An Experimental Study: The Effect Of Administration By Amniocentesis In Treatment For Hypoxia Fetus Rats In Intrahepatic Cholestasis Of Pregnancy

Objective: To explore the effect of administration by amniocentesis in treatment of hypoxia fetus rats in intrahepatic cholestasis of pregnancy (ICP) .Methods: 40 SD pregnant rats of 15 days of pregnancy were randomly divided into four groups:intrauterine administration of SAMe (IUS),intrauterine administration of Sodium Chloride (IUN) , intravenous administration of SAMe (IVS) and blank control (IC). There are ten pregnant rats in every group. On 15th day of pregnancy, ICP rat models were set up with Estradiol Benzoate (EB, 2.5mg·kg-1·d-1). On 17th day of pregnancy,SAMe ware injected into amniotic cavity of group one (IUS) through amniocentasis,while same volume of saline were administrated the same way in group two (IUN). At the same time,SAMe were injected though tail veins in group three (IVS). No treatment had to be done in group four as control (IC). On 20th day of pregnancy (the third day after administration) , all rats of each group were killed. The rate of meconium-stained amniotic fluid and the still birth rate were calculated. The serum level of ALT, AST, ALP, TBA ,TBIL, DBIL were measured . Total bile acid (TBA) level in amniotic fluid was examed. After delivery, the placenta of pregnant rats were taken for histological analysis with light microscope by HE staining; some physiological indexs of the fetal rats has been measured. The protein expression of ET-1 and HIF-1αin the placenta were determined by immunohistochemistry. The mRNA expression of HIF-1αin the placenta were examined by reverse transcription PCR.Results: The rate of meconium-stained amniotic fluid and the still birth rates after administration through amniocentesis were lower in IUS and IUN than IVS and IC(P<0.05); There were no significance (P>0.05) in the serum level of ALT, AST, ALP, TBA, TBIL, DBIL and the development of fetal rats between IUS, IUN,IVS and IC; Compared with IVS and IC, IUS and IUN showed low level of TBA in Amniotic fluid (P<0.01); Pathohistological examination under microscope showed placental villus swelling, narrowed intervillous space , trophocyte hyperplasia and necrosis; The protein of ET-1 in placenta expressed much lower in IUS and IUN than IVS and IC (P<0.01);The protein and mRNA expressions of HIF-1αin placenta were significantly lower in IUS and IUN than IVS and IC (P<0.01).Conclusions: SAMe and Sodium Chloride administrating with a single by amniocentesis is effective for treating hypoxia status of fetus in ICP SD rats without a rising of still birth rate, which can decrease the level of TBA in amniotic fluid more effectively, reduce the expression of ET-1 and HIF-1αin placenta, and release hypoxia status of placenta, so as to reduce the risk of meconium-stained amniotic fluid and fetal death.