MATERNAL AND FETAL ERYTHROPOIETIN - PHYSIOLOGICAL-ASPECTS AND CLINICAL-SIGNIFICANCE

Erythropoietin (EPO) is of special interest in the perinatal period in the mother and fetus. On the one hand, thanks to the recent developme nt of highly sensitive radio-immunoassays and the ability to monitor e ndogenous EPO production, we can now study the physiological aspects o f maternal and fetal erythropoiesis and materno-fetal interrelations, and diagnose raised EPO levels as markers of oxygen deficiency. On the other hand, the availability of recombinant human EPO (rHuEPO) permit s therapeutic intervention against anaemia during and after pregnancy. This paper reviews available studies showing a rise in maternal and f etal EPO levels in parallel with gestational age and, in certain patho logical states of pregnancy, grossly raised EPO levels in amniotic flu id and fetal blood entirely unrelated to maternal values. The theoreti cal and experimental arguments against transplacental passage of EPO i n the human are discussed. Initial results with rHuEPO have shown rapi d correction of maternal post-partum anaemia. No studies on its use du ring pregnancy are available to date.