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RMU

Uruguayan Medical Journal

ISSN: 1688-0390


Vol.21 - Nº 3 - Oct. 2005

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Prevalence of elevated levels of lipoprotein (a) in complicated pregnancies with intrauterine fetal grow restriction

OTERO AM; BIANCHI A; DELLEPIANE M; POU FERRARI R; STORCH E; PONS JE; ALONSO TELECHEA J; LENS D; ATTARIAN D; MOTTA N; CERIA B; FERRARI A
Rev Med Urug 2005; 21: 236-241
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract

Abstract

Background. An adequate placental circulation is vitally important to fetus grow.

Fibrinolytic mechanism play an important role in placental circulation.

Defective placental circulation is frequently seen in pregnant women with intrauterine fetal grow restriction (IFGR). Lipoprotein(a)[Lp(a)] is an antifibrinolytic activator when competing with plasminogen due to their structural similarities. Lp(a) levels are genetically determined: women with high levels of Lp(a) may present an environment of poor fibrinolytic balance in the placenta, that produces repercussions of fetal grow.

Objective: To determine the prevalence of Lp(a) excess in women with IFGR and no ginecologic, endocrine or autoimmune related causes.

Methods: Control population: 50 women with at least 2 normal pregnancies and no lost pregnancies. Study population: 30 pregnant women with IFGR (p<10%).

Intrauterine fetal grow was determined by conventional or color Doppler echography in both fetal and placental uterine arteries. Serum Lp(a) was measured by immuno-turbidimetric metyhods with antihuman Lp(a) antibodies (rabbits) [Tina-quant lipoprotein(a) ? (Diagnostica Stago)].

Cut value of Lp(a) was 300 mg/L. The elevated levels of Lp(a) were confirmed after pregnancy when values found were pathologic. All patients were interviewed to focus on familial heart disease history.

Results: Lp(a) was higher than 300 mg/L in 3/50 (6%) of the control population compared to 11/30 (36.6%) of the study population. High levels of Lp(a) in women with IFGR ranged from 930 to 2 020 mg/L. These levels were confirmed after pregnancy in 100% of women with IFGR.

All these women had a familial history of heart disease.

Conclusion: high levels of Lp(a) are associated with women with IFGR. Further studies on fibrinolytic mechanisms should be of interest for women with IFGR.