Browsing by Author "Kuczynski, E. (7003870928)"

Objective: To evaluate maternal and fetal apolipoprotein A-I and B (Lp A-I and Lp B) concentrations in uncomplicated pregnancies across the second half of pregnancy. Study design: Paired (n = 55) maternal and fetal umbilical venous samples were obtained at diagnostic cordocenteses from 20 to 36 weeks. Levels of Lp A-I and Lp B were measured by turbimetric assay. Results: Maternal Lp B (r = 0.30; p = 0.03) but not Lp A-I (r = -0.02, p = 0.5) levels displayed a significant correlation with gestational age. Moreover, the ratio of Lp B to Lp A-I significantly increased across gestation in maternal plasma (r = 0.30; p = 0.04). Fetal Lp A-I and Lp B values did not correlate with gestational age, or maternal Lp A-I or Lp B levels. Moreover, no significant correlation was found between the ratio of fetal plasma Lp B to Lp A-I and gestational age. The mean (± SD) maternal plasma Lp A-I concentration was significantly higher than the corresponding mean fetal Lp A-I level [1.55 (0.48) versus 0.78 (0.5); p < 0.001]. Similarly, the mean maternal Lp B level was significantly higher than the corresponding fetal value [1.28 (0.33) versus 0.46 (0.30); p < 0.001]. Conclusion: Fetal Lp A-I and Lp B levels were significantly lower than maternal levels and did not correlate with gestational age.

Objective To evaluate the effect of Rh alloimmunization and intrauterine transfusion on fetal stress hormone levels. Method Umbilical venous samples were obtained immediately prior to transfusion in 51 anemic fetuses and in a control group of 30 non-anemic fetuses. In 16 of the anemic fetuses a repeat sample was obtained post-transfusion. Samples were assessed for hematocrit, pH and levels of β-endorphin, cortisol and adrenocorticotropin. Results The mean initial hematocrit was significantly lower, while the median concentrations of β-endorphin and cortisol were higher in anemic compared with non-anemic fetuses at initial sampling. In contrast, fetal adrenocorticotropin levels did not differ between the groups. Among anemic fetuses, both serum β-endorphin and cortisol levels displayed a strong negative correlation with fetal hematocrit (r =- 0.46, p = 0.006 and r = - 0.54, p < 0.001, respectively). Among anemic fetuses sampled before and after transfusion, levels of β-endorphin were significantly lower, while cortisol levels were significantly higher post-transfusion. Maternal cortisol levels also increased post-transfusion. Conclusion Fetal anemia is associated with increased β-endorphin and cortisol levels. While intrauterine transfusion is associated with a decline in β-endorphin concentrations, fetal cortisol levels increase following transfusion, potentially reflecting transplacental passage of post-transfusion increases in maternal cortisol.