Nutritional intra-amniotic therapy increases survival in a rabbit model of fetal growth restriction

作者：Gulcin Gumus Hatice; Illa Miriam; Pla Laura; Zamora Monica; Crispi Fatima; Gratacos Eduard

来源：PLos One, 2018, 13(2): e0193240.

DOI：10.1371/journal.pone.0193240

Objective
To evaluate the perinatal effects of a prenatal therapy based on intra-amniotic nutritional supplementation in a rabbit model of intrauterine growth restriction (IUGR).
Methods
IUGR was surgically induced in pregnant rabbits at gestational day 25 by ligating 40-50% of uteroplacental vessels of each gestational sac. At the same time, modified-parenteral nutrition solution (containing glucose, amino acids and electrolytes) was injected into the amniotic sac of nearly half of the IUGR fetuses (IUGR-T group n = 106), whereas sham injections were performed in the rest of fetuses (IUGR group n = 118). A control group without IUGR induction but sham injection was also included (n = 115). Five days after the ligation procedure, a cesarean section was performed to evaluate fetal cardiac function, survival and birth weight.
Results
Survival was significantly improved in the IUGR fetuses that were treated with intra-amniotic nutritional supplementation as compared to non-treated IUGR animals (survival rate: controls 71% vs. IUGR 44% p = 0.003 and IUGR-T 63% vs. IUGR 44% p = 0.02), whereas, birth weight (controls mean 43g +/- SD 9 vs. IUGR 36g +/- SD 9 vs. IUGR-T 35g +/- SD 8, p = 0.001) and fetal cardiac function were similar among the IUGR groups.
Conclusion
Intra-amniotic injection of a modified-parenteral nutrient solution appears to be a promising therapy for reducing mortality among IUGR. These results provide an opportunity to develop new intra-amniotic nutritional strategies to reach the fetus by bypassing the placental insufficiency.

• 出版日期2018-2-21