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Fetal Hypoxia

In Utero Hypoxia


Presentation

  • We report for the first time an unusual presentation of blueberry muffin lesions in a neonate born from a mother affected by severe anemia during pregnancy.[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]
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]
Intravenous Drugs
  • Drug: Allopurinol sodium Allopurinol sodium 500 mg / 50 mL, intravenously, single dose Other Name: Acepurin Placebo Comparator: Placebo 500 mg mannitol/50 mL water for injection intravenously Drug: Mannitol Mannitol 500 mg/50 mL water for injection,[clinicaltrials.gov]
Thrombosis
  • Lesions associated with circulatory stasis and thrombosis, including villous capillary congestion (VC), umbilical vessel distension (UVD), chorionic plate vessel distension (CPD), umbilical vessel thrombosis (UVT), fetal vascular thrombosis (FVT), intimal[ncbi.nlm.nih.gov]
  • Fetal hypoxia can occur from a number of reasons: umbilical cord prolapse cord occlusion or cord thrombosis placental infarction maternal smoking intrauterine growth restriction (IUGR) : can also be a consequence Three categories are proposed for the[radiopaedia.org]
Eruptions
  • 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]
Papule
  • 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]
Hydrops Fetalis
  • fetalis O36.3 - Maternal care for signs of fetal hypoxia O36.4 - Maternal care for intrauterine death O36.5 - Maternal care for poor fetal growth O36.6 - Maternal care for excessive fetal growth O36.7 - Maternal care for viable fetus in abdominal pregnancy[icd-code.org]
Neonatal Seizures
  • However, this current strategy fails to recognize as many as 85% of growth restricted fetuses and although intrapartum monitoring has reduced the incidence of neonatal seizures, the rates of cerebral palsy and neonatal death have not decreased since its[journals.plos.org]
  • 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]
Motor Disturbances
  • Despite the enormous impact of CP, there is no animal model that reproduces the hypertonia and motor disturbances of this disorder.[ncbi.nlm.nih.gov]
Ataxia
  • Terminally the tissue may be irreparably damaged. anemic hypoxia due to inadequate supply of hemoglobin in the blood. cerebral hypoxia may be acute or chronic causing either a tremor-convulsion syndrome or one of longer term weakness, ataxia, apparent[medical-dictionary.thefreedictionary.com]

Workup

  • Usually the diagnostic workup is initiated based on the risk factors of the pregnant mother and the presenting signs and symptoms.[xpertdox.com]
Base Deficit
  • There were poor correlations between hypoxanthine concentrations and those of hydrogen ion, base deficit and lactate.[ncbi.nlm.nih.gov]
  • If there is a base deficit of 12 mmol/L or above, this suggests metabolic acidosis.[abclawcenters.com]
Cardiac Output Decreased
  • Moreover, in experimental animals during steady state hypoxia, several cardiovascular parameters are affected (heart rate/cardiac output decreases and blood pressure increases) while placental flow don't show a significant variation thus suggesting a[ncbi.nlm.nih.gov]
  • REFLEX REDISTRIBUTION OF FETAL CARDIAC OUTPUT DECREASED FLOW INCREASED FLOW KIDNEYS (OLIGURIA)  BRAIN (OLIGOAMNIOS) LUNGS (RDS)  HEART GUT (NEC) LIVER/MUSCLE (IUGR) BODY FAT/  ADRENALS GLYCOGEN STORES 18.[slideshare.net]

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]
  • Mild to severe instances of hypoxic-ischemia encephalopathy can know a 60 percent survival rate with lifelong treatments and monitoring necessary.[wisegeek.com]
  • 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.[journals.lww.com]

Prognosis

  • The presence of seizures indicates a poor prognosis, particularly as further brain damage will likely occur. Related wiseGEEK Articles[wisegeek.com]
  • In this population, the prematurity and impairment of the placental area proved to have a key role in the prognosis of survival of the newborn.[scielo.br]
  • 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]
  • Treatment options and prognosis As mentioned, the majority of brachial plexus injuries will resolve spontaneously over the course of several months to a year.[shoulderdystociainfo.com]
  • The exciting discovery that microRNAs circulate in the blood and may reflect gene expression in a distant tumour, has led to enthusiasm for the role of circulating miRs as biomarkers for cancer detection and prognosis [8].[journals.plos.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]
  • However, a recent meta-analysis concluded it is premature to implicate specific pregnancy complications in etiology of ASD[ 12 ].[bmcmedresmethodol.biomedcentral.com]
  • 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]

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]
  • Epidemiology. 2001, 12: 291-294. 10.1097/00001648-200105000-00005.[bmcmedresmethodol.biomedcentral.com]
  • 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]
  • 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]
  • While a sense of the degree and type of injury can be estimated by physical exam and clinical observation of the baby’s movement limitations, the true extent of brachial plexus injuries and the specific pathophysiology involved can only be definitively[shoulderdystociainfo.com]
  • It will discuss the clinical consequences of intrauterine hypoxia and how to identify patients that present with placental pathophysiology.[dovepress.com]

Prevention

  • 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]

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