The relationship between human fetal cardiovascular hemodynamics and serum erythropoietin levels in growth-restricted fetuses

Anna Girsen, Kaarin Mäkikallio, Vilho Hiilesmaa, Esa Hämäläinen, Kari Teramo, Juha Räsänen

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Objective: We hypothesized that in growth restricted fetuses, erythropoietin (EPO) secretion is increased in proportion to the severity of cardiovascular compromise. Study Design: Thirty-eight growth restricted fetuses underwent Doppler ultrasonography of cardiovascular hemodynamics. An umbilical artery (UA) blood sample was taken at delivery for EPO analysis. Group 1 fetuses (n=9) had normal UA and ductus venosus (DV) velocimetries. Group 2 fetuses (n=18) showed an abnormal UA and a normal DV velocimetry. Group 3 fetuses (n=11) had abnormal UA and DV velocimetries. Normal EPO values were determined in 19 uncomplicated pregnancies (control group). Results: In group 3, EPO levels were higher (P<.05) than in groups 1 and 2. All fetuses in group 3 had EPO concentrations above the 90th percentile EPO value in the control group. The corresponding incidences were 44% and 50% in groups 1 and 2. Fetuses with retrograde aortic isthmus net blood flow had greater (P<.001) EPO levels than fetuses with antegrade net blood flow. Descending aorta, UA, DV and left hepatic vein pulsatility index values correlated significantly with EPO concentrations. Conclusion: In fetal growth restriction, serum EPO concentration is increased in proportion to the severity of fetal cardiovascular compromise. Furthermore, in fetuses with retrograde aortic isthmus net blood flow, EPO levels are increased.

Original languageEnglish (US)
Pages (from-to)467.e1-467.e6
JournalAmerican journal of obstetrics and gynecology
Volume196
Issue number5
DOIs
StatePublished - May 2007

Keywords

  • Doppler
  • erythropoietin
  • fetal growth restriction
  • placental insufficiency

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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