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KMID : 0377619970620060527
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Korean Jungang Medical Journal
1997 Volume.62 No. 6 p.527 ~ p.527
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Pathophysiologic Consideration of Mid Gestational IUGR
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Yoshihiko, Takeda
Mitutoshi, Iwashita/Yosiki, Kudo/Akira, Mori
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Abstract
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Two major factors of genetic disorders and nutritional supply were considered to be pathogenesis of IUGR. The latter were further divided into maternal environmental disorders and placental dysfunction. Of these factors, disorders of placental transfer has been considered to be main role of the etiology of IUGR. It has been clarified that placental transfer were regulated mainly by regional utero-placental circulation and villous function. IGF-1 was found to be closely correlated to transfer kinetics of the villous tissue. Among 6 binding protein reported, BP-1 to BP-4 were identified in maternal plasma. Maternal BP-1 showed negative co relation to fetal birth weight, while BP-3 which is major component of serum BP did not show any correlation to fetal weight. In addition, IGF binding protein interacts IGF-1 binding to the receptor at the cell surface by its phospholysation.
Furthermore IGFBP-1 increase in IUGR fetus. We have confirmed in experimental study that neutralization of IGF-1 produced IUGR fetus. IGF-1 also acts fetal maturation confirmed by biosynthesis of surfactant in alveolar cell and air space. Homodynamic disorder are characterized by reduction in systemic circulation including placenta and concomitant increase of brain circulation. Pressure waveform together with velocimetry could evaluate fetal compensatory status in hypoxia. Present lecture will be concentrated of IGF activities and homodynamic changes on the pathophysiology of IUGR.
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KEYWORD
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