The change of fetal heart rate short-term variability during the course of histological chorioamnionitis in fetal sheep

Kyozuka, Hyo; Yasuda, Syun; Hiraiwa, Tomoko; Nomura, Yasuhisa; Fujimori, Keiya

doi:10.1016/j.ejogrb.2018.06.015

Cited by 10 publications

(18 citation statements)

References 26 publications

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“…These results are biologically plausible because our previous animal study with an intrauterine in ammation pregnant sheep model proved that the histological in ammation directly caused metabolic acidosis, and not respiratory acidosis. 21 Previously, we have reported that labor UC and immature gestational age at delivery were related to hCAM in SPTB cases. 10 The reason why UC leads to intrauterine in ammation is still unclear.…”

Section: Discussionmentioning

confidence: 90%

Labor Dystocia and Risk of Histological Chorioamnionitis and Funisitis: A Study from a Single Tertiary Referral Center

Kyozuka

Murata

Fukuda

et al. 2020

Preprint

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Background: Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of labor dystocia in histological chorioamnionitis and funisitis has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis.Methods: In this retrospective cohort study, the patients who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was graded as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2.Result: Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9-20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7-21.8), funisitis (adjusted odds ratio, 9.4; 95% confidence interval, 1.8-48.2), and funisitis stage ≥2 (adjusted odds ratio, 23.5; 95% confidence interval, 2.3-23.8). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7-7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2-7.9), and funisitis (adjusted odds ratio, 4.5; 95% confidence interval, 1.2-16.8). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion: Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.

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Section: Discussionmentioning

confidence: 90%

Labor Dystocia and Risk of Histological Chorioamnionitis and Funisitis: A Study from a Single Tertiary Referral Center

Kyozuka

Murata

Fukuda

et al. 2020

Preprint

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“…Fetal response to mild hypoxia is initially protective. In addition, fetal response to moderate hypoxia involves substantial compensations via the autonomic (parasympathetic [vagus] and sympathetic [beta-adrenergic]) nervous system 20 - 23) . However, these compensatory mechanisms break down in the presence of severe asphyxia, and fetal brain damage can occur because central blood flow is not sufficiently maintained 24) .…”

Section: Discussionmentioning

confidence: 99%

First trimester heterotopic pregnancy with shock treated laparoscopically, followed by uneventful term pregnancy and normal birth

Nomura

Kyozuka

Jin

et al. 2021

FJMS

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Heterotopic pregnancy (HP), a coexistence of intrauterine and ectopic pregnancies, is extremely rare. Although there have been many reports of maternal outcomes in pregnant women with HP, they have not described fetal neurodevelopmental outcomes and survival. A 30 -yearold Japanese woman in early gestation who had undergone two previous cesarean deliveries was transferred to our hospital with vital signs of shock. HP was confirmed by ultrasonography and laparoscopic surgery, and right salpingectomy was performed. At term, a 2,875 g neonate was delivered via cesarean section without any complications.

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“…This could result in underestimation of the actual fetal condition, causing a delay in the management of the abnormal FHR pattern during labor [37]. Kyozuka et al [38] reported that development of severe acidosis in a fetus because of lipopolysaccharide induced intrauterine inflammation with an impaired FHR pattern indicates low oxygenation. Therefore, a scenario in which a high DII during pregnancy can increase the risk of fetal acidosis at birth is when the intrapartum FHR pattern is modified because of severe intrauterine inflammation with resultant delay in obstetric intervention on the basis of the FHR pattern.…”

Section: Discussionmentioning

confidence: 99%

Dietary Inflammatory Index during Pregnancy and the Risk of Intrapartum Fetal Asphyxia: The Japan Environment and Children’s Study

et al. 2020

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We aimed to examine the impact of a daily pro-inflammatory diet during pregnancy on intrapartum fetal acidemia using a large birth cohort study in Japan. We used data on singleton pregnancies in the Japan Environment and Children’s Study (JECS) involving births from 2011 to 2014 through vaginal delivery to calculate the maternal dietary inflammatory index (DII). Participants were categorized according to DII quintiles. A multiple logistic regression model was used to estimate the risk of a pro-inflammatory diet on fetal umbilical artery pH. In total, 56,490 participants were eligible for this study. Multiple regression analysis showed that nulliparous women who had undergone vaginal delivery and were consuming a pro-inflammatory diet had an increased risk of pH < 7.10 (adjusted odds ratio [aOR]: 1.64, 95% confidence interval [CI]: 1.12–2.39). Among these women, the risk of pH < 7.10 was not affected by the duration of labor (aOR: 1.64, 95% CI: 1.11–2.42). In conclusion, following a pro-inflammatory diet during pregnancy is a risk factor for fetal acidosis among nulliparous women undergoing vaginal delivery. A high DII diet during pregnancy may modify the intrapartum fetal heart rate pattern via intrauterine inflammation.

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The change of fetal heart rate short-term variability during the course of histological chorioamnionitis in fetal sheep

Abstract: Our study suggests that STV increased as the fetal condition deteriorated during the course of histological CAM.

Cited by 10 publications

References 26 publications

Labor Dystocia and Risk of Histological Chorioamnionitis and Funisitis: A Study from a Single Tertiary Referral Center

Labor Dystocia and Risk of Histological Chorioamnionitis and Funisitis: A Study from a Single Tertiary Referral Center

First trimester heterotopic pregnancy with shock treated laparoscopically, followed by uneventful term pregnancy and normal birth

Dietary Inflammatory Index during Pregnancy and the Risk of Intrapartum Fetal Asphyxia: The Japan Environment and Children’s Study

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