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[Maternal blood and amniotic fluid insulin-like growth factor detection and amniotic cavity drug delivery for early diagnosis and management of fetal growth restriction].

OBJECTIVE
To explore the relationship between insulin-like growth factors (IGFs) and fetal growth restriction (FGR) and early treatment of FGR.


METHODS
The levels of IGF-I and IGF-II were detected with radioimmunoassay in maternal blood and amniotic fluid samples of 44 pregnant women with FGR and 36 normal gravidas. The 44 gravidas with FGR were randomized into treatment group with amino acid by a pediatric administration to the amniotic cavity formula and control group with intravenous infusion of compound amino acid. The therapeutic effects were compared between the two groups on the basis of B-type ultrasound findings.


RESULTS
Maternal blood IGF-I and amniotic fluid IGF-I and IGF-II levels in the pregnant women with FGR were significantly lower than those in normal gravidas (P<0.01). After therapy, IGF-I and IGF-II levels were significantly increased in the treatment group (P<0.01), but no obvious changes in IGF-I and IGF-II levels were observed in the control group (P>0.05). Compared with the control group, IGF-I and IGF-II levels increased significantly in the amniotic fluid in the treatment group, with also marked elevation of IGF-I levels in maternal blood (P<0.01). Better therapeutic effects were achieved in the treatment group than in the control group (P<0.01), and the birth weights of the neonates in the treatment group were basically normal.


CONCLUSIONS
Detection of amniotic fluid IGF-I and IGF-II and maternal blood IGF-I can help predict the condition and facilitate early diagnosis of FGR. Injection of pediatric amino acid into the amniotic cavity can be effective for treatment of FGR.