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598 Umbilical perfusion is maintained in experimental IUGR
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Volume 185, Number 6 AmJ Obstet Gynecol 597 ORAL PRENATAL TREATMENT WITH PEPTIDES INCREASES ADULT PERFORMANCE IN A LEARNING PARADIGM CATHERINE SPONG 1, JOY VINK2, ,JONATHAN AUTH 2, ILANA GOZES 3, DOUGLAS BRENNEMAN2; INICHD, NIH, SDMP, LDN & PPB, Bethesda, MD; 2NICHD, NIH, SDMP, LDN, Betbesda, MD; 3Tel Aviv Univ, Tel Aviv OBJECTIVE: To evaluate the eftects of an oral prenatal administration of two neuroprotective peptides (NAPVSIPQ and SALLRSIPA) on adult performance in a learning paradigm. Previous work demonstrated that the all D amino acid conformation of these peptides is orally active and was able to prevent tetal death in a model of fetal alcohol syndrome. In addition, these peptides have been shown to prevent alcohol-induced learning deficits in the same model. Also, in a model of neurodegeneration, administration to newborn pups increased performance in neonatal behaviors. Previous work in vivo has demonstrated that these peptides can alter proinflammatory cytokines and prevent oxidative damage. STUDY DESIGN: On gestational day 8, pregnant mice were fasted for one hour and then received peptides (40ug/0.2ml) or placebo via gavage (orally). Delivery occurred around day 20. Male offspring were eartagged with all identifying markers of coded treatments removed. Adult male offspring were tested in the Morris watermaze to assess learning. Testing was twice daily tbr a 7d period. Latency to find the hidden plattbrm was recorded. All testing was performed blinded to the treatment group. RESULTS: The offspring from litters treated with both oral peptides prenatally (n = 27) learned significantly faster than controls (n = 34), with an earlier onset of learning and an overall decreased latency (P < .03). Treatment with either peptide alone did not afti~ct performance (D-NAP [n - 13] vs control [n = 14]; D4AL [n = 24] vs control [n - 26], P= NS). Also, a double dose of D-SAL (80ug daily, n = 9) vs control (n = 11) did not alter learning performance. CONCLUSION: Prenatal oral administration of these peptides at the time of organogenesis and central nepeous system formation resulted in improved performance of adult male oltspring in a learning paradigm, the Morris watermaze. These data indicate that long-lasting behavioral changes can be elicited by prenatal peptide treatment. 599 SMFM Abstracts S243 THE EFFECT OF CORRECTION OF FETAL ANEMIA ON THE MIDDLE CEREBRAL ARTERY PEAK SYSTOLIC VELOCITY VALUE ERICH COSMI l, THEODOR STEFOS 1, LAURA DETTI t, GIANCARLO MAR11, tUniversity of Virginia, Obstetrics and Gynecology, Charlottesville, VA OBJECTIVE: One of the compensatory hemodyuamic mechanisms seen in the anemic fetus is an increased blood velocity. We studied the eftect of correction of fetal anemia on the middle cerebral artery peak systolic velocity vahle. STUDY DESIGN: With Doppler ultrasonograph)~, middle cerebral artery peak systolic velocity was measured in 41 fetuses before and immediately after 54 intrauterine transthsions fbr severe red blood cell alloimmunization, The fetuses were divided into two groups: 17 fetuses studied at first transfusion (Group A); and 24 fetuses enrolled to the study following the first transfusion (Group B). Both fetal hemoglobin and middle cerebral artery peak systolic velocity values were plotted over the respective reference ranges as a tunction of gestational age and analyzed with t paired test. RESULTS: The values of middle cerebral artery peak systolic velocity decreased in all fetuses but one (P < .05). The values of middle cerebral artery peak systolic velocity before transfusion were above the upper limit of the reference range in 60% of the Dtuses of Group A and in 38% of Group B, respectively. Following correction of anemia only one value remained above the upper limit of the reference range. CONCLUSION: The correction of fetal anemia with intrauterine blood transfusion decreases significantly and normalizes the value of the fietal middle cerebral artery peak systolic velocity. This change may be the consequence of both an increased blood viscosity and increased oxygen saturation following correction of fetal anemia. 598 UMBILICAL PERFUSION IS MAINTAINED IN EXPERIMENTAL IUGR UWE LANG l, R.SCOTT BAKER 2, KENNETH E. CLARK~; 1Justus-Liebig- Universitfit Giessen, Obstetrics and Gynecology, Giessen, Hessen; 2University of Cincinnati, Obstetrics and Gynecology, Cincinnati, OH; 3University of Cincinnati, Obstetrics and Gynecology, Cincinnati, OH OBJECTIVE: Intrauterine growth restriction (IUGR) can be caused by a chronic restriction of uterine blood flow. In an animal model ensuing changes in umbilical perfusion and fetal weight were examined longitudinally. STUDY DESIGN: Pregnant sheep were instrmnented with an externally adjustable occluder on the common internal iliac artery to regulate uterine blood flow in the last third of gestation. Flow probes on both uterine arteries and the common umbilical artery provided blood flow measurements. Uterine blood flow (UBF) was kept at app. 750 ml/min in the IUGR group whereas UBF in equally instrumented controls was allowed to rise physiologically. RESULTS: On gestational day (gd) 138, when the experiment was terminated, UBF in controls was significantly higher than in restricted animals (P < .001). Body weight and ponderal index in fetuses of flow restricted mothers was lower than in controls (P< .001). Umbilical blood flow (UmbBF) in IUGR fetuses throughout the experiment was lower than in controls (P < .001). When blood flows were calculated per kg fetal body weight, UBF in controls was 380 ml/min/kgBw at gd 117 and 330 ml/min/kgBw at gd 138. In the IUGR group UBF dropped from 315 ml/min/kgBw (gd 117) to 250 ml/min/kgBw (gd 138). UmbBF in controls decreased from 230 ml/min/kgBw (gd 117) to 160 ml/min/kgBw (gd 138). In IUGR fetuses, however, UmbBF per kg body weight (215 ml/min/kgBw on gd 117) did not drop accordingly (210 mlmin/kgBw on gd 138). Thus UmbBF per kg fetal body weight stayed significantly higher in IUGR fetuses than in controls at gd 138 (P< .0IL CONCLUSION: Experimental intrauterine growth restriction in sheep is accompanied by adaptive changes in umbilical perfusion, which may allow the fetus to make up for the reduced delivery of substrates and oxygen cansed by the decrease in uterine blood flow. 600 LAMELLAR BODY COUNT COMPARED TO THE FETAL LUNG MATU- RITY (FLM) FOR THE PREDICTION OF PULMONARY MATURITY ANTHONY SCISCIONE l, PATRICK WILSON 2, MARY LOOMIS l, 8TEVEN JOHNSON ~, MARJORIE POLLOCK4, ANNE O'SHEA 1, JAMES MANLEY 4, MARTHA RODE4; 1Newark, DE; 2Christiana Hospital, Dept of Pathology, Newark, DE; 3Christiana Hospital, Pathology, Newark, DE; 4Christiana Hospital, Newark, DE OBJECTIVE: The fetal lung maturity TDX-FLM TM is a commercially available test based on the Surfactant to Albmnin ratio in amniotic fluid. Because of its accuracy and ease of use, it has becmne a coImnon test tor puhnonary maturity. Recently, lamellar body counts have been reported as an accurate, easy and inexpensive way to deterxnine pulmonaxT maturity. We sought to compare the accuracy of these two tests fbr puhnonary maturity. STUDY DESIGN: All amniocentesis specimens sent for puhnonary maturity studies in our institution between 4/00 and 7/01 had FLM and Lamellar body counts analyzed. A FLM >55 and a Lamellar body count >40,000 were considered mature. The rate of respiratory distress syndrome (RDS) between the two groups was examined. Clinical and radiologic evidence of RDS were necessary to make the diagnosis. RESULTS: There were 102 women who had an amniocentesis for puhnonary maturity during the study period. Sixty-five were delivered within 3 days of the test and are used for the analysis. There were 21 neonates with the diagnosis of RDS. The results are presented in the Table for each individual test and using the tests together with any positive test as a sign of puhnonary maturity. CONCLUSION: The FLM and lamellar body counts have a similar accuracy. However, the use of the FI,M test or the combined tests is associated with a greater nmnber of false positive results than the lamellar body count alone. The lamellar body count should be considered as a first line, inexpensive test for pulmonaiT maturity. Table POSITIVE NEGATIVE PREDICTIVE PREDICTIVE SENSITIVITY SPECIFICITY VALUE VALUE FLM 80.9% 56.8% 47.2% 86.2% Lamellar body 80.9% 68.2% 54.8% 88.2% Combined 92.6% 31.5% 33.3% 92%
Transcript of 598 Umbilical perfusion is maintained in experimental IUGR
Volume 185, Number 6 AmJ Obstet Gynecol
597 ORAL PRENATAL TREATMENT WITH PEPTIDES INCREASES ADULT PERFORMANCE IN A LEARNING PARADIGM CATHERINE SPONG 1, JOY VINK 2, ,JONATHAN AUTH 2, ILANA GOZES 3, DOUGLAS BRENNEMAN2; INICHD, NIH, SDMP, LDN & PPB, Bethesda, MD; 2NICHD, NIH, SDMP, LDN, Betbesda, MD; 3Tel Aviv Univ, Tel Aviv
OBJECTIVE: To evaluate the eftects of an oral prenatal administration of two neuroprotective peptides (NAPVSIPQ and SALLRSIPA) on adult performance in a learning paradigm. Previous work demonstrated that the all D amino acid conformation of these peptides is orally active and was able to prevent tetal death in a model of fetal alcohol syndrome. In addition, these peptides have been shown to prevent alcohol-induced learning deficits in the same model. Also, in a model of neurodegenerat ion, administration to newborn pups increased performance in neonatal behaviors. Previous work in vivo has demonstrated that these peptides can alter proinflammatory cytokines and prevent oxidative damage.
STUDY DESIGN: On gestational day 8, pregnant mice were fasted for one hour and then received peptides (40ug/0.2ml) or placebo via gavage (orally). Delivery occurred around day 20. Male offspring were eartagged with all identifying markers of coded treatments removed. Adult male offspring were tested in the Morris watermaze to assess learning. Testing was twice daily tbr a 7d period. Latency to find the hidden plattbrm was recorded. All testing was performed blinded to the treatment group.
RESULTS: The offspring from litters treated with both oral peptides prenatally (n = 27) learned significantly faster than controls (n = 34), with an earlier onset of learning and an overall decreased latency (P < .03). Treatment with either peptide alone did not afti~ct performance (D-NAP [n - 13] vs control [n = 14]; D4AL [n = 24] vs control [n - 26], P= NS). Also, a double dose of D-SAL (80ug daily, n = 9) vs control (n = 11) did not alter learning performance.
CONCLUSION: Prenatal oral administration of these peptides at the time of organogenesis and central nepeous system formation resulted in improved performance of adult male oltspring in a learning paradigm, the Morris watermaze. These data indicate that long-lasting behavioral changes can be elicited by prenatal peptide treatment.
599
SMFM Abstracts S243
THE EFFECT OF CORRECTION OF FETAL ANEMIA ON THE MIDDLE CEREBRAL ARTERY PEAK SYSTOLIC VELOCITY VALUE ERICH COSMI l, THEODOR STEFOS 1, LAURA DETTI t, GIANCARLO MAR11, tUniversity of Virginia, Obstetrics and Gynecology, Charlottesville, VA
OBJECTIVE: One of the compensatory hemodyuamic mechanisms seen in the anemic fetus is an increased blood velocity. We studied the eftect of correction of fetal anemia on the middle cerebral artery peak systolic velocity vahle.
STUDY DESIGN: With Doppler ultrasonograph)~, middle cerebral artery peak systolic velocity was measured in 41 fetuses before and immediately after 54 intrauterine transthsions fbr severe red blood cell alloimmunization, The fetuses were divided into two groups: 17 fetuses studied at first transfusion (Group A); and 24 fetuses enrolled to the study following the first transfusion (Group B). Both fetal hemoglobin and middle cerebral artery peak systolic velocity values were plotted over the respective reference ranges as a tunction of gestational age and analyzed with t paired test.
RESULTS: The values of middle cerebral artery peak systolic velocity decreased in all fetuses but one (P < .05). The values of middle cerebral artery peak systolic velocity before transfusion were above the upper limit of the reference range in 60% of the Dtuses of Group A and in 38% of Group B, respectively. Following correction of anemia only one value remained above the upper limit of the reference range.
CONCLUSION: The correction of fetal anemia with intrauterine blood transfusion decreases significantly and normalizes the value of the fietal middle cerebral artery peak systolic velocity. This change may be the consequence of both an increased blood viscosity and increased oxygen saturation following correction of fetal anemia.
598 UMBILICAL PERFUSION IS MAINTAINED IN EXPERIMENTAL IUGR UWE LANG l, R.SCOTT BAKER 2, KENNETH E. CLARK~; 1Justus-Liebig- Universitfit Giessen, Obstetrics and Gynecology, Giessen, Hessen; 2University of Cincinnati, Obstetrics and Gynecology, Cincinnati, OH; 3University of Cincinnati, Obstetrics and Gynecology, Cincinnati, OH
OBJECTIVE: Intrauterine growth restriction (IUGR) can be caused by a chronic restriction of uterine blood flow. In an animal model ensuing changes in umbilical perfusion and fetal weight were examined longitudinally.
STUDY DESIGN: Pregnant sheep were instrmnented with an externally adjustable occluder on the common internal iliac artery to regulate uterine blood flow in the last third of gestation. Flow probes on both uterine arteries and the common umbilical artery provided blood flow measurements. Uterine blood flow (UBF) was kept at app. 750 ml /min in the IUGR group whereas UBF in equally instrumented controls was allowed to rise physiologically.
RESULTS: On gestational day (gd) 138, when the exper iment was terminated, UBF in controls was significantly higher than in restricted animals (P < .001). Body weight and ponderal index in fetuses of flow restricted mothers was lower than in controls (P< .001). Umbilical blood flow (UmbBF) in IUGR fetuses throughout the experiment was lower than in controls (P < .001). When blood flows were calculated per kg fetal body weight, UBF in controls was 380 ml /min/kgBw at gd 117 and 330 ml /min/kgBw at gd 138. In the IUGR group UBF dropped from 315 ml /min /kgBw (gd 117) to 250 m l / m i n / kgB w (gd 138). UmbBF in controls decreased from 230 ml /min /kgBw (gd 117) to 160 ml /min /kgBw (gd 138). In IUGR fetuses, however, UmbBF per kg body weight (215 ml /min/kgBw on gd 117) did not drop accordingly (210 mlmin/kgBw on gd 138). Thus UmbBF per kg fetal body weight stayed significantly higher in IUGR fetuses than in controls at gd 138 (P< .0IL
CONCLUSION: Experimental intrauterine growth restriction in sheep is accompanied by adaptive changes in umbilical perfusion, which may allow the fetus to make up for the reduced delivery of substrates and oxygen cansed by the decrease in uterine blood flow.
600 LAMELLAR BODY COUNT COMPARED TO THE FETAL LUNG MATU- RITY (FLM) FOR THE PREDICTION OF PULMONARY MATURITY ANTHONY SCISCIONE l, PATRICK WILSON 2, MARY LOOMIS l, 8TEVEN JOHNSON ~, MARJORIE POLLOCK 4, ANNE O'SHEA 1, JAMES MANLEY 4, MARTHA RODE4; 1Newark, DE; 2Christiana Hospital, Dept of Pathology, Newark, DE; 3Christiana Hospital, Pathology, Newark, DE; 4Christiana Hospital, Newark, DE
OBJECTIVE: The fetal lung maturity TDX-FLM TM is a commercially available test based on the Surfactant to Albmnin ratio in amniotic fluid. Because of its accuracy and ease of use, it has becmne a coImnon test tor puhnonary maturity. Recently, lamellar body counts have been reported as an accurate, easy and inexpensive way to deterxnine pulmonax T maturity. We sought to compare the accuracy of these two tests fbr puhnonary maturity.
STUDY DESIGN: All amniocentesis specimens sent for puhnonary maturity studies in our institution between 4/00 and 7/01 had FLM and Lamellar body counts analyzed. A FLM >55 and a Lamellar body count >40,000 were considered mature. The rate of respiratory distress syndrome (RDS) between the two groups was examined. Clinical and radiologic evidence of RDS were necessary to make the diagnosis.
RESULTS: There were 102 women who had an amniocentesis for puhnonary maturity during the study period. Sixty-five were delivered within 3 days of the test and are used for the analysis. There were 21 neonates with the diagnosis of RDS. The results are presented in the Table for each individual test and using the tests together with any positive test as a sign of puhnonary maturity.
CONCLUSION: The FLM and lamellar body counts have a similar accuracy. However, the use of the FI,M t e s t or the combined tests is associated with a greater nmnber of false positive results than the lamellar body count alone. The lamellar body count should be considered as a first line, inexpensive test for pulmonai T maturity.
Table
POSITIVE NEGATIVE PREDICTIVE PREDICTIVE
SENSITIVITY SPECIFICITY VALUE VALUE
FLM 80.9% 56.8% 47.2% 86.2% Lamellar body 80.9% 68.2% 54.8% 88.2% Combined 92.6% 31.5% 33.3% 92%
