Intrauterine Amino Acid Feeding of the Fetus

Heller, L

doi:10.1007/978-1-4684-3249-7_18

Cited by 15 publications

(3 citation statements)

References 8 publications

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“…24], Growth retardation is associated with condi tions that decrease the availability of nu trients in maternal blood and conditions that affect the transfer of nutrients to the fetus [7,11,26,31,35], The question whether growth retardation can be treated with intrauterine, nutritional supplementation has, therefore, been raised. Supplementation by amniotic injection of amino acids has even been at tempted in a small number of human preg nancies [17,30]. However, fetal metabolism could not be evaluated in the human and the extent to which the injected amino acids en tered the fetus was unclear [30].…”

Section: Discussionmentioning

confidence: 99%

Effects of Intrauterine Nutritional Supplementation on Fetal Growth Retardation

Charlton

Johengen²

1985

Neonatology

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The effects of fetal nutritional supplementation on experimentally induced growth retardation were investigated in third-trimester sheep. The control group, C, was fed ad libitum (n = 8). Group R received a protein- and calorie-restricted diet over the last 3 weeks of gestation (n = 8). Group RS was given the same restricted diet as group R, and fetal, intragastric supplements of amino acids and glucose (n = 7). Over the experimental period, maternal weight increased 4.1 ± 0.6 kg in C but was stable in R and RS (p < 0.01). R and RS ewes and fetuses showed biochemical evidence of malnutrition but the changes were less severe in the RS group (p < 0.05). Nutrient levels did not change in group C ewes and fetuses. At delivery, R lambs were smaller in weight and length than RS or C (p < 0.05); gestational ages were the same. Weights were: R, 2,702 ± 182 g; RS, 3,235 ± 121 g; and C, 3,290 ± 297 g. R also had lower fetal to maternal weight ratios and higher brain to body weight ratios than RS or C (p ≤ 0.05). Placental size was reduced 28% in R compared to C (p < 0.05) and was intermediate in RS. The disparity in fetal size was explained by differences in nutrient acquisition between groups. Over the experimental period, caloric intake rose 24% in C fetuses; near delivery, they had the highest umbilical uptakes of carbohydrate and α-amino nitrogen. After maternal diet was limited, R and RS fetuses had dramatic decreases in umbilical uptake of α-amino nitrogen and static umbilical uptakes of carbohydrate. Caloric intake fell 42% in R. RS fetuses, however, were receiving sufficient gastric supplementation so that umbilical + gastrointestinal carbohydrate uptake equalled that of controls, and entry of α-amino nitrogen and calories was intermediate, between those of R and C. Fetal oxygen consumption reflected the differences in nutrient uptake, being greatest in C, lowest in R and intermediate in RS. Fetal supplementation lessened the drain on maternal nutrients and promoted more normal fetal growth and metabolism.

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Section: Discussionmentioning

confidence: 99%

Effects of Intrauterine Nutritional Supplementation on Fetal Growth Retardation

Charlton

Johengen²

1985

Neonatology

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“…Another main point of the current work is that fetal levels of radioactive leucine are substantially higher when that radioisotope is injected into the amniotic sac rather than by an intravenous route into the pregnant mother. T h e superiority of the intra-amniotic route has also been demonstrated in humans for steroids (11) and for antibiotics (10), and the potential usefulness of this route must be considered in cases of fetal malnutrition (5,12,16,19), in situations where transplacental passage of the therapeutic compound following maternal injection is suboptimal, as with erythromycin (15) and thryoxine (20), or when fetal damage occurs in the course of certain lysosomal storage diseases where one cannot wait until birth to institute enzyme replacement therapy.…”

Section: Discussionmentioning

confidence: 99%

Fetal Absorption of ³H‐Leucine Injected into the Amniotic Sacs of Pregnant Rats

Lev

Loud

Laitio

et al. 1979

Intl J Gynecology & Obste

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When injected into the amniotic sacs of fetal rats in late pregnancy, 3H-leucine is rapidly absorbed and incorporated into fetal proteins as determined by liquid scintillation spectrometry. Peak values in the fetal liver and pancreas occur around four hours after injection. Approximately 21% of the radioisotope is retained in the injected fetus at 24 hours. The remainder escapes into the maternal circulation and accounts for a gradual increase in levels in noninjected fetuses from the same litter and for persistently high counts found in maternal serum as late as 24 hours after the injection. Specific activity of the radioisotope in fetal tissues is considerably higher (100- to 200-fold) when 3H-leucine is injected inth the amniotic sac rather than intravenously into the mother. The possible treatment of various fetal disorders by means of intra-amniotic injections is discussed.

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“…It has been estimated that the late-gestation @ruman fetus m 9 obtain as much as 10% of its daily protein requirements by this means (49-5 1). Thus, nutrients administered into amniotic fluid can be taken up by the fetal gut and may be used for tissue accretion (52)(53)(54)(55). We have demonstrated recently that the supplementation of growth factors by this route may also be a possibility.…”

Section: Fetal Enteral Supplementationmentioning

confidence: 99%

Antenatal therapy for intrauterine growth retardation

1997

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Currently, there is no effective antenatal therapy for intrauterine growth retardation (IUGR). Although the IUGR fetus is undernourished in utero and there have been many attempts to treat IUGR with nutritional supplements, most studies have been poorly controlled, and there is no evidence to date that nutrient supplements can reverse the process of IUGR once it is established. Nutrient supplementation is also potentially risky and a combination of nutrients is likely to be needed. Alternative approaches to antenatal therapy for IUGR that show promise include fetal growth hormone and insulin‐like growth factor I treatment to improve fetal growth. Fetal and maternal hormone supplements may also prove useful in IUGR by improving placental function and thus fetal substrate supply. Fetal enteral supplementation by the administration of growth factors and/or nutrients into the amniotic fluid may also prove effective and clinically feasible. It seems likely that combinations of these approaches will be required before effective therapy can be devised for the IUGR fetus in utero. □ Amniotic fluid, fetus, growth, growth hormone, growth retardation, insulin‐like growth factor I, nutrition, therapy

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Intrauterine Amino Acid Feeding of the Fetus

Cited by 15 publications

References 8 publications

Effects of Intrauterine Nutritional Supplementation on Fetal Growth Retardation

Effects of Intrauterine Nutritional Supplementation on Fetal Growth Retardation

Fetal Absorption of ³H‐Leucine Injected into the Amniotic Sacs of Pregnant Rats

Antenatal therapy for intrauterine growth retardation

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Intrauterine Amino Acid Feeding of the Fetus

Cited by 15 publications

References 8 publications

Effects of Intrauterine Nutritional Supplementation on Fetal Growth Retardation

Effects of Intrauterine Nutritional Supplementation on Fetal Growth Retardation

Fetal Absorption of 3H‐Leucine Injected into the Amniotic Sacs of Pregnant Rats

Antenatal therapy for intrauterine growth retardation

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Fetal Absorption of ³H‐Leucine Injected into the Amniotic Sacs of Pregnant Rats