June 20th, 2018

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A Note from the Editor-in-Chief
Authors:  L. D. Devoe, M.D.
  Welcome to the September-October 2012 Editor-in-Chief’s page. We return to our standard format of focusing on several articles in this issue that will be of potential interest to obstetricians and gynecologists.

In This Issue:

• Assessment of Vascular Endothelial Growth Factor, Basic Fibroblast Growth Factor, and Transforming Growth Factor Levels in Amniotic Fluid
M. A. Bedaiwy, J. M. Burlingame, M. Hussein, R. Flyckt, R. Assad, and T. Falcone

Responses to in utero stress are only capable of being measured antenatally by indirect and often crude methods such as estimated ultrasonographic growth trends, targeted Doppler velocimetry of the fetal vasculature system, and biophysical testing. While these tools are used in standard fetal surveillance, they are not specific markers of placental adaptation to stress and may be confounded by other environmental factors. Bedaiwy and colleagues have undertaken an exploratory analysis of amniotic fluid polypeptide growth factors, specifically VEGF, bFGF, and TGF-b2. While their study group is small and is distributed over second and third trimesters, their finding that pregnancies complicated by maternal tobacco abuse showed a statistically significant association with elevated amniotic fluid VEGF may be a biologically plausible relationship since it is known that smoking affects placental growth and senescence, contributing to subnormal fetal growth, placental abruption, and prematurity. Could VEGF be a clinically useful marker for pregnancy complications in this setting? It is too soon to say with any certainty, but these findings should stimulate more investigations in this area.
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