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Sotiriadis A, Hernandez-Andrade E, da Silva Costa F, Ghi T, Glanc P, Khalil A, Martins WP, Odibo AO, Papageorghiou AT, Salomon LJ, Thilaganathan B. ISUOG Practice Guidelines: role of ultrasound in screening for and follow-up of pre-eclampsia. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2019; 53:7-22. [PMID: 30320479 DOI: 10.1002/uog.20105] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/15/2018] [Accepted: 07/22/2018] [Indexed: 06/08/2023]
Affiliation(s)
- A Sotiriadis
- Second Department of Obstetrics and Gynecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Hernandez-Andrade
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Hutzel Women Hospital, Wayne State University, Detroit, MI, USA
| | - F da Silva Costa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; and Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - T Ghi
- Obstetrics and Gynecology Unit, University of Parma, Parma, Italy
| | - P Glanc
- Department of Radiology, University of Toronto, Toronto, Ontario, Canada
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK; and Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - W P Martins
- SEMEAR Fertilidade, Reproductive Medicine and Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - A O Odibo
- Department of Obstetrics and Gynecology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - A T Papageorghiou
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK; and Nuffield Department of Obstetrics and Gynecology, University of Oxford, Women's Center, John Radcliffe Hospital, Oxford, UK
| | - L J Salomon
- Department of Obstetrics and Fetal Medicine, Hopital Necker-Enfants Malades, Assistance Publique-Hopitaux de Paris, Paris Descartes University, Paris, France
| | - B Thilaganathan
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, London, UK; and Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Lecuyer M, Rubio M, Chollat C, Lecointre M, Jégou S, Leroux P, Cleren C, Leroux-Nicollet I, Marpeau L, Vivien D, Marret S, Gonzalez BJ. Experimental and clinical evidence of differential effects of magnesium sulfate on neuroprotection and angiogenesis in the fetal brain. Pharmacol Res Perspect 2017; 5. [PMID: 28805973 PMCID: PMC5684858 DOI: 10.1002/prp2.315] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/05/2017] [Accepted: 01/10/2017] [Indexed: 01/25/2023] Open
Abstract
Clinical studies showed beneficial effects of magnesium sulfate regarding the risk of cerebral palsy. However, regimen protocols fluctuate worldwide and risks of adverse effects impacting the vascular system have been reported for human neonates, keeping open the question of the optimal dosing. Using clinically relevant concentrations and doses of magnesium sulfate, experiments consisted of characterizing, respectively, ex vivo and in vivo, the effects of magnesium sulfate on the nervous and vascular systems of mouse neonates by targeting neuroprotection, angiogenesis, and hemodynamic factors and in measuring, in human fetuses, the impact of a 4‐g neuroprotective loading dose of magnesium sulfate on brain hemodynamic parameters. Preclinical experiments using cultured cortical slices from mouse neonates showed that the lowest and highest tested concentrations of magnesium sulfate were equally potent to prevent excitotoxic‐induced cell death, cell edema, cell burst, and intracellular calcium increase, whereas no side effects were found regarding apoptosis. In contrast, in vivo data revealed that magnesium sulfate exerted dose‐dependent vascular effects on the fetal brain. In particular, it induced brain hypoperfusion, stabilization of Hif‐1α, long‐term upregulation of VEGF‐R2 expression, impaired endothelial viability, and altered cortical angiogenesis. Clinically, in contrast to 6‐g loading doses used in some protocols, a 4‐g bolus of magnesium sulfate did not altered fetal brain hemodynamic parameters. In conclusion, these data provide the first mechanistic evidence of double‐sword and dose‐dependent actions of magnesium sulfate on nervous and vascular systems. They strongly support the clinical use of neuroprotection protocols validated for the lowest (4‐g) loading dose of magnesium sulfate.
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Affiliation(s)
- Matthieu Lecuyer
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Marina Rubio
- INSERM U1237 unit "Serine proteases and Pathophysiology of the neurovascular Unit", Normandy University, Caen, France
| | - Clément Chollat
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France.,Department of Neonatal Paediatrics and Intensive Care, Rouen Hospital, Rouen, France.,Department of Neonatal Intensive Care, Port-Royal University Hospital, APHP, Paris, France
| | - Maryline Lecointre
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Sylvie Jégou
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Philippe Leroux
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Carine Cleren
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Isabelle Leroux-Nicollet
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France
| | - Loic Marpeau
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France.,Department of Obstetrics, Rouen Hospital, Rouen, France
| | - Denis Vivien
- INSERM U1237 unit "Serine proteases and Pathophysiology of the neurovascular Unit", Normandy University, Caen, France
| | - Stéphane Marret
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France.,Department of Neonatal Paediatrics and Intensive Care, Rouen Hospital, Rouen, France
| | - Bruno J Gonzalez
- Normandie University, UNIROUEN, INSERM U1245 NeoVasc Team, Rouen University Hospital, IRIB, F76000 Normandy Centre for Genomic and Personalized Medicine, Rouen, France
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Suliburska J, Kocyłowski R, Komorowicz I, Grzesiak M, Bogdański P, Barałkiewicz D. Concentrations of Mineral in Amniotic Fluid and Their Relations to Selected Maternal and Fetal Parameters. Biol Trace Elem Res 2016; 172:37-45. [PMID: 26547910 PMCID: PMC4893386 DOI: 10.1007/s12011-015-0557-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 10/25/2015] [Indexed: 12/12/2022]
Abstract
The concentrations of various trace elements in amniotic fluid (AF) change over the course of pregnancy, with gestational age and fetus growth. The aim of the present study was to evaluate the concentrations of selected essential and toxic elements in AF and their relations to maternal and fetal parameters. The study was carried out in 39 pregnant women, aged 34.6 ± 4.7 years, between weeks 16 and 26 of gestation. Amniotic fluid samples were obtained during the standard procedure of amniocentesis in high-risk patients for chromosomal abnormalities. An inductively coupled plasma mass spectrometry (ICP-MS) technique was used to determine the levels of Al, As, Ba, Cd, Co, Cr, Cu, Mg, Mn, Ni, Sr, U, and V in AF. Body mass and blood pressure were measured in all the women. The basic parameters of fetal development were also assayed. It was found that the age of the mother, the gender of the fetus, and the week of the pregnancy may affect the concentrations of mineral in the amniotic fluid. Moreover, several significant correlations between the essential and toxic elements and maternal and fetal parameters were observed. In particular, negative and positive correlations between fetal parameters and magnesium and copper levels in AF, respectively, were seen. The present findings demonstrate the association between minerals in AF and fetal development.
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Affiliation(s)
- J Suliburska
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland.
| | - R Kocyłowski
- PreMediCare New Med Medical Centre, ul. Drużbickiego 13, 61-693, Poznan, Poland
- Department of Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338, Łódź, Poland
| | - I Komorowicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska 89b, 61-614, Poznan, Poland
| | - M Grzesiak
- Department of Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338, Łódź, Poland
| | - P Bogdański
- Department of Education and Obesity Treatment and Metabolic Disorders, University of Medical Sciences, ul. Szamarzewskiego 84, 60-569, Poznan, Poland
| | - D Barałkiewicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska 89b, 61-614, Poznan, Poland
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Galinsky R, Davidson JO, Drury PP, Wassink G, Lear CA, van den Heuij LG, Gunn AJ, Bennet L. Magnesium sulphate and cardiovascular and cerebrovascular adaptations to asphyxia in preterm fetal sheep. J Physiol 2015; 594:1281-93. [PMID: 26077461 DOI: 10.1113/jp270614] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 06/08/2015] [Indexed: 11/08/2022] Open
Abstract
Magnesium sulphate is a standard therapy for eclampsia in pregnancy and is widely recommended for perinatal neuroprotection during threatened preterm labour. MgSO4 is a vasodilator and negative inotrope. Therefore the aim of this study was to investigate the effect of MgSO4 on the cardiovascular and cerebrovascular responses of the preterm fetus to asphyxia. Fetal sheep were instrumented at 98 ± 1 days of gestation (term = 147 days). At 104 days, unanaesthetised fetuses were randomly assigned to receive an intravenous infusion of MgSO4 (n = 6) or saline (n = 9). At 105 days all fetuses underwent umbilical cord occlusion for 25 min. Before occlusion, MgSO4 treatment reduced heart rate and increased femoral blood flow (FBF) and vascular conductance compared to controls. During occlusion, carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. After occlusion, fetal heart rate was lower and carotid and femoral arterial conductance and blood flows were higher in MgSO4-treated fetuses than controls. Femoral arterial waveform height and width were increased during MgSO4 infusion, consistent with increased stroke volume. MgSO4 did not alter the fetal neurophysiological or nuchal electromyographic responses to asphyxia. These data demonstrate that a clinically comparable dose of MgSO4 increased FBF and stroke volume without impairing mean arterial pressure (MAP) or carotid blood flow (CaBF) during and immediately after profound asphyxia. Thus, MgSO4 may increase perfusion of peripheral vascular beds during adverse perinatal events.
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Affiliation(s)
- Robert Galinsky
- The Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Joanne O Davidson
- The Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Paul P Drury
- The Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Guido Wassink
- The Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Christopher A Lear
- The Department of Physiology, University of Auckland, Auckland, New Zealand
| | | | - Alistair J Gunn
- The Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Laura Bennet
- The Department of Physiology, University of Auckland, Auckland, New Zealand
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