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Restrained cerebral hyperperfusion in response to superimposed acute hypoxemia in growth-restricted human fetuses with established brain-sparing blood flow.

Fu, Jing LU and Olofsson, Per LU (2006) In Early Human Development 82(Dec 1). p.211-216
Abstract
Objective: To investigate the cerebral circulatory response to superimposed acute hypoxemia in growth-restricted fetuses with established brain-sparing flow (BSF) during basal conditions. Material and methods: 76 term fetuses suspected of growth restriction were exposed to Doppler velocimetry in the umbitical artery (UA) and middle cerebral artery (MCA), and in 38-39 cases also in Galen's vein (GV), straight sinus (SS), and transverse sinus (TS), before and during an oxytocin challenge test (OCT), and simultaneous to electronic fetal heart rate monitoring. Nonparametric statistical analyses compared presence/absence of established BSF (MCA-to-UA pulsatility index [PI] ratio < 1.08) with a two-tailed P < 0.05 considered significant.... (More)
Objective: To investigate the cerebral circulatory response to superimposed acute hypoxemia in growth-restricted fetuses with established brain-sparing flow (BSF) during basal conditions. Material and methods: 76 term fetuses suspected of growth restriction were exposed to Doppler velocimetry in the umbitical artery (UA) and middle cerebral artery (MCA), and in 38-39 cases also in Galen's vein (GV), straight sinus (SS), and transverse sinus (TS), before and during an oxytocin challenge test (OCT), and simultaneous to electronic fetal heart rate monitoring. Nonparametric statistical analyses compared presence/absence of established BSF (MCA-to-UA pulsatility index [PI] ratio < 1.08) with a two-tailed P < 0.05 considered significant. Results: The OCT (positive/negative) was not different in the BSF group (BSFG, N = 16) and the normal flow group (NFG, N=60) (P=0.2). During uterine contractions, the MCA PI decreased in the NFG, but not in the BSFG. De novo GV pulsations and increase of GV maximum flow velocity occurred during contractions in the NFG, but not in the BSFG. Significant SS flow velocity waveform changes were found in neither group and TS flow changes in the BSFG only. Conclusions: Fetuses without established brain-sparing flow during basal conditions responded with both arterial and venous brain-sparing flow during acute hypoxemia, whereas in fetuses with established brain-sparing flow the cerebral circulatory responses were absent or equivocal. Fetuses with established brain-sparing flow may have a limited capacity of further cerebral hyperperfusion during superimposed acute hypoxic stress. (c) 2005 Elsevier Ireland Ltd. All rights reserved. (Less)
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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
blood flow, contraction, pregnancy, Doppler, oxytocin, uterine, venous, brain-sparing
in
Early Human Development
volume
82
issue
Dec 1
pages
211 - 216
publisher
Elsevier
external identifiers
  • pmid:16326048
  • wos:000236771500009
  • scopus:33645004186
ISSN
1872-6232
DOI
10.1016/j.earlhumdev.2005.09.009
language
English
LU publication?
yes
id
ada7366e-1ea1-48c2-a196-9e7db6db9270 (old id 148956)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16326048&dopt=Abstract
date added to LUP
2016-04-01 15:58:35
date last changed
2021-05-25 04:51:17
@article{ada7366e-1ea1-48c2-a196-9e7db6db9270,
  abstract     = {Objective: To investigate the cerebral circulatory response to superimposed acute hypoxemia in growth-restricted fetuses with established brain-sparing flow (BSF) during basal conditions. Material and methods: 76 term fetuses suspected of growth restriction were exposed to Doppler velocimetry in the umbitical artery (UA) and middle cerebral artery (MCA), and in 38-39 cases also in Galen's vein (GV), straight sinus (SS), and transverse sinus (TS), before and during an oxytocin challenge test (OCT), and simultaneous to electronic fetal heart rate monitoring. Nonparametric statistical analyses compared presence/absence of established BSF (MCA-to-UA pulsatility index [PI] ratio &lt; 1.08) with a two-tailed P &lt; 0.05 considered significant. Results: The OCT (positive/negative) was not different in the BSF group (BSFG, N = 16) and the normal flow group (NFG, N=60) (P=0.2). During uterine contractions, the MCA PI decreased in the NFG, but not in the BSFG. De novo GV pulsations and increase of GV maximum flow velocity occurred during contractions in the NFG, but not in the BSFG. Significant SS flow velocity waveform changes were found in neither group and TS flow changes in the BSFG only. Conclusions: Fetuses without established brain-sparing flow during basal conditions responded with both arterial and venous brain-sparing flow during acute hypoxemia, whereas in fetuses with established brain-sparing flow the cerebral circulatory responses were absent or equivocal. Fetuses with established brain-sparing flow may have a limited capacity of further cerebral hyperperfusion during superimposed acute hypoxic stress. (c) 2005 Elsevier Ireland Ltd. All rights reserved.},
  author       = {Fu, Jing and Olofsson, Per},
  issn         = {1872-6232},
  language     = {eng},
  number       = {Dec 1},
  pages        = {211--216},
  publisher    = {Elsevier},
  series       = {Early Human Development},
  title        = {Restrained cerebral hyperperfusion in response to superimposed acute hypoxemia in growth-restricted human fetuses with established brain-sparing blood flow.},
  url          = {https://lup.lub.lu.se/search/ws/files/4531361/625190.pdf},
  doi          = {10.1016/j.earlhumdev.2005.09.009},
  volume       = {82},
  year         = {2006},
}