نسبة عامل النمو (1) الشبية بالأنسولين فى مصل الحبل السرى ومصل الأمهات فى الحمل الطبيعى وحمل ما قبل التشنج الحملى

                "UMBILICAL CORD SERUM AND MATERNAL SERUM INSULIN LIKE GROWTH FACTOR I IN UNCOMPLICATED PREGNANCY AND IN PREGNANCY COMPLICATED BY "Huda Ragab Awaad PREECLAMPSIA

                                                "The aim of this work is to determine IGF-I level in patients with preeclampsia compared with healthy pregnant control subjects and determine whether IGF-I can be used as a predictor of newborn birth weight in preeclampsia and normotensive pregnancies from the relation between maternal and umbilical cord serum IGF-I levels.

The present study was conducted on 80 pregnant women at delivery and their neoborns for the period from September 2005 to February 2006 at Ain Shams University, Maternity Hospital and laboratory analysis was done at Medical Research Centre, Ain Shams University.

There were 60 pregnant women with preeclampsia (14 of them had mild PE and 46 had severe PE) and 20 pregnant normotensive women as control subjects.

All the pregnant women were completed 34 weeks to 42 weeks gestation, singleton pregnancies, non smokers, and without structural congenital anomalies. Cases with twins and diabetes with pregnancy were excluded.

All pregnant women were subjected to: complete history taking, full clinical examination (general, abdominal, and vaginal), complete urine analysis, estimation of blood glucose, estimation of IGF-I levels(by sampling immediately at admission then centrifuged and stored at -20 till analysis).

All neonates were subjected to estimation of cord blood IGF-I levels (by sampling of umbilical cord immediately at delivery then centrifuged and stored at -20 till analysis), full examination of neonates as regarding fetal weight, length, and APGAR scoring and the results were correlated to cord IGF-I levels.

This study revealed a statistically highly significant difference between preeclampsia cases and controls as regards (fetal weight, fetal length, and placental weight), and a statistically significant difference between cases and controls as regards (APGAR 1 minute, and APGAR 5 minute) which are more better among controls.

The study revealed that maternal IGF-I levels were higher among controls than PE cases with a statistically highly significant difference in between, and between controls and severe PE cases there was a statistically highly significant difference in between, and a statistically significant difference between mild PE cases and controls. On the other hand the study revealed no statistically significant difference in maternal IGF-I between severe and mild PE cases.

The study revealed that fetal IGF-I levels showed no statistically significant difference between PE cases and controls, neither between mild and severe PE cases, neither between mild or severe PE and controls.

The study revealed that maternal IGF-I levels showed a statistically significant inverse correlation with birth weight but not statistically significant for fetal length. Also the study found the best cut off value for maternal IGF-I, which is 280 ng/ml below this value it can predict poor outcome or low birth weight among PE cases.

The study revealed that maternal IGF-I levels showed no statistically significant difference as regards fetal gender (male or female), or mode of delivery (CS or vaginal), or placental weight, or APGAR 1 min., or APGAR 5 min, or SBP, or DBP, gestational age, or parity.

This study revealed that fetal IGF-I levels showed a statistically significant inverse correlation with birth weight and length, and found out the best cut off value for fetal IGF-I, which is 90 ng/ml above this value it can predict poor outcome or low birth weight among PE cases.

The study revealed a statistically significant positive correlation between maternal IGF-I and fetal IGF-I among preeclampsia cases.

Also, the study showed that female fetuses had a higher levels of fetal IGF-I compared to males with a statistically significant difference in between, also showed that fetuses delivered by CS had higher levels of fetal IGF-I levels compared to fetuses delivered vaginally with a statistically significant difference in between.

The study revealed a statistically significant positive correlation between fetal IGF-I and gestational age, diastolic blood pressure. And statistically significant inverse correlation between fetal IGF-I and APGAR 5 min. On the other hand fetal IGF-I showed no statistically significant correlation with parity, systolic blood pressure, APGAR 1 min., placental weight.

This study concluded that maternal IGF-I in PE cases are lower than normotensive controls. Maternal serum IGF-I levels are inversely correlated with birth weight, and positively correlated with umbilical cord IGF-I, the best cut off value for maternal IGF-I is 280 ng/ml below this value it can predict low birth weight among PE cases..

Also the study concluded that umbilical cord serum IGF-I (fetal IGF-I) levels were inversely correlated with birth weight and length."