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Is increased maternal endothelin-1 concentration associated with neonatal asphyxia and preterm delivery in intrahepatic cholestasis of pregnancy?

Abstract：

OBJECTIVES:To evaluate plasma endothelin-1 (ET-1) and fetuin-A concentrations in women with intrahepatic cholestasis of pregnancy (ICP) and to determine whether there is any association between these parameters and fetal asphyxia. METHODS:We carried out a prospective case-control study consisting of 32 women with ICP at third trimester of pregnancy and 32 pregnant women without ICP. Blood samples from maternal peripheral venous circulation were collected and ET-1 and fetuin-A levels were determined from the plasma samples. Pulse-wave Doppler and Apgar scores were also recorded. RESULTS:ET-1 concentrations were significantly higher in ICP patients. No difference was observed in fetuin-A levels between the two groups. Six newborns were declared as asphyctic (APGAR score at the 5 min <7). Maternal ET-1 levels did not correlate with the APGAR score at 5 min, total bile acid (TBA) and umbilical artery systolic/diastolic ratio with ICP patients. TBA levels were positively correlated with umbilical artery systolic/diastolic ratio negatively correlated with APGAR score at the 1' and 5'-Apgar score in all subjects. Plasma ET-1 concentration was higher in the preterm neonates of mothers with ICP compared with normal term neonates of mothers. CONCLUSIONS:Although these data did not show evidence that maternal ET-1 would be associated with fetal distress, we can speculate that maternal ET-1 may be playing a role in the underlying pathology regarding microvascular dysfunction especially in the preterm neonates of mothers with ICP. Elevated TBA levels may increase the risk of asphyxia whereas fetuin-a (as an anti-inflammation marker) does not seem to have effect in women with ICP.

journal_name

Arch Gynecol Obstet

journal_title

Archives of gynecology and obstetrics

authors

Kebapcilar AG,Kebapcilar L,Taner CE,Bozkaya G,Sahin G,Gokulu SG

doi

10.1007/s00404-009-1261-3

subject

Has Abstract

pub_date

2010-12-01 00:00:00

pages

617-21

issue

6

eissn

0932-0067

issn

1432-0711

journal_volume

282

pub_type

杂志文章

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