.182 (3), p.650-654
Main Authors: Di Iorio, Romolo, Marinoni, Emanuela, Letizia, Claudio, Gazzolo, Diego, Lucchini, Claudia, Cosmi, Ermelando V.
Format: Article
Language:English
Subjects:
Adrenomedullin
Adult
Biological and medical sciences
Birth Weight
Blood Flow Velocity
Diseases of mother, fetus and pregnancy
Doppler ultrasonography
Female
Fetal Growth Retardation - blood
Fetal Growth Retardation - diagnostic imaging
Fetal Growth Retardation - etiology
fetoplacental hemodynamics
Gestational Age
Gynecology. Andrology. Obstetrics
Humans
intrauterine growth restriction
maternal plasma
Medical sciences
Peptides - blood
Placental Insufficiency - blood
Pregnancy
Pregnancy. Fetus. Placenta
Ultrasonography, Prenatal
umbilical plasma
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Summary:To examine whether adrenomedullin, a novel vasoactive peptide produced by the placenta, participates in the uteroplacental hemodynamic alterations in intrauterine growth restriction, we studied the correlation between adrenomedullin levels and fetoplacental blood flow. Maternal and umbilical blood samples were collected in pregnancies complicated by intrauterine growth restriction with abnormal umbilical artery Doppler findings and in control pregnancies. Adrenomedullin levels were measured by means of a specific radioimmuncassay, and flow velocimetry wave-forms were recorded from uterine, umbilical, and fetal middle cerebral arteries. Mean adrenomedullin values in umbilical plasma were higher (P < .05) in patients with intrauterine growth restriction (63.7 ± 34.2 pg/mL; n = 16) than in control subjects (38.1 ± 14.8 pg/mL; n = 16). A significant correlation was found between maternal adrenomedullin levels and umbilical artery pulsatility index. Moreover, fetal adrenomedullin concentrations correlated negatively with middle cerebral artery pulsatility index and positively with umbilical artery pulsatility index/middle cerebral artery pulsatility index ratio. This study provides evidence that adrenomedullin is increased in fetuses with intrauterine growth restriction in response to reduced uteroplacental blood flow and suggests that it may participate in the fetal hemodynamic modifications.
ISSN:0002-9378
1097-6868
DOI:10.1067/mob.2000.103944