Maternal volume homeostasis in early pregnancy in relation to fetal growth restriction

Duvekot, Johannes J.; Cheriex, Emile C.; Pieters, Frans; Menheere, P. P. C. A.; Schouten, Hubert J. A.; Peeters, Louis L.H.

doi:10.1016/0029-7844(94)00417-c

Cited by 110 publications

(63 citation statements)

References 18 publications

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“…Inadequate plasma volume expansion has been associated with poor pregnancy outcome. This is especially evident in women with pre-eclampsia (Soffronoff et al, 1977;Silver et al, 1998), as well as in pregnancies complicated by intrauterine growth retardation (Duvekot et al, 1995). The diminished decrease in creatinin, uric acid, and hematocrit in the women in our study with early pregnancy loss may also indicate insufficient volume expansion and thereby maladaptation to pregnancy that ultimately results in early pregnancy loss.…”

Section: Biochemical Parametersmentioning

confidence: 63%

Maternal periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome

et al. 2003

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Objectives: To evaluate periconceptional maternal biochemical and hematological parameters and vitamin profiles in relation to the risk of early pregnancy loss and birth weight. Design: Prospective longitudinal study. Setting: University Medical Centre Nijmegen, Academic Medical Centre, Amsterdam, Maria and Elisabeth Hospitals, Tilburg, and Catharina Hospital, Eindhoven, The Netherlands. Subjects: A cohort of 240 women recruited before pregnancy. Interventions: Blood samples were taken preconceptional and at 6 and 10 weeks amenorrhea in which the concentrations of hemoglobin, hematocrit, creatinin, uric acid, total protein, serum iron, total iron-binding capacity, ferritin, and the concentrations of retinol, tocopherol, thiamine, riboflavin, pyridoxal-5 0 -phosphate, cobalamin and folate were analyzed. Main outcome measures: Risk of early pregnancy loss and birth weight. Results: The risk of early pregnancy loss increased with increasing prepregnancy weight, and when the periconceptional decline in hematocrit, creatinin and uric acid was less profound (slope: Po0.01). Maternal smoking was negatively associated with birth weight (mean reduction of 183 g, Po0.05). Maternal age and prepregnancy weight were positively associated with birth weight (Po0.01). No significant associations were found between vitamin concentrations and risk of early pregnancy loss or birth weight. Conclusions: Several periconceptional biochemical parameters are significantly associated with early pregnancy loss. The effects of maternal periconceptional health on embryonic development and subsequent pregnancy outcome should be further explored.

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Section: Biochemical Parametersmentioning

confidence: 63%

Maternal periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome

et al. 2003

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“…Several studies, in human and in pregnant animals, have demonstrated that a reduced volume expansion during pregnancy leads to a reduced cardiac output and significant reduction in uteroplacental blood flow that alter the normal fetal growth. 4,5,30,31 Nevertheless, it is reasonable to speculate that, in addition to the systemic hemodynamic changes, serotonin caused important local effects. Serotonin has a marked vasoconstrictor effect on umbilical and chorionic arteries, suggesting that it may play a role in the regulation of placental blood flow.…”

Section: Discussionmentioning

confidence: 99%

Pregnant Rats Treated With a Serotonin Precursor Have Reduced Fetal Weight and Lower Plasma Volume and Kallikrein Levels

et al. 2007

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Abstract-Pregnant women with preeclampsia have increased serotonin levels, suggesting a possible role of this amine in abnormal pregnancy. With the hypothesis that an increase in serotonin would reduce volume expansion and cause fetal growth restriction, we evaluated the maternal and fetal effects of the administration of the serotonin precursor 5-hidroxytryptophan (5-HTP) to Sprague-Dawley rats. At pregnancy day 13 (nϭ19) or in random cycle nonpregnant rats (nϭ10), animals were assigned to a single injection of 5-HTP (100 mg/kg IP) or to a control group. Animals were studied at day 21, after overnight urinary collection. Additional pregnant rats received ketanserin (1 mg/kg), a 5-HT 2 receptor antagonist, 1 hour before 5-HTP injection. In pregnant rats, 5-HTP lowered plasma volume (control: 22Ϯ1.1; 5-HTP: 17Ϯ0.7 mL; PϽ0.001) and creatinine clearance, whereas serum creatinine and urinary protein excretion were increased; no changes were observed in nonpregnant rats. Systolic blood pressure did not change significantly. Urinary kallikrein activity and plasma aldosterone levels decreased only in pregnant animals. Fetal (control: 5.5Ϯ0.1; 5-HTP: 4.2Ϯ0.2 g; PϽ0.001) and placental weights were reduced. In nonpregnant and pregnant animals, 5-HTP caused profound renal morphological alterations and decreased kallikrein immunostaining. Preadministration of ketanserin abolished all of the changes associated with the use of 5-HTP. These data indicate that the administration of a serotonin precursor to pregnant rats limits plasma volume expansion and fetal growth via 5-HT 2 receptors, suggesting a possible role for serotonin in abnormal pregnancy. We postulate that an increased vascular resistance, both at the placental and renal levels, mediates these effects. Key Words: preeclampsia/pregnancy Ⅲ experimental models Ⅲ acute kidney failure Ⅲ kallikrein Ⅲ aldosterone Ⅲ plasma volume Ⅲ serotonin N ormal pregnancy, in humans and other mammals, is characterized by a significant reduction in systemic vascular resistance associated with lower arterial blood pressure, increased cardiac output, stimulation of the renin-angiotensin system, and plasma volume expansion. 1-3 These changes cause an important increment in uteroplacental blood flow, allowing normal fetal growth.In previous studies we have observed that pregnancy complications, such as fetal growth restriction or preeclampsia, are associated with reduced plasma volume expansion, increased vascular resistance, and lower levels of plasma renin activity, plasma aldosterone, and urinary kallikrein activity. 4,5 In preeclampsia an increased platelet aggregation has been described, with a consequent increment in serotonin (5-hydroxytryptamine; 5-HT) levels. 6 Serotonin is an endogenous amine synthesized by the enzymes tryptophan hydroxylase and decarboxylase from 5-hydroxytryptophane (5-HTP) and is metabolized by the enzyme monoamino-oxidase A to 5-hydroxyindole-3-acetic acid. 7 Serotonin has multiple cardiovascular effects, causing either blood vessel dilation through its 5-HT 1...

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“…Activation of the renin-angiotensin-aldosterone system eventually counterbalances the loss in venous reserve by a renin-, angiotensin-and aldosterone-driven rise in plasma volume, thereby restoring venous fullness 58 . Maternal hemodynamic maladaptation early in pregnancy has been associated with vascular complications later in pregnancy 59,60 . Substantial circulatory stress in response to a fall in afterload, oversensitivity to vessel tone-increasing stimuli or a venous compartment that is too shallow to accommodate the increased circulatory volume are related to early pregnancy maladaptation 60,61 .…”

Section: Discussionmentioning

confidence: 99%

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis

Haas

Ghossein‐Doha

Kuijk

et al. 2017

Ultrasound Obstet Gynecol

176

132

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Maternal volume homeostasis in early pregnancy in relation to fetal growth restriction

Abstract: Fetal growth restriction is preceded by defective volume adaptation very early in pregnancy. It appears that the maternal compensation mechanisms are unable to resolve the transient state of vascular underfill seen in this period in normal gestation.

Cited by 110 publications

References 18 publications

Maternal periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome

Maternal periconceptional biochemical and hematological parameters, vitamin profiles and pregnancy outcome

Pregnant Rats Treated With a Serotonin Precursor Have Reduced Fetal Weight and Lower Plasma Volume and Kallikrein Levels

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis

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