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Fetal Hypoxia

In Utero Hypoxia


Presentation

  • CASE PRESENTATION: A male, white Caucasian, neonate showed a cutaneous rash at birth, suggestive of "blueberry muffin"-like lesions.[ncbi.nlm.nih.gov]
  • This report presents cord blood values of term Bolivian infants classified by altitude, ethnic group, and parity: 105 from La Paz (3600 m) and 46 from Santa Cruz (400 m).[ncbi.nlm.nih.gov]
  • This review gives an overview of the present knowledge in this field.[ncbi.nlm.nih.gov]
  • All groups presented abnormal CTG patterns and were comparable with regard to maternal age and parity. SETTING: The Fetal Surveillance Unit of the 2nd Department of Obstetrics and Gynecology, "Aretaieion" Hospital, Athens University, Greece.[ncbi.nlm.nih.gov]
  • The present study indicates that kininase I acts as a regulatory factor in bradykinin degradation.[ncbi.nlm.nih.gov]
Cerebral Palsy
  • More recently, materno-fetal infection has been implicated as a causative factor in cases of cerebral palsy associated with preterm and term birth.[ncbi.nlm.nih.gov]
  • Abstract AIMS: The development of fetal heart rate (FHR) variability and acceleration, and their loss in the hypoxic brain damage and cerebral palsy (CP) is investigated.[ncbi.nlm.nih.gov]
  • This is mainly because of consequences of fetal hypoxia that may lead to cerebral palsy. A fetus suffering from hypoxia initially compensates by producing energy through anaerobic metabolism.[ncbi.nlm.nih.gov]
  • Abstract Prenatal hypoxia-ischemia to the developing brain has been strongly implicated in the subsequent development of the hypertonic motor deficits of cerebral palsy (CP) in premature and full-term infants who present with neonatal encephalopathy.[ncbi.nlm.nih.gov]
Hunting
  • Follow-up assessment included growth measures, neurological examination, Bayley Scales of Infant Development, and a modified Uzgiris and Hunt Scale. Eight children (13%) had a major deficit and 10 children (16%) had a minor deficit at 1 year.[ncbi.nlm.nih.gov]
Papule
  • BACKGROUND: Neonatal blueberry muffin lesions are rare cutaneous eruptions, presenting as transient, non-blanching, red-violaceous papules, mostly localized in the trunk, head and neck, attributable to a marked dermal hematopoietic activity.[ncbi.nlm.nih.gov]
Fetal Disorder
  • Fetal outcomes were studied with actocardiograms of central nervous system lesion and common fetal disorders. The relation of hypoxic rabbit heart rate and PaO 2 were studied.[omicsonline.org]
Neonatal Seizures
  • When compared with intermittent auscultation of FHR, continuous electronic FHR monitoring is associated with a reduction in the risk of neonatal seizures at the expense of an increased risk of cesarean delivery9, Irrespective of the method used to analyze[ispub.com]
Cognitive Deficit
  • However, an episode of hypoxia in excess of 1 hour resulting in a metabolic acidosis of the order of 25 mEq/L will be followed by motor and cognitive deficits in approximately 50% of children.[ncbi.nlm.nih.gov]

Workup

  • Usually the diagnostic workup is initiated based on the risk factors of the pregnant mother and the presenting signs and symptoms.[xpertdox.com]
Decreased Oxygen Saturation
  • RESULTS: Umbilical artery Doppler revealed an initial increase in the RI and the PI in the presence of decreased oxygen saturation. The differences observed in Doppler velocity and impedance indices correlated with PO values.[ncbi.nlm.nih.gov]
Small For Gestational Age Fetus
  • Ultrasonic recognition of the small-for-gestational-age fetus. Obstet Gynecol . 1987;69:631–5. 13. Rutherford SE, Phelan JP, Smith CV, Jacobs N.[aafp.org]

Treatment

  • CONCLUSIONS: Maternal treatment with allopurinol during fetal hypoxia did not significantly lower neuronal damage markers in cord blood. Post hoc analysis revealed a potential beneficial treatment effect in girls.[ncbi.nlm.nih.gov]
  • Animal studies have suggested the possibility of prophylactic treatment to prevent neuronal loss after the hypoxic event. Intrapartum diagnostic tools should aim for detecting fetal hypoxemia/hypoxia when the fetus is still compensated.[ncbi.nlm.nih.gov]
  • Mild to severe instances of hypoxic-ischemia encephalopathy can know a 60 percent survival rate with lifelong treatments and monitoring necessary.[wisegeek.com]
  • Treatment with antioxidants of animal pregnancies complicated with reduced oxygen delivery to the fetus prevents the alterations in fetal growth, and the cardiovascular, metabolic and endocrine dysfunction in the fetal and adult offspring.[ncbi.nlm.nih.gov]
  • Maternal vitamin C (antioxidant) treatment can ameliorate fetal vasoconstriction in hypoxic pregnancies, and therefore has the potential to improve outcomes.[anzsnasm.com]

Prognosis

  • The presence of seizures indicates a poor prognosis, particularly as further brain damage will likely occur. Related wiseGEEK Articles[wisegeek.com]
  • One-minute Apgar score usually predicts immediate neonatal outcome of the baby, while 5-minute or later Apgar score is fairly predictive of future mental prognosis of such infant.[easymbbs.org]

Etiology

  • Abstract To investigate the hypothesis that chronic fetal hypoxia contributes to the etiology of sudden infant death syndrome (SIDS), a possible interaction between the effect of maternal cigarette smoking and low hematocrit during pregnancy on the risk[ncbi.nlm.nih.gov]
  • BACKGROUND: Cortical gray matter reductions and cerebrospinal fluid (CSF) increases are robust correlates of schizophrenia, but their relationships to obstetric and other etiologic risk factors remain to be established.[ncbi.nlm.nih.gov]
  • If myocardial depression is severe enough, late decelerations may be absent all together Etiologies of Late Decelerations Excessive uterine contractions Maternal hypotension Maternal hypoxemia (asthma, pneumonia) Reduced placental exchange as in: Hypertensive[perinatology.com]
  • PATHOLOGICAL DECREASE IN RATE OF GROWTH (ULTRASOUND B MODE) SOONER OR LATER GROWTH RESTRICTED FETUSES BECOME HYPOXEMIC,HYPOXIC AND ACIDOTIC (THIS CAN BE DIAGNOSED BY DOPPLER) FETAL ILLNESS IS RELATED TO FETAL,MATERNAL AND PLACENTAL CAUSES MOST FREQUENT ETIOLOGY[slideshare.net]

Epidemiology

  • OBJECTIVE: The authors examined in an epidemiologic sample the contributions of genetic predisposition and history of fetal hypoxia to hippocampal volume in patients with psychosis.[ncbi.nlm.nih.gov]
  • The epidemiology of molar pregnancy and choriocarcinoma. Clin Obstet Gynecol 1984; 27: 153. ‎ Pagina 773 - Pediatr 1989:115:105. 56. Boepple PA. Mansfield MJ. Link K. et al.[books.google.ro]
  • References: Fetal Distress: Diagnosis, Conditions & Treatment at Fetal Distress – Pathogenesis, Epidemiology, Presentation, Investigations, Management at Hofmeyr GJ, Lawrie TA (2012 Jan 18) Amnioinfusion for potential or suspected umbilical cord compression[medicalfoxx.com]
  • Epidemiology The overall risk of prompt caesarean delivery needed for fetal concern was shown to be 3.1% in an unselected population [ 1 ] .[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • “If there are more focus on pattern recognition and pathophysiology it all becomes more evident.”[neoventa.com]
  • Maeda K, Kimura S, Nakano H (1969) Studies on fetal pathophysiology. J Japan Soc Obstet Gynecol 21: 877-886. Sameshima H (2011) Fetal hypoxia – physiological approach. J Japan Soc Obstet Gynecol 63: 2054-2059.[omicsonline.org]
  • Clerici G, Luzietti R, Di Renzo G. " Monitoring of Antepartum and intrapartum fetal hypoxemia: pathophysiological basis and available techniques. "Biol Neonate, 2001; 246-253. 3. Bobrow C, Soothill P. "Causes and consequences of fetal acidosis."[ispub.com]
  • It will discuss the clinical consequences of intrauterine hypoxia and how to identify patients that present with placental pathophysiology.[dovepress.com]

Prevention

  • As severe organic fetal brain damage could develop through fetal hypoxia in the loss of variability, early delivery before the loss of variability will prevent infantile CP.[ncbi.nlm.nih.gov]
  • Animal studies have suggested the possibility of prophylactic treatment to prevent neuronal loss after the hypoxic event. Intrapartum diagnostic tools should aim for detecting fetal hypoxemia/hypoxia when the fetus is still compensated.[ncbi.nlm.nih.gov]
  • Collectively, this information could lead to the development of preventive diagnoses and therapeutic strategies in the fetal programming of cardiovascular and neurological disorders. Copyright 2011 Elsevier Ltd. All rights reserved.[ncbi.nlm.nih.gov]
  • Treatment with antioxidants of animal pregnancies complicated with reduced oxygen delivery to the fetus prevents the alterations in fetal growth, and the cardiovascular, metabolic and endocrine dysfunction in the fetal and adult offspring.[ncbi.nlm.nih.gov]

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