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 post-mortem 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. Copyright

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doi.org/10.1159/000089055, hdl.handle.net/1765/31803
Fetal Diagnosis and Therapy
Erasmus MC: University Medical Center Rotterdam

Brandenburg, H, Bartelings, M.M, Wisse, L.J, Steegers-Theunissen, R.P.M, & Gittenberger-de Groot, A.C. (2005). Increased expression of vascular endothelial growth factor in cardiac structures of fetus with hydrops as compared to nonhydropic controls. Fetal Diagnosis and Therapy, 21(1), 84–91. doi:10.1159/000089055