Amniotic levels of nitric oxide and vascular endothelial growth factor in pregnancy with subsequent intrauterine fetal death

Abstract

Objective: Nitric oxide (NO) and vascular endothelial growth factor (VEGF) regulate angiogenesis and seem involved in the early stages of placentation. If angiogenesis is reduced, this may lead to poor placentation and fetal death. This study was aimed to determine whether VEGF and NO are associated to subsequent fetal death. Study design: We retrospectively assessed NO and VEGF on midtrimetster amniotic fluid from seven women who had subsequently had intrauterine fetal death before 20 weeks, and compared the results with those of 14 controls matched for age and gestation. All women had undergone amniocentesis for maternal age. All were at 16 weeks of gestation. None had shown chromosomal abnormalities. Results (mean±S.D.) were tested for statistics with Student’s t-test with significance at P<0.05. Results: Women with subsequent fetal death had both amniotic NO and VEGF lower than women with normal pregnancy (NO 3.28±1.20 μg/mg creatinine versus 6.02±1.57 μg/mg creatinine, P<0.05; VEGF 210.10±69.55 pg/ml versus 255.05±88.66 pg/ml). Conclusions: An early reduction of both NO and VEGF may be responsible of an impaired placental vascular development and endothelial regulation that may lead to fetal death.