Die intrauterine Wachstumsretardierung - Perinatale Mortalität und postnatale Morbidität an einem Perinatalzentrum1

Meyberg, R; Boos, R.; Babajan, A.; Ertan, A. K.; Schmidt, Werner

doi:10.1055/s-2000-9581

Cited by 23 publications

(11 citation statements)

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“…The incidence of prematurity varies from 14 to 83%, as compared to 5-15% in the general population. Low BW occurs in 19-67% of neonates, as compared to 5-13% in the general population in developed countries [14,15] (see table 1 for details). Therefore, morbidity is increased, with an average hospitalization time in the neonatal intensive care unit of 35.2 B 16.2 days in the study of Bar et al [13].…”

Section: Prematurity Iugr Low Bw (! 2500 G)mentioning

confidence: 99%

In utero Exposure to Immunosuppressive Drugs

Prévot

Martini

Guignard³

2002

Neonatology

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The number of pregnant women receiving immunosuppressants for anti-rejection therapy or autoimmune diseases is increasing. All immunosuppressive drugs cross the placenta, raising questions about the long-term outcome of the children exposed in utero. There is no higher risk of congenital anomalies. However, an increased incidence of prematurity, intrauterine growth retardation (IUGR) and generally low birth weight has been reported, as well as maternal hypertension and preeclampsia. The most frequent neonatal complications are those associated with prematurity and IUGR, as well as adrenal insufficiency with corticosteroids, immunological disturbances with azathioprine and cyclosporine, and hyperkalemia with tacrolimus. The long-term follow-up of infants exposed to immunosuppressants in utero is still limited and experimental studies raise the question whether there could be an increased incidence at adult age of some pathologies including renal insufficiency, hypertension and diabetes.

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Section: Prematurity Iugr Low Bw (! 2500 G)mentioning

confidence: 99%

In utero Exposure to Immunosuppressive Drugs

Prévot

Martini

Guignard³

2002

Neonatology

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“…Blood pH, PCO 2 , and PO 2 were measured with a blood gas analyzer (model ABL50, Radiometer, Copenhagen, Denmark), and blood Hb and oxygen saturation were measured using a hemoximeter (model OSM2, Radiometer) and corrected to the body temperature of the animal at the time of sampling.…”

mentioning

confidence: 99%

Intrauterine Growth Restriction Ameliorates the Effects of Gradual Hemorrhagic Hypotension on Regional Cerebral Blood Flow and Brain Oxygen Uptake in Newborn Piglets

et al. 2004

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Data are scant regarding the development of cerebrovascular autoregulation in intrauterine growth-restricted (IUGR) newborns. We tested the hypothesis that IUGR improves the ability of neonates to withstand critical periods of gradual hemorrhagic hypotension by optimizing cerebrovascular autoregulation. Studies were conducted on 1-d-old anesthetized piglets divided into groups of normal weight (NW, n ϭ 14, body weight ϭ 1518 Ϯ 122 g) and IUGR (n ϭ 14, body weight ϭ 829 Ϯ 50 g) animals. Physiologic parameters, including regional cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO 2 ), were similar in NW and IUGR piglets under baseline conditions. Controlled arterial blood loss [hemorrhagic hypotension (HH)] induced a stepwise reduction of the mean arterial blood pressure of 49 Ϯ 3 mm Hg (mild HH), 39 Ϯ 3 mm Hg (moderate HH), and 30 Ϯ 3 mm Hg (severe HH) in seven NW and seven IUGR piglets (p Ͻ 0.05). In NW piglets, cortical CBF and CMRO 2 was reduced already at moderate HH (p Ͻ 0.05). A similar CMRO 2 reduction occurred during severe HH in NW and IUGR piglets (p Ͻ 0.05). In addition, during mild and moderate HH, primarily in IUGR piglets, an increase in regional CBF of brainstem, cerebellum, and thalamus was shown compared with baseline values (p Ͻ 0.05). Furthermore, under these conditions, cerebral cortex blood flow was maintained in newborn IUGR animals. In contrast, NW piglets exhibited a significant reduction in CBF (p Ͻ 0.05) during moderate HH. Thus, IUGR resulted in an improved ability to withstand critical periods of gradual oxygen deficit as shown by improved cerebrovascular autoregulation during hemorrhagic hypotension. Asymmetric IUGR (type II) is still an unresolved problem in perinatal medicine. Perinatal mortality is markedly increased (1-3), as well as the incidence of perinatal asphyxia, because placental insufficiency is the main cause of IUGR (4).The perinatal morbidity and mortality of neonates after IUGR is mainly caused by postasphyxial encephalopathy (4). The most dangerous complication is brain injury secondary to hypoxic-ischemic disease, which is the predominant form of all brain injuries encountered in the perinatal period (5). Periods of arterial hypotension are frequently involved in the initial period of acute perinatal asphyxia (6). Cerebrovascular autoregulation protects against brain hypoperfusion, provided arterial pressure does not fall below the lower limit of the autoregulatory range. The efficiency of autoregulation to prevent hypoperfusion generally improves with increasing fetal age and maturity of the brain (7-9). This implies that the immature brain is susceptible to ischemia during hypotension (10). Therefore, poor autoregulation may place the immature brain at risk for injury (11,12).The slow down of fetal growth late in gestation after intrauterine malnutrition, although resulting in IUGR, can be regarded as a compensatory process, which enables the fetus to survive (13,14). Growth reduction is primarily achieved by altering the endocrine milieu, possi...

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“…lntroduction Intrauterine growth retardation (IUGR) is a common problem in obstetrics (5 ± 15 %) [1]. Perinatal mortality is 4 ± 8 times higher in children with IUGR than in normal children [1].…”

Section: Fmri´bold´schaf Fetus´akute Hypoxie´sauerstoffsättigungmentioning

confidence: 99%

“…Perinatal mortality is 4 ± 8 times higher in children with IUGR than in normal children [1]. Although uteroplacental insufficiency is the pathogenic mechanism that most frequently causes IUGR [2], other possible causes without a significant increase in perinatal mortality and morbidity like the constitutionally small fetus [3] or cases in which the data of the last menstrual cycle are not available or incorrect [4] should be excluded.…”

Section: Fmri´bold´schaf Fetus´akute Hypoxie´sauerstoffsättigungmentioning

confidence: 99%

Functional magnetic resonance imaging (fMRI) for fetal oxygenation during maternal hypoxia: initial results

Wedegärtner¹,

Tchirikov²,

Koch³

et al. 2002

Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr

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Die intrauterine Wachstumsretardierung - Perinatale Mortalität und postnatale Morbidität an einem Perinatalzentrum1

Abstract: Children with IUGR are exposed to high perinatal mortality and postnatal morbidity. Premature babies in association with an IUGR are at high risk. The surveillance of the pregnant women and the new-born children should be performed in a perinatal centre.

Cited by 23 publications

References 0 publications

In utero Exposure to Immunosuppressive Drugs

In utero Exposure to Immunosuppressive Drugs

Intrauterine Growth Restriction Ameliorates the Effects of Gradual Hemorrhagic Hypotension on Regional Cerebral Blood Flow and Brain Oxygen Uptake in Newborn Piglets

Functional magnetic resonance imaging (fMRI) for fetal oxygenation during maternal hypoxia: initial results

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