Avaliação das alterações dos níveis de peptídeo natriurético: anp, bnp e da síntese de óxido nítrico em fetos com diagnóstico ultra-sonográfico de crescimento intra-uterino restrito (CIUR)

• Ano de defesa: 2003
• Autor(a) principal: Juliana Silva Barra
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Saúde da mulher; Óxido nítrico; Ginecologia; Equilíbrio ácido-básico; Feto; Gestantes; Ultrassonografia pré-natal; Obstetrícia; Diagnóstico pré-natal; Peptídeos natriuréticos
• Link de acesso: http://hdl.handle.net/1843/ECJS-84NJNK

Intra-uterine growth restriction is the second risk factor for perinatal mortality. When intra-uterine growth restriction is associated with uteroplacental insufficiency, compensatory mechanisms to maintain oxygenation and nutritional supply for the fetal heart, brain and kidneys might occur ( brain sparing effect ). Some substances found in fetuses and mothers can cause vessel dilatation, such as atrial natriuretic peptide, brain natriuretic peptide and nitric oxide. Fetuses with intra-uterine growth restriction and altered doppler velocimetry of the inferior vena cava present higher concentrations of atrial natriuretic peptide Capponi et al. (1997).. Yallampali e Garfield (1994), verified that low levels of plasmatic nitric oxide in pregnant rats caused intra-uterine growth restriction. This study aims to evaluate the behavior of atrial natriuretic peptide, brain natriuretic peptide and nitric oxide in a group of small fetuses for gestacional age with or without brain sparing and if the same ones are related to this compensatory mechanism. Selected 132 pregnant women of Hospital das Clinicas da Universidade Federal de Minas Gerais with sonographic diagnosis of intra-uterine growth restriction were selected . According to the results of doppler velocimetry of umbilical artery and middle cerebral artery, they were divided into three groups: fetuses with and without brain sparing and normal fetus. At cesarian section, a sample of 10 ml of umbilical cord blood was obtained. It was processed (4 ºC, 4000rpm, 10min) and stored to negative 80ºC . Atrial natriuretic peptide, brain natriuretic peptide were determined by radioimmunoassay technique described by Gutkowska et al. (1987). The determination of the nitrate concentration was accomplished through the analysis of nitric oxide (NO Analiser Siervers, USA). Observed fetuses with intra-uterine growth restriction and brain sparing effect presented significantly higher levels of Atrial natriuretic peptide (p = 0.01) and brain natriuretic peptide (p = 0.016). Positive correlations between the umbilical-cerebral index and ANP (P = 0,01) and the umbilical-cerebral index and brain natriuretic peptide (P=0,027) were observed. Concluded natriuretic peptides fetuses with brain sparing effect present a significant rise in. No difference of nitric oxide levels were observed among the studied groups.