INTRAUTERINE THERAPY OF INTRAUTERINE GROWTH RESTRICTION

Abstract

BackgroundIntrauterine growth restriction (IUGR) is one of the most prevalent causes of fetal mortality and fetal morbidity, affecting up to 10% of all births and it is associated with increased risk of neurological, cardiovascular and metabolic diseases later in life. Even though numerous studies intended to find a therapy for IUGR, no standard therapy for IUGR has been established so far.ObjectiveTo examine the effect of an intrauterine nutritional therapy in the IUGR rabbit model in terms of survival and birth weight.MethodsIUGR was surgically induced in pregnant rabbits (n=16) at gestational age 25 by ligating 40–50%of uteroplacental vessels of each gestational sac in both uterine horns. At the same moment, fetal injections of Total Parenteral Nutrition solution (TPN) was administered into the amniotic sac of IUGR fetuses (n=90) in one horn, whereas sham injection was performed in the contralateral horn (n=86). Five days after, a cesarean section was performed obtaining treated and non‐treated IUGR animals.ResultsSurvival rate of treated IUGR animals were significantly higher than the non‐treated IUGR animals (61.5% and 41.9% respectively, p=0.013). Birth weight were similar between groups (38.4 g ± 9.3 SD vs. 36.2 g ± 8.5 SD, p=0.49, treated vs. non‐treated IUGR respectively,).ConclusionOur data suggests that TPN solution directly administrated to the IUGR animals at the time of IUGR induction could increases the survival rate, with no difference in birth weight. Further studies are needed in order to confirm the results and try to fully evaluate the potential benefits of such strategy in promoting fetal survival.Support or Funding InformationThis study was partly supported by grants from Ministerio de Economia y Competitividad (ref. SAF2012‐37196); the Instituto de Salud Carlos III (ref. (PI12/00851) integrado en el Plan Nacional de I+D+I y cofinanciado por el ISCIII‐Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER) “Otra manera de hacer Europa”; Obra Social “la Caixa” (Barcelona, Spain); and AGAUR 2014 SGR grant n&[ordm] 928 (Barcelona, Spain). HGG has also been funded with support of the Erasmus + Programme of the European Union (Framework Agreement number: 2013‐0040). This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.