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Objective: To evaluate relationship of maternal hepatic vein Doppler flow parameters and cardiac output (CO) with neonatal birth weight in uncomplicated pregnancies (UP) and pregnancies complicated by fetal growth restriction (FGR) .
 Methods: Hepatic vein impedance index (HVI), venous pulse transit time (VPTT), and CO were measured in women with UP at the 14th-37th weeks and complicated by FGR at the 26th-37th weeks who underwent maternal hepatic hemodynamic and echocardiographic examination during the ultrasonography. After delivery, the birth weight and the birth weight percentile of each neonate in this study were recorded. Correlations among HVI, VPTT, and CO were analyzed.
 Results: In the UP group, HVI, VPTT, and CO changed with the increase of gestation. In the FGR group, HVI was higher, VPTT was shorter, CO and neonatal birth weight were obviously lower than those in the UP at the 26th-37th weeks (P<0.05).
 Conclusion: There is a series of adaptive changes in hepatic venous hemodynamics and CO in UP with the increase of gestation to meet the demand of fetal growth, while the maladaptive changes in hepatic venous hemodynamics and CO in pregnant woman may contribute to FGR.

Objective: To explore the effect of intrauterine growth retardation (IUGR) on insulin sensitivity in neonates and the relationship between insulin sensitivity and plasma adiponectin level., Methods: Eighty-two term neonates with IUGR and 90 term neonates born appropriate for gestational age (AGA) were enrolled. Weight, height, head circumference and abdomen circumference of the neonates were measured within 24 hours after birth. Fasting serum glucose (FG), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), plasma insulin and adiponectin were detected in two groups on the 7th day after birth. Homeostasis model assessment for insulin resistance (HOMA-IR) index and insulin sensitivity index (ISI) were calculated., Results: There were no significant differences in the levels of FG, TG, HDL and LDL between the IUGR and AGA groups (P>0.05). The plasma insulin level in the IUGR group was higher than that in the AGA group, but the plasma adiponectin level was lower than that in the AGA group (P<0.05). HOMA-IR index in the IUGR group was higher than that in the AGA group, but ISI was lower than that in the AGA group (P<0.05). Both Pearson correlation analysis and multiple linear regression analysis showed HOMA-IR index was negatively correlated with plasma adiponectin level and birth weight (P<0.05)., Conclusions: The neonates with IUGR display a higher plasma insulin level and decreased insulin sensitivity. The decreased plasma adiponectin level may be associated with the decreased insulin sensitivity.

Objective: To investigate whether fetal growth restriction (FGR) has an adverse effect on white matter development., Methods: A total of 28 full-term small for gestational age (SGA) infants were enrolled as study subjects and 15 full-term appropriate for gestational age infants were enrolled as control group. Conventional head magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were performed for all infants. The white matter was divided into 122 regions. The two groups were compared in terms of fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity of different brain regions., Results: Compared with the control group, the SGA group had a significantly lower fractional anisotropy in 16 brain regions (P<0.01), a significantly higher mean diffusivity in 7 brain regions (P<0.05), a significantly higher axial diffusivity in 8 brain regions (P<0.05), and a significantly higher radial diffusivity in 16 brain regions (P<0.05)., Conclusions: FGR may cause abnormalities in the maturity and integrity of white matter fiber tracts.

Objective: To investigate the renal function of small-for-gestational-age (SGA) infants at the early stage after birth., Methods: A total of 40 preterm SGA infants, 33 full-term SGA infants, 80 preterm appropriate-for-gestational-age (AGA) infants, and 33 full-term AGA infants were included in this study. The following indices were compared between the SGA infants and AGA infants within 48 hours after admission: blood urea nitrogen (BUN), serum creatinine (SCr), estimated glomerular filtration rate (eGFR), blood pressure, urine volume per body weight, and proteinuria., Results: The preterm SGA group had a significantly lower BUN level than the preterm AGA group (P<0.05). However, there were no significant differences in SCr level, eGFR, and blood pressure between the two groups (P>0.05). The full-term SGA group had a significantly higher SCr level and a significantly lower eGFR than the full-term AGA group (P<0.05). However, there were no significant differences in BUN level and blood pressure between the two groups (P>0.05). There was no significant difference in urine volume per body weight between the preterm SGA and preterm AGA groups (P>0.05) and between the full-term SGA and full-term AGA groups (P>0.05). There was no significant difference in the incidence of proteinuria between the preterm SGA and preterm AGA groups (P>0.05). Proteinuria was not present in the SGA full-term and AGA full-term groups., Conclusions: SCr and eGFR can be used as the diagnostic indices for early renal damage of SGA infants. The renal function is worse in full-term SGA infants than in full-term AGA infants.

Objective: To study the effects of postnatal growth retardation on early neurodevelopment in premature infants with intrauterine growth retardation (IUGR)., Methods: A retrospective analysis was performed on the clinical data of 171 premature infants who were born between May 2008 and May 2012 and were followed up until a corrected gestational age of 6 months. These infants were classified into two groups: IUGR group (n=40) and appropriate for gestational age (AGA) group (n=131). The growth retardation rates at the corrected gestational ages of 40 weeks, 3 months, and 6 months, as well as the neurodevelopmental outcome (evaluated by Gesell Developmental Scale) at corrected gestational ages of 3 and 6 months, were compared between the two groups., Results: The growth retardation rate in the IUGR group was significantly higher than in the AGA group at the corrected gestational ages of 40 weeks, 3 months, and 6 months. All five developmental quotients evaluated by Gesell Developmental Scale (gross motor, fine motor, language, adaptability and individuality) in the IUGR group were significantly lower than in the AGA group at the corrected gestational ages of 3 months. At the corrected gestational age of 6 months, the developmental quotients of fine motor and language in the IUGR group were significantly lower than in the AGA group, however, there were no significant differences in the developmental quotients of gross motor, adaptability and individuality between the two groups. All five developmental quotients in IUGR infants with catch-up lag in weight were significantly lower than in IUGR and AGA infants who had caught up well., Conclusions: Growth retardation at early postnatal stages may adversely affect the early neurodevelopment in infants with IUGR.

Objective: To observe catch-up growth in height within two years of birth in infants of different sexes, gestational ages, and birth weights with intrauterine growth retardation (IUGR)., Methods: Follow-up was performed on 294 IUGR infants and 300 healthy full-term infants at 4, 6, 9, 12, 15, 18, 21 and 24 months after birth to measure the height, calculate the height increase and compare the two groups with respect to height increase., Results: The success rates of catch-up growth in height were 72.2% in male infants and 71.5% in female infants (P=0.90), and were 77.4% in preterm small-for-gestational age (SGA) infants and 68.6% in full-term SGA infants (P=0.11). Success rates of catch-up growth in height in infants with birth weights between 1500-2499 g was higher than in those with birth weights of <1500 g and ≥2500 g (P<0.01). The male infants showed significant catch-up growth at 4, 6, 18, 21 and 24 months after birth, while significant catch-up growth was found in female infants at 4, 6, 9, 12 and 21 months after birth. Of the male infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 6 and 9 months after birth. Of the female infants, preterm SGA infants showed significantly greater height increase than the full-term SGA infants at 4 and 18 months after birth. For both male and female infants, height increase at 4 months after birth was significantly greater in those with birth weights of <1500 g than in those with birth weights of ≥2500 g. For male infants, height increases at 4, 6, 18, 21 and 24 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g. For female infants, height increases at 4, 6, 9, 12 and 21 months after birth were significantly greater in those with birth weights of 1500-2499 g than in those with birth weights of ≥2500 g., Conclusions: The catch-up growth in height within two years of birth in infants with IUGR occurs mainly in the first year after birth in female infants, but can be seen in the first six months and the second year after birth in male infants. Preterm SGA infants better catch-up growth than full-term SGA infants, and infants with birth weights of below 1500 g and between 1500-2499 g show better catch-up growth than those with birth weights of ≥2500 g.

Objective: To study changes of glycolipid metabolism and adipocyte function in an catch-up growth intrauterine growth retardation (IUGR) rat model., Methods: IUGR rat model was established by maternal nutrition restriction during pregnancy. Newborn IUGR pups were used as IUGR group, and normal newborn pups were used as control group (appropriate for gestational age, AGA group). At age of 12 weeks, plasma samples were collected for the test of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), adiponectin and acylation stimulating protein (ASP). Oral glucose tolerance test (OGTT) was performed for the test of glucose and insulin levels, and insulin resistance index (IRI) was calculated. Expression of glucose transfer 4 (GLUT-4) in adipocytes was examined by confocal microscopy., Results: Body weight and BMI in the IUGR group were significantly higher than in the AGA group by 12 weeks (P<0.01), and plasma TC, TG and LDL-C levels in the IUGR group were higher than in the AGA group, but HDL-C was lower (P<0.05). In the OGTT test, blood glucose level and IRI score in the IUGR group were higher than in the AGA group (P<0.05). Compared with the AGA group, the IUGR group had a higher ASP level (P<0.05) and a lower adiponection level (P<0.05). GLUT4 expression in the adipocytes was significantly lower in the IUGR group than in the AGA group (P<0.05)., Conclusions: Catch-up growth may be obviously noted in IUGR rats after birth. Both hyperlipidaemia and insulin resistance occur at age of 12 weeks. Dysfunction of adipocytes decreased expression of GLUT-4 may be risk factors for insulin resistance in IUGR rats.

Objective: To study the relationship between Ghrelin and growth hormone secretagogue receptor (GHSR) expression and the catch-up growth in rats with intrauterine growth restriction (IUGR)., Methods: The rat model of IUGR was established by food restriction during pregnancy. The small for gestational age (SGA) and appropriate for gestational age (AGA) rat pups from the pregnant rats were used as the experimental group. The AGA rat pups from the pregnant rats without food restriction served as the control group. The samples from the stomach fundus and hypothalamus were taken postnatal days 0, 20 and 40. Ghrelin mRNA and GHSR mRNA expression were determined by real-time fluorescence quantitative PCR (real-time FQ-PCR). Ghrelin protein and GHSR protein expression were examined by immunohistochemistry (IHC)., Results: At postnatal day 0, both Gherlin mRNA and protein levels in the stomach fundus were significantly higher, while GHSR mRNA expression in the hypothalamus were significantly lower in SGA rats from food restriction group than those in AGA rats from restriction and control groups. At postnatal day 20, the ghrelin protein expression in the stomach of fundus, and GHSR mRNA and protein expression in the hypothalamus in SGA catch-up rats were significantly higher than those in SGA non-catch-up growth rats and AGA rats from the control group. At postnatal day 40, there were no significant differences among SGA catch-up growth rats, SGA non-catch-up growth rats and normal AGA rats., Conclusions: Ghrelin-GHSR might be involved in the physiological regulation and pathological process in IUGR rats. It is also possibly involved in the regulation of catch-up growth in the early life of SGA rats.

Objective: To study the effect of behavioral training on the learning and memory abilities and changes of NR2B and GluR1 expressions in the hippocampus of offspring rats with fetal growth retardation (FGR)., Methods: A FGR model was established in SD rats by passive smoking. The offspring rats were divided into FGR group and control group, each then randomized into training and untrained group. Morris water maze behavioral training was carried out in postnatal months 2 and 4, and the learning and memory abilities of the young rats were assessed using dark-avoidance test and step-down test. NR2B and GluR1 expression in the hippocampus of the rats were detected by immunohistochemistry., Results: In the dark-avoidance and step-down tests, the FGR rats showed deteriorated learning and memory performance in comparison with the control group, but behavioral training resulted in improved performance of the rats. The performance in FGR group was much improved after behavioral training, and the model factor and the training factor showed a significant interaction (P<0.05). The expression of NR2B and GluR1 in CA1 and CA3 regions of the hippocampus decreased in FGR group, then the their expressions in the CA1 region increased after training in both FGR and control groups, and the increment was especially obvious in GluR1 expression in the CA1 region at postnatal month 2. The two factors showed a significant interaction (P<0.05)., Conclusion: Behavioral training can improve the learning and memory abilities of FGR offspring rats, the mechanism of which is probably related to increased expression of NR2B and GluR1 in the CA1 region of the hippocampus.

Objective: To explore the correlation between adipocyte factors (adiponectin and visfatin) and fetus intrauterine growth., Methods: Enzyme immunoassay was used to measure the adiponectin and visfatin levels in maternal and umbilical serum from 14 women with fetal growth restriction (FGR group), 14 women with macrosomia (macrosomia group) and 14 normal pregnant women (control group). The correlations of cord serum adiponectin and visfatin with maternal serum adiponectin and visfatin were analyzed., Results: (1) Serum visfatin levels in FGR mothers [(41.4 +/- 5.5)] microg/L were significantly higher than that in control women [(34.7 +/- 4.9) microg/L] and macrosomia mothers [(37.3 +/- 4.4) microg/L; P < 0.01, P < 0.05]. Serum adiponectin levels in macrosomia mothers [(4.1 +/- 1.3) mg/L] were significantly lower than that in control women [(6.6 +/- 1.5) mg/L] and FGR mothers [(6.4 +/- 1.3) mg/L; P < 0.01]. (2) Serum visfatin levels in FGR babies [(58.1 +/- 7.6) microg/L] were significantly increased than that in control newborns [(42.6 +/- 7.8) microg/L] and macrosomia babies [(48.5 +/- 9.1) microg/L; P < 0.01, P < 0.05]. Serum adiponectin levels in macrosomia babies [(6.5 +/- 1.3) mg/L] were significantly decreased than that in control newborns [(7.7 +/- 1.5) mg/L] and FGR babies [(7.7 +/- 1.0) mg/L; P < 0.05, P < 0.05]. (3) Maternal serum visfatin levels were positively correlated with umbilical serum visfatin levels (r = 0.720, P < 0.01). Umbilical serum adiponectin levels were higher than that in maternal serum, but there were no relationship between them (r = 0.301, P > 0.05)., Conclusion: The changes of visfatin and adiponectin levels may be related to the occurrence of FGR and fetal macrosomia.

Objective: To investigate the expressions of the insulin receptor (IR), insulin receptor substrate-1 (IRS-1), insulin receptor substrate-2 (IRS-2), phosphatidyl inositol 3-kinase (PI3K) and insulin-like growth factor-1 (IGF-1) of the livers of the male adult rats born with intrauterine growth retardation (IUGR),and to find out the relationship between IUGR and insulin resistance in their adult life., Methods: The foods were available ad libitum throughout the pregnancy to the control group and the rats in the experimental group were fed 50% of the control group to build the IUGR animal model. Liver samples were collected when the male offspring grew up to 12 weeks old. The mRNA expressions of hepatic IR, IRS-1, IRS-2, PI3K, and IGF-1 were detected by RT-PCR. The protein expressions of hepatic IR, IRS-1, and IRS-2 were analyzed by immunohistochemistry., Results: The mRNA expressions of hepatic IR in the adult male rats with IUGR were significantly lower than control group [(0.41+/-0.06) vs (0.62+/-0.11), P<0.05]. But the expressions of hepatic IR protein were similar [(6.21+/-0.57) vs (6.69+/-0.47), P>0.05] in both groups. The mRNA and protein expressions of the hepatic IRS-1 [mRNA: (0.77+/-0.20) vs (1.32+/-0.42), P<0.05; protein: (2.15+/-0.23) vs (5.96+/-0.38), P<0.05] and IRS-2 [mRNA: (1.05+/-0.28) vs (1.48+/-0.40), P<0.05; protein: (4.33+/-0.29) vs (7.08+/-0.35), P<0.05] of the IUGR rats were reduced; there were no differences between the hepatic PI3K mRNA expressions in the 2 groups [(1.12+/-0.19) vs (1.18+/-0.24), P>0.05]. The expressions of hepatic IGF-1 mRNA of the rats with IUGR were significantly lower than those in control group [(0.55+/-0.12) vs (1.22+/-0.34), P<0.05]. There was close relation between the reduction of the expression of hepatic IGF-1 mRNA and the expression of IRS-1 mRNA (r=0.821, P<0.05) and IRS-2 mRNA(r=0.643, P<0.05) in the adult male rats with IUGR., Conclusion: The reduced expressions of IRS-1 and IRS-2 caused the lower expression of hepatic IGF-1 in the adult male rats with IUGR, which was related to the stunted growth and the insulin resistance. There were no relation of the expressions of hepatic IR and PI3K and the insulin resistance in adult male rats with IUGR.

Objective: To test the impact of fetal growth restriction (FGR) on the spatial learning and memory abilities of the offspring of rats., Methods: FGR Model of Sprague-Dawley rats was constructed according to the method of passive smoking. The offspring of the rats were divided into male FGR group, male control group, female FGR group and female control group. Within each group, the rats were randomly divided into three subgroups to be tested at 1, 2, and 4 months of age, respectively (n =10 for each subgroup). Morris water maze task was performed to assess the spatial learning and memory abilities of the rats., Results: The escape latencies to find the platform were shortened with increased training times for all of the rats. At the age of 1 and 2 months, both male and female rats in the FGR group spent more time in finding the platform than their counterparts in the control group (P < 0.05). At the age of 4 months, significant prolonged latency was only found in the female rats. The rats in the FGR group, except the 4 months old male rats, were more likely to use non-effective strategies (random or marginal strategies) to find the platform than the efficient strategies (tendency or straight strategies). The rats in the FGR group stayed in the platform shorter than those in the control groups (P < 0.05)., Conclusion: FGR can cause gender- and age-specific impairment of spatial learning and memory abilities to the offspring.

Objective: To investigate the influences of fetal growth retardation (FGR) and postnatal high fat diet (HF) on the development of insulin resistance (IR), puberty development and fertility problems in female rat offspring., Methods: FGR model was induced by maternal low protein diet. 32 newborn FGR rats and 32 control rats were randomly divided into two equal groups: FGR/HF group (with the mother rats given with high fat diet for 3 weeks after delivery), FGR/N (with the mother rats given with normal diet), C/HF group (control newborn rat group with the mother rats given with high fat diet), and C/N group (control newborn rat group with the mother rats given with normal diet). The pups were fed by mother milk. All pups were weaned at the 4th week of age and then fed with the diet the same diet as that during the lactation period until the end of experiment. From day 30 onwards, vaginal opening and oestrous cycle were inspected daily on 10 pups in each group. At the 13th week, body weight, length and perirenal fat weight/body weight (Fw/Bw) were recorded for 10 pups in each group. At the same time, fasting plasma glucose (FPG), fasting insulin (FINS), and testosterone level were measured. From the 13th week onwards, mating test was performed for 6 pups in each group., Result: At the 13th week, there was an obesity tendency in the FGR/N, FGR/HF and C/HF groups. The FINS levels were all higher, and insulin sensitivity index (ISI) levels were all significantly lower in these three groups than in the C/N group (all P < 0.05). The homeostasis model assessment insulin resistance index (HOMA-IR) levels of the FGR/N and FGR/HF groups were significantly higher than that of the C/N group (both P < 0.05), the FINS and HOMA-IR of the FGR/HF group were significantly higher than that of the FGR/N group (both P < 0.05). There was oligoovulation in the FGR and high fat diet rats, the pregnancy rate of the FGR/HF group was significantly lower than that of the C/N group (P < 0.05). FGR/HF group had the most serious obesity, IR and fertility problems., Conclusion: There are puberty disturbance, oligoovulation and IR in FGR and high fat diet rats. IR, puberty development and fertility problems are linked and occur independently of the postnatal nutrition, but can be exacerbated by postnatal high fat diet.

Objective: To investigate the therapeutic effect of L-arginine (L-Arg) administration on fetus growth retardation (FGR) due to pregnancy-induced hypertension and explore its mechanism., Methods: Sixty-eight pregnant women with pregnancy-induced hypertension and FGR were enrolled in this study, and 25 of them were given L-Arg in addition to routine therapy. Umbilical artery flow parameters and serum NO concentrations in maternal and umbilical blood were measured, and the therapeutic effects were evaluated according to neonatal birth weight., Results: L-Arg therapy markedly decreased the systolic/diastolic value, pulse index and resistant index (P=0.000,0), while increased the fast blood velocity rate(P=0.000,0). NO contents in maternal and umbilical blood were 60.45-/+22.68 and 28.45-/+11.35 micromol/L in L-Arg group, respectively, significantly higher than those in routine treatment group (P=0.000,0 and 0.001,7, respectively) but lower than those in the control group (P=0.000,8 and 0.000,0, respectively). The neonatal birth weights were 2.9-/+0.3 kg in L-Arg group, significantly higher than that in routine treatment group (2.7-/+0.3 kg, P=0.006,8) and similar with that of the control group (3012.9-/+295.9 g, P=0.176,2)., Conclusion: L-Arg promote intrauterine growth of the fetus by increasing NO production and improving the umbilical artery flow in pregnant women with pregnancy-induced hypertension and FGR.

Objective: To investigate the islet beta-cell function and insulin sensitivity in adult male rats born intrauterine growth retardation caused by uterine placenta insufficiency., Methods: Bilateral uterine artery ligation (UAL) was performed on day 17 of gestation in the pregnant Wistar rats; sham-operated pregnant rats served as controls. The birth weights of the offspring in the UAL group were below the mean values of the birth weights of the control group more than 2SD, defined as IUGR. The tests were done in the adult male offspring (n=9 for each group). The glucose tolerance test was processed and Modified Beta-Cell function Index (MBCI) was calculated to evaluating the islet beta-cell endocrine function. Hyperinsulinemic-euglycemic clamp, the gold standard method to test the insulin resistance in the peripheral tissue was performed and insulin induced glucose infusion rate (GIR) was used to evaluate the insulin sensitivity., Results: (1) Though the mean birth weight of the newborn in the UAL group (4.49+/-0.56) g is much more than two standard deviations below the mean weight of that of the control group (6.16+/-0.30) g, P<0.001. The body weights of the UAL adult male offspring (382+/-37.51) g were significantly higher than those of the control group(339+/-24.06) g, P<0.01; (2) During a glucose tolerance test, the glucose levels of the UAL adult offspring [0 min, (3.96 +/-0.25) mmol/L; 30 min, (6.61+/-0.57) mmol/L; 60 min, (7.34+/-0.47) mmol/L; 120 min, (6.27+/-0.37) mmol/L] were significant higher than those of the controls [0 min, (3.56+/-0.22) mmol/L; 30 min, (5.74+/-0.32) mmol/L; 60 min, (5.89+/-0.29) mmol/L; 120 min, (3.89+/-0.25) mmol/L], P<0.05. The peak of insulin secretion is delayed and the insulin level at 120 min (84.65+/-11.79) mU/L is much higher than that of the controls (50.01+/-7.43) mU/L, P<0.05. MBCI values in the UAL adult male offspring (26.42+/-5.59) is significantly lower than those of in the control group (55.88+/-10.20), P<0.001. (3) The GIR in UAL adult offspring [16.86+/-1.59 mg/(kg . min)] is significantly lower than that of control group [20.35+/-2.38 mg/(kg . min)], P<0.05., Conclusion: The adult male rats born intrauterine growth retardation are prone to be obesity. The impaired islet beta-cell function and insulin resistance would be the risk factors for the development of type 2 diabetes mellitus.

Objective: To investigate the effect of heparin on umbilical blood flow in pregnant women with fetal growth retardation (FGR)., Methods: A total of 103 FGR women were randomized into control group (n=37), standard heparin group (n=35) and low-molecular-weight heparin group (n=31). Low-molecular-weight dextran was given in the control group, and the other two groups received agents for intervention as indicated. The umbilical blood flow, 1-minute Apgar score, body weight and gestational age of the neonates were measured and compared between the 3 groups., Results: As the gestational age increases, the systolic/diastolic (S/D) ratio, pulsatility index (PI) and resistance index (RI) were significantly lowered in the two heparin groups in comparison with those in the control group (P<0.05). One-minute Apgar score and body weight of the neonates were significantly greater in the two heparin groups (P<0.05), and the gestational age was also significantly longer (P<0.05). No statistical differences in the indices measured were noted between the two heparin groups (P>0.05)., Conclusions: Heparin, which is safe for both the mothers and their fetuses, might improve fetal growth and development, increase neonate body weight, prolong the gestational age and raise the one-minute Apgar score.

Objective: To establish intrauterine growth retardation (IUGR) models in rats for study of the etiology, pathology and therapy of this disease., Method: Partial ligation of the medial segment of the uterine artery and vein was performed in 10 Sprague-Dawley rats with pregnancy (17 d) to establish IUGR models, and another 9 rats with pregnancy of the same length which did not receive the operation were used as control. On day 21 of pregnancy, the fetuses and placentas in both groups were surgically taken and weighted, and the incidence of IUGR and mortality in the fetus were observed., Results: Significant decrease in the average weight of the fetuses (3.32+/-0.54 g) and placentas (0.38+/-0.05 g) occurred in the ligated group as compared with those of the control group (4.55+/-0.76 g and 0.44+/-0.11 g, P<0.005). An incidence of IUGR as high as 33.33% was resulted in the fetus of ligation group, significantly higher than that in the control group (1.14%, P<0.005), but no significant difference was observed in the mortality between the 2 groups (4.94% vs 3.41%, P>0.05)., Conclusion: IUGR models can be successfully established in SD rats by partial ligation of the medial segment of the uterine artery and vein.

Objective: To study the relationship between placental vascular endothelial growth factor (VEGF) expression and intrauterine growth retardation (IUGR) with abnormal Umbilical artery flow velocity waveforms (UmA FVWS), and deduce the oxygen content in placental terminal villi., Methods: The VEGF expression levels in syncytiotrophoblast and stroma cells were determined by sp immunohistochemistry, and were compared between the following 4 groups: abnormal UmA FVWS and IUGR (AVAW), abnormal UmA FVWS and normal birth-weight (AVNW), normal UmA FVWS and IUGR (NVAW), normal UmA FVWS and normal birth-weight (NVNW). Each group included 10 cases., Results: In all the placentae, VEGF was mainly expressed in syncytiotrophoblasts with less immunostaining in stroma cells. The intensity of VEGF immunostaining in stroma cells was similar in the groups studied so far. The VEGF expression in syncytiotrophoblasts was significantly reduced in group AVAW (VEGF positive rate in syncytiotrophoblasts is 13.0%), compared with NVAW (VEGF positive rate in syncytiotrophoblasts is 38.50%; P < 0.01) and NVNW (VEGF positive rate in syncytiotrophoblasts is 39.6%; P < 0.01). There was a negative linear correlation between VEGF positive rate in syncytiotrophoblasts and the values of UmA PI (r = -0.52, P < 0.001), RI (r = -0.43, P < 0.01), S/D (r = -0.40, P < 0.01)., Conclusions: The reduction of VEGF expression levels in syncytiotrophoblasts correlates with abnormal UmA FVWS and IUGR. The reduced expression of VEGF in syncycciotrophoblasts may be responsible for the impaired development of all classes of vessels and villi of the placentas from IUGR with abnormal UmA FVWS. The oxygen content is increased within terminal villi of IUGR with abnormal UmA FVWS.

Objective: To study the utero-placental-fetal circulation (UPFC) in normal pregnancy and intrauterine growth retardation (IUGR) cases., Methods: Color doppler ultrasound was used to detect UPFC in 150 second and third trimester pregnant women, of which 89 cases were normal pregnancy and 58 cases were IUGR. 3 cases were IUGR with chronic renal failure. Hemodynamical value of the umbilical artery (UmA), umbilical vein (UmV) and uterine artery (UtA) were examined directly. The indices included time average velocity (TAV), pulsatility index (PI), resistance index (RI), systolic/diastolic (S/D) ratio, blood flow volume (Q). The maternal serum estriol (E3), human placental lactogen (HPL) and plasma thromboxane B2 (TXB2)/6-keto-PGF1 alpha (6-KP) were measured simultaneously., Results: The result shows that in normal pregnancy group UPFC is abundant gradually with increasing gestational age. In IUGR group 92.53% of cases showed that TAV and Q of UmA, UmV markedly decreased and PI, RI and S/D ratio of UmA elevated at 20 weeks of gestation. There were significant difference between the two groups, maternal serum E3, HPL level in IUGR group were significantly lower than that of the normal pregnancy group, 6-KP level reduced, and TXB2/6-KP ratio significantly increased., Conclusion: Using color doppler ultrasound examining hemodynamical changes of UmA, UmV and UtA could observe UPFC function directly. It is one of the best method to early diagnose and predict the prognosis of IUGR.

Objective: To assess fetal cardiac function by Doppler echocardiography in intrauterine growth retardation (IUGR)., Methods: We investigated the changes in cardiac function in 64 normal fetuses and 36 fetuses with IUGR. Blood flow velocity waveforms were obtained from the aorta, pulmonary artery and atrioventricular valves. The following variables were measured: peak flow velocity (PFV), mean velocity (V), accelerate time (ACT), systolic volume (SV) and cardiac output (CO) represented the systolic function; the peak early flow velocity (PFVe), peak late flow velocity (PFVa), PFVe/PFVa (E/A), mean velocity (V) of mitral or tricuspid valve represented the diastolic function., Results: In normal fetuses, the PFV, V, ACT of aorta were all greater than those of pulmonary artery, whereas SV, CO in left ventricle were smaller. The PFVe, PFVa in mitral valve were smaller than those of tricuspid valve. In IUGR fetuses, the PFV, V, SV, CO of aorta or pulmonary artery were significantly lower than those of normal. The ACT in pulmonary artery decreased significantly, but increased in aortic artery. The SV, Co of left ventricle were greater than those of righ ventricle. The E/A of mitral and tricuspid valve, PFVe, PFVa, V of tricuspid valve were all decreased. The PFVe, PFVa in mitral valve were greater than those of tricuspid valve., Conclusions: The changes of cardiac function in IUGR are probably caused by "brain sparing", which means a redistribution of cardiac flow after hypoxia.

Objective: To evaluate the effect of uterine-placental-fetal blood flow velocity waveforms (FVWs) on predicting fetal hypoxia and acidosis in high risk pregnancy., Methods: 46 women of normal term pregnancy (normal group) and 32 women of high risk term pregnancy (high risk group) were examined with colour Doppler ultrasound for their FVWs including maternal uterine artery (UtA), fetal umbilical artery (UmA), middle cerebral artery (MCA), and renal artery (RA). Umbilical artery blood gases were analysed at delivery in high risk group., Results: The resistance index (RI), pulsatile index (PI) and ratio of peak systolic to least diastolic flow velocity (S/D) of UtA, UmA and RA were higher and the PI, S/D of MCA was lower significantly in the high risk group than that of normal the group (P < 0.05). In the high risk pregnancy, when UmA PO2 was less than 2.5 kPa, the S/D of UtA, PI, S/D of UmA and RI, PI, S/D of RA were increased, and the PI of MCA was decreased (P < 0.05). There were a positive correlation between PI of UmA, RA and PO2 pH of UmA, and a negative correlation between the former and PCO2 of UmA. But there were a negative correlation between PI of MCA and PO2, pH of UmA, and a positive correlation between the former and UmA PCO2., Conclusion: In the high risk pregnancy, fetal cerebral blood flow increased, whereas blood flow of fetal peripheral vessels (especially renal vessel) decreases. There is a good correlation between fetal hypoxia and fetal blood FVWs. The indices of the fetal blood FVMs can identify fetal hypoxia and acidosis.