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Vol. 21, No. 1, 2006
Issue release date: December 2005
Fetal Diagn Ther 2006;21:84–91

Increased Expression of Vascular Endothelial Growth Factor in Cardiac Structures of Fetus with Hydrops as Compared to Nonhydropic Controls

Brandenburg H. · Bartelings M.M. · Wisse L.J. · Steegers E.A.P. · Gittenberger-de Groot A.C.
aDepartment of Obstetrics and Gynecology, Erasmus Medical Center, University of Rotterdam, Rotterdam, and bDepartment of Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands

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Objective: The hypothesis that severe fetal hydrops is caused by an excess of vascular endothelial growth factor (VEGF), mainly produced in the fetal heart, is tested. Methods: Immunohistochemical VEGF-stained postmortem biopsies from the right ventricle and right atrium of 8 hydropic fetuses were compared to those of 8 nonhydropic fetuses. The endocardium, myocardium, epicardium, endothelium, and vascular smooth muscle cells were scored on intensity of VEGF-staining. The Mann-Witney test was used to test for significancy (p < 0.05) of the differences in staining. Increased vascularization as a result of VEGF was measured in both groups by standard randomization count. Results: The endocardium, epicardium and endothelium of the coronary vessels showed significantly (p < 0.05) more intense VEGF-staining in the hydrops group than in the control group. The atria showed more intense staining than the ventricles in both groups. The hydropic fetuses showed a significantly increased number of coronary vessels in the myocardium. These vessels contained more blood cells than the coronary vessels in nonhydropic fetuses. Conclusion: The fetal heart appears to be a major source of excess VEGF in fetal hydrops.

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