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Acute centralization of blood flow in compromised human fetuses evoked by uterine contractions.

Li, Hui ; Gudmundsson, Saemundur LU and Olofsson, Per LU (2006) In Early Human Development 82(11). p.747-752
Abstract
Background: During fetal hypoxia blood is redistributed to the brain ('brain-sparing'). Sequential changes of the cerebral and placental circulation in parallel in comparisons between basal conditions and acute hypoxic stress have not yet been thoroughly studied in human fetuses. Aim: To explore acute fetal middle cerebral artery (MCA) circulatory changes relative to umbilical artery (UA) blood flow in a clinical experimental model with hypoxic stress provoked by uterine contractions during an oxytocin challenge test (OCT). Study design: Prospective comparative between imminently compromised (OCT positive) and un-compromised (OCT negative) fetuses. Subjects and methods: 82 term pregnancies suspected of intrauterine growth restriction were... (More)
Background: During fetal hypoxia blood is redistributed to the brain ('brain-sparing'). Sequential changes of the cerebral and placental circulation in parallel in comparisons between basal conditions and acute hypoxic stress have not yet been thoroughly studied in human fetuses. Aim: To explore acute fetal middle cerebral artery (MCA) circulatory changes relative to umbilical artery (UA) blood flow in a clinical experimental model with hypoxic stress provoked by uterine contractions during an oxytocin challenge test (OCT). Study design: Prospective comparative between imminently compromised (OCT positive) and un-compromised (OCT negative) fetuses. Subjects and methods: 82 term pregnancies suspected of intrauterine growth restriction were exposed to simultaneous electronic fetal heart rate monitoring and Doppler recordings of pulsatility index (PI) in the UA and MCA during basal conditions and during uterine contractions and relaxations at an OCT. Outcome measures: Sequential changes of UA and MCA PI, OCT positive vs. negative cases. Nonparametric statistics with a P < 0.05 considered significant. Results: The UA PI was significantly higher in OCT positive cases (N=10) compared with OCT negative cases (N=72) during uterine contractions and relaxations, but not during basal measurements. During contractions and relaxations the MCA PI decreased significantly in both groups (brain-sparing), but significantly more in OCT positive cases. Conclusions: During acute hypoxic stress, changes towards a centralization of blood flow to the brain develop in imminently compromised (OCT positive) fetuses at an expense of the umbilicoplacental. blood flow, and the brain-sparing flow is more pronounced than in uncompromised (OCT negative) fetuses. (Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
index, pulsatility, pregnancy, cerebral, middle cerebral artery, umbilical, Doppler
in
Early Human Development
volume
82
issue
11
pages
747 - 752
publisher
Elsevier
external identifiers
  • wos:000242232400007
  • scopus:33750369372
ISSN
1872-6232
DOI
10.1016/j.earlhumdev.2006.03.011
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Research Unit for Urogynaecology and Reproductive Pharmacology (013242710), Pediatrics/Urology/Gynecology/Endocrinology (013240400)
id
0da6bc27-3211-4b56-9055-bd2a04fb6661 (old id 156974)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16678364&dopt=Abstract
date added to LUP
2016-04-01 15:49:34
date last changed
2021-09-29 05:20:46
@article{0da6bc27-3211-4b56-9055-bd2a04fb6661,
  abstract     = {Background: During fetal hypoxia blood is redistributed to the brain ('brain-sparing'). Sequential changes of the cerebral and placental circulation in parallel in comparisons between basal conditions and acute hypoxic stress have not yet been thoroughly studied in human fetuses. Aim: To explore acute fetal middle cerebral artery (MCA) circulatory changes relative to umbilical artery (UA) blood flow in a clinical experimental model with hypoxic stress provoked by uterine contractions during an oxytocin challenge test (OCT). Study design: Prospective comparative between imminently compromised (OCT positive) and un-compromised (OCT negative) fetuses. Subjects and methods: 82 term pregnancies suspected of intrauterine growth restriction were exposed to simultaneous electronic fetal heart rate monitoring and Doppler recordings of pulsatility index (PI) in the UA and MCA during basal conditions and during uterine contractions and relaxations at an OCT. Outcome measures: Sequential changes of UA and MCA PI, OCT positive vs. negative cases. Nonparametric statistics with a P &lt; 0.05 considered significant. Results: The UA PI was significantly higher in OCT positive cases (N=10) compared with OCT negative cases (N=72) during uterine contractions and relaxations, but not during basal measurements. During contractions and relaxations the MCA PI decreased significantly in both groups (brain-sparing), but significantly more in OCT positive cases. Conclusions: During acute hypoxic stress, changes towards a centralization of blood flow to the brain develop in imminently compromised (OCT positive) fetuses at an expense of the umbilicoplacental. blood flow, and the brain-sparing flow is more pronounced than in uncompromised (OCT negative) fetuses.},
  author       = {Li, Hui and Gudmundsson, Saemundur and Olofsson, Per},
  issn         = {1872-6232},
  language     = {eng},
  number       = {11},
  pages        = {747--752},
  publisher    = {Elsevier},
  series       = {Early Human Development},
  title        = {Acute centralization of blood flow in compromised human fetuses evoked by uterine contractions.},
  url          = {https://lup.lub.lu.se/search/files/4483650/625469.pdf},
  doi          = {10.1016/j.earlhumdev.2006.03.011},
  volume       = {82},
  year         = {2006},
}