Hypoxia: Animal experiments and clinical implications

Kawagoe, Yasuyuki; Sameshima, Hiroshi

doi:10.1111/jog.13429

Cited by 6 publications

(8 citation statements)

References 36 publications

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“…These physiological and biochemical responses to UCO do represent a mild hypoxia response that may be unlikely to be severe enough to cause overt encephalopathy. Nonetheless, a mild hypoxic event does mimic some of the transient events that might occur during human pregnancies regardless of neonatal outcome (32).…”

Section: Discussionmentioning

confidence: 99%

The physiological effects of creatine supplementation in fetal sheep before, during, and after umbilical cord occlusion and global hypoxia

Tran

Muccini

Snow

et al. 2021

Journal of Applied Physiology

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The aim of this study was to investigate the effects of direct creatine infusion on fetal systemic metabolic and cardiovascular responses to mild acute in utero hypoxia. Pregnant ewes (n=28) were surgically instrumented at 118 days gestation (dGa). A constant intravenous infusion of creatine (6 mg.kg-1.h-1) or isovolumetric saline (1.5 ml.h-1) began at 121 dGa. After 10 days, fetuses were subjected to 10-minute umbilical cord occlusion (UCO) to induce mild global hypoxia (saline-UCO, n=8; creatine-UCO, n=7) or sham UCO (saline-control, n=6; creatine-control, n=7). Cardiovascular, arterial blood gases and metabolites, and plasma creatine were monitored prior to, during, and then for 72 hours following the UCO. Total creatine content in discrete fetal brain regions was also measured. Fetal creatine infusion increased plasma concentrations 5-fold but had no significant effects on any measurement pre-UCO. Creatine did not alter fetal physiology during the UCO or in the early recovery stage, up to 24 hours after UCO. During the late recovery stage, 24-72 hours after UCO, there was a significant reduction in the arterial oxygen pressure and saturation in creatine fetuses (PUCO x TREATMENT = 0.02 and 0.04, respectively). At 72 hours after UCO, significant creatine loading was detected in cortical grey matter, hippocampus, thalamus and striatum (PTREATMENT = 0.01-0.001). In the striatum, the UCO itself increased total creatine content (PUCO = 0.019). Overall, fetal creatine supplementation may alter oxygen flux following an acute hypoxic insult. Increasing total creatine content in the striatum may also be a fetal adaptation to acute oxygen deprivation.

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Section: Discussionmentioning

confidence: 99%

The physiological effects of creatine supplementation in fetal sheep before, during, and after umbilical cord occlusion and global hypoxia

Tran

Muccini

Snow

et al. 2021

Journal of Applied Physiology

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“…Extramedullary erythropoiesis results in increased numbers of nucleated RBCs (NRBCs) named erythroblasts in the peripheral blood [103, 104]. The increased mass of RBCs is associated with an increased capacity to transport oxygen and buffering capacity of the fetal blood, which are mediated by the increased hemoglobin level [105]. However, severe intrauterine hypoxia may also result in dysfunctional erythropoiesis with subsequent anemia [106].…”

Section: Fetal Hematological Responses To Chronic Hypoxiamentioning

confidence: 99%

Mechanisms of Fetal Adaptation to Chronic Hypoxia following Placental Insufficiency: A Review

Zegarra¹,

Dall’Asta

Ghi

2022

Fetal Diagn Ther

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Placental insufficiency is associated with reduced oxygen and nutrient supply to the fetus, which may result in fetal growth restriction (FGR). In an attempt to cope with the hostile intrauterine environment, FGR fetuses respond through metabolic, endocrine, vascular, cardiac, behavioral, hematological, and immunological adaptive mechanisms. However, permanent sequelae may result from such adaptive mechanisms. In this review, we describe the mechanisms of fetal adaptation to the hostile intrauterine environment in FGR of uteroplacental origin and detail their pathophysiology and potential implications for the extrauterine life of the individual.

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“…Due to these hypoxic events triggering the fetal sympathetic and parasympathetic nervous systems, variations in the fetal heart rate (FHR) can be monitored to detect signs of fetal compromise [ 8 , 10 , 11 ]. The primary source of FHR surveillance in the early half of the twentieth century was via the use of intermittent auscultation, and in the late 1960s, with the development of ultrasound technology, continuous cardiotocography (CTG) was introduced for fetal monitoring [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Computerised Cardiotocography Analysis for the Automated Detection of Fetal Compromise during Labour: A Review

Mendis,

Palaniswami,

Brownfoot

et al. 2023

Bioengineering

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The measurement and analysis of fetal heart rate (FHR) and uterine contraction (UC) patterns, known as cardiotocography (CTG), is a key technology for detecting fetal compromise during labour. This technology is commonly used by clinicians to make decisions on the mode of delivery to minimise adverse outcomes. A range of computerised CTG analysis techniques have been proposed to overcome the limitations of manual clinician interpretation. While these automated techniques can potentially improve patient outcomes, their adoption into clinical practice remains limited. This review provides an overview of current FHR and UC monitoring technologies, public and private CTG datasets, pre-processing steps, and classification algorithms used in automated approaches for fetal compromise detection. It aims to highlight challenges inhibiting the translation of automated CTG analysis methods from research to clinical application and provide recommendations to overcome them.

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Hypoxia: Animal experiments and clinical implications

Cited by 6 publications

References 36 publications

The physiological effects of creatine supplementation in fetal sheep before, during, and after umbilical cord occlusion and global hypoxia

The physiological effects of creatine supplementation in fetal sheep before, during, and after umbilical cord occlusion and global hypoxia

Mechanisms of Fetal Adaptation to Chronic Hypoxia following Placental Insufficiency: A Review

Computerised Cardiotocography Analysis for the Automated Detection of Fetal Compromise during Labour: A Review

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