CONGRESSO ISGE FIRENZE 2022
Abstract Title: THE ROLE OF A GLUTEN FREE DIET AND ANTIBIOTIC TREATMENT ON THE PREVENTION OF FETAL GROWTH RESTRICTION, PRETERM BIRTH, TO INCREASE THE PLACENTAL BLOOD FLOW.
Author(s)/Speaker: PELOTTI D (Speaker), FRATTINI G
Topic: 4.12 Pregnancy and lifestyle
Text: Context – In industrialized countries, about four-fifths of low birth-weight infants are born preterm and a fifth of these pre-term births are due to intrauterine growth restriction(IUGR).. The etiology of IUGR remains undetermined, but several risk factors for the conditions have been identified. Intrauterine growth restriction (IUGR) is defined as fetal growth less than the normal growth potential of a specific infant because of genetic or environmental factors. Various maternal, placental, neonatal, environmental and genetic factors are contributing to the preponderance of IUGR infants. Objective – In this review we would like to present the possible etiology related to maternal, fetal and placental causes; short term and long term neurodevelopmental outcomes, and evidence based preventive interventions effective in reducing the IUGR burden. The main aim of this study is to analyze that treatment with combined gluten free, low carb diet and antibiotic therapy increases the placental blood flow and particularly improves abnormal uterine artery doppler velocimetry in high risk pregnancy. Such pathological changes are considered to be responsible for very high utero-placental resistance, leading to blood flow insufficiency in pre-eclampsia or intrauterine growth retardation. It is possible that Gluten free diet and antibiotic administration could have a role on anticoagulant, vasomotor and inflammatory effects of the endothelium altered by the bacterial inflammation caused by celiac disease. Method - we examined one hundred and seventy pregnant patients afferent to our private practice starting from the 28th week of amenorrhea with umbilical artery flow Doppler alterations with PI values> 2 SD by gestational period, with fetuses affected by IUGR and without obvious maternal pathology. We subjected patients to antibiotic therapy with diaminocillin 1 gram tablets every 12 hours for 6-12 days and with low carb and gluten-free diet. We monitored patients: control of clinical and blood chemistry parameters, weekly ultrasound assessment of fetal growth and umbilical artery Doppler flowmetry. Results - The diet and the antibiotic therapy have determined a rapids resolution of the parameters already altered of the velocimetria Doppler and improve of fetal growth in all the patients in the following week to the therapy. Conclusion - the data above reported they propose the objective of a therapy of the IUGR in pregnancy to the goals of the prolongation of the pregnancy, necessary to reduce the connected risks to the fetal prematurity and the prospect of an outpatient IUGR management.