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[Prenatal diagnosis and treatment of intrauterine growth retardation]
Insights
This study investigated allylestrenol for intrauterine growth retardation (IUGR). The medicated group showed significantly increased fetal body weight and improved maternal hormone levels compared to controls.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Reproductive Endocrinology
Context:
- Intrauterine growth retardation (IUGR) affects fetal development and is diagnosed using estimated fetal weight (EFW) and specific growth curves.
- Maternal hormonal profiles, including plasma estriol, urinary estriol, and plasma human placental lactogen (hPL), are indicators of fetal well-being.
- Standard management for IUGR includes bed rest and dietary modifications.
Purpose:
- To evaluate the efficacy of oral allylestrenol in improving fetal growth in pregnancies diagnosed with IUGR.
- To assess the impact of allylestrenol on maternal hormonal levels (estriol and hPL) in IUGR pregnancies.
Summary:
- A randomized controlled trial involving 150 pregnancies diagnosed with IUGR (EFW < -1.5 SD) was conducted.
- Seventy-five pregnancies received oral allylestrenol (30 mg/day), while 75 served as controls.
- Ultrasonic measurements (biparietal diameter, abdominal circumference) and biochemical markers were monitored bi-weekly. The medicated group demonstrated statistically significant increases in EFW and significant rises in maternal plasma estriol, urinary estriol, and plasma hPL compared to the control group.
Impact:
- Oral allylestrenol administration led to a statistically significant increase in fetal body weight in IUGR pregnancies.
- Treatment with allylestrenol resulted in significant improvements in maternal hormonal profiles, suggesting a positive effect on placental function and fetal health.
- These findings indicate a potential therapeutic benefit of allylestrenol in managing intrauterine growth retardation.
Abstract:
A diagnosis of intrauterine growth retardation (IUGR) was made in 150 pregnancies on the basis that the estimated fetal body weight was less than -1.5 SD of the intrauterine growth curve for the Japanese population in two consecutive measurements. The estimation of fetal body weight was made from the biparietal diameter and abdominal circumference using the formula of Shepard et al. Maternal plasma estriol, urinary estriol and plasma hPL were determined, and routine instructions to take daytime bedrest and a high protein diet were made. 75 optionally selected cases were given oral allylestrenol 30 mg/day until the time of delivery (the medicated group), and the other 75 cases (control group) were given no medication. Ultrasonic and biochemical measurements were repeated every two weeks thereafter. The estimated fetal weight calculated from Shepard's formula was of sufficient accuracy to make it possible to predict the fetal weight before delivery. In the control group, the estimated fetal weight averaged 1,281 grams at the initial measurements at an average of 32.7 weeks' gestation when the diagnosis of IUGR was made, and 2,498 grams at the final measurements at an average of 38.7 weeks gestation immediately before delivery. In the medicated group, the estimated fetal weight averaged 1,242 grams at the initial measurements at 32.8 weeks' gestation, and 2,826 grams at the final measurements at 39.0 weeks' gestation. Statistically significant increases in the fetal body weight were noted in the medicated group. Maternal plasma estriol, urinary estriol and plasma hPL concentrations rose significantly in the medicated group when compared with the control group.(ABSTRACT TRUNCATED AT 250 WORDS)