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

• Published in: PloS one 2018-02, Vol.13 (2), p.e0193240-e0193240
• Main Authors: Gumus, Hatice Gulcin, Illa, Miriam, Pla, Laura, Zamora, Monica, Crispi, Fatima, Gratacos, Eduard
• Format: Article
• Language: English
• Subjects: Amino acids; Amnion; Animals; Biology and Life Sciences; Biomedical research; Birth weight; Catheters; Causes of; Cesarean section; Complications and side effects; Diet therapy; Dietary supplements; Disease Models, Animal; Female; Fetal growth retardation; Fetal Growth Retardation - pathology; Fetal Growth Retardation - physiopathology; Fetal Growth Retardation - therapy; Fetal malnutrition; Fetuses; Growth rate; Health risk assessment; Heart; Heart diseases; Hospitals; Infant mortality; Injection; Medicina prenatal; Medicine; Medicine and Health Sciences; Methods; Mortality; Nutrició; Nutrient solutions; Nutrients; Nutrition; Nutritional Support - instrumentation; Nutritional Support - methods; Parenteral nutrition; Placenta; Pregnancy; Prenatal development; Prenatal medicine; Prevention; Rabbits; Research and Analysis Methods; Risk factors; Studies; Survival; Therapy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0193240

To evaluate the perinatal effects of a prenatal therapy based on intra-amniotic nutritional supplementation in a rabbit model of intrauterine growth restriction (IUGR). 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. 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. 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.