Fetal Hypoxia Research Articles

In pre-clinical study fetal hypoxia caused autophagy and mitochondrial impairment in ovary granulosa cells mitigated by melatonin supplement

IntroductionFetal hypoxia has long-term effects on postnatal reproductive functions and the mitochondrial impairments of ovarian granulosa cells may be one of the causes. Melatonin applied to mitigate mitochondrial dysfunction and autophagy in mammalian cells has been reported. However, the potential mechanisms by which fetal hypoxia damages reproductive function in neonatal female mice and the melatonin effects on this problem remain unclear. ObjectivesThis research aimed to explore the mechanism that fetal hypoxia damages reproductive function in neonatal female mice and attempt to improve the reproductive function by treating with melatonin in vivo and in vitro. MethodsWe established a fetal hypoxia model and confirmed that fetal hypoxia affects ovarian function by inducing GC excessive autophagy. Transcriptomic analysis, gene interference, cell immunofluorescence, immunohistochemistry and western blot were conducted to explore and verify the underlying mechanisms in mice GCs and KGN cells. Finally, melatonin treatment was executed on hypoxia-treated mice GCs and KGN cells and melatonin injection to fetal-hypoxia-treated mice to determine its effect. ResultsThe results of in vitro experiments found that fetal hypoxia led to mitochondrial dysfunction in ovarian GCs causing autophagic cell death. And the PI3K/Akt/FoxO pathway mediated the occurrence of this process by transcriptome analysis of ovarian GCs from normal and fetal hypoxia mice, which was further verified in mice GCs and KGN cells. Additionally, melatonin administration prevented autophagic injuries and mitochondrial impairments in hypoxia-treated mice GCs and KGN cells. Meanwhile, in vivo experiments by melatonin injection ameliorated oxidative stress of ovary in fetal-hypoxia-treated mice and improved their low fertility. ConclusionOur data found that fetal hypoxia causes ovarian GCs excessive autophagy leading to low fertility in neonatal female mice and mitigated by melatonin. These results provide a potential therapy for hypoxic stress-related reproductive disorders.

PSV-16 Different Late Gestation Heat Stress Time-Windows and Their Effects on Newborn Holstein Calves from Northwest México

Abstract Exposure to heat stress (HS) during the dry period not only exerts negative effects on the welfare of pregnant cows, but also impairs the development of the fetus in the utero. When dams are subjected to late-gestation HS, affectations to their placental function and blood placental flow occur, generating fetal hypoxia and growth retardation of their calves. Since on the last 60 d of gestation bovine fetuses undergo through a phase of accelerated growth where they accrue around 60% of their birth weight, the number of days that their dams become exposed to HS during this period could affect differently their body weight and oxygenation status at birth. Therefore, the objective of this study was to determine the effects of different late-gestation HS time-windows on the birth weight and oxygen saturation of newborn Holstein calves. The study was conducted at the Yaqui valley in northwest México, a semiarid zone where the temperature and humidity index (THI) exceeds the dairy cattle thermal threshold from mid-March to mid-October (~7 months). Under such environmental dynamic, all cows within this geographical zone experience HS at some point during their gestation; nonetheless, depending on the conception date of the cow, different late-gestation HS time-windows arise. To assess the influence of the number of days of intrauterine HS exposure during late gestation (e.g., days with an average THI > 72 units), three intrauterine heat-stressed groups of calves were formed: G1 = calves born to dams exposed to HS less than 20 d within the last 60 d of gestation (n = 30), G2 = calves born to dams exposed to HS between 21 and 40 d within the last 60 d of gestation (n = 20), and G3 = calves born to dams exposed to HS for more than 40 d within the last 60 d of gestation (n = 16). Upon calving, variables such as sex, birth weight (BW, kg) and oxygen saturation (SpO2, %) were recorded. A general linear model that included the effects of sex of the calf and intrauterine HS calves’ group was implemented to analyze BW and SpO2. Harmonic means were compared via the Tukey-Kramer test. Harmonic means (±SE) for BW and SpO2 among groups were 42.42 ± 0.92, 40.84 ± 1.11, and 34.73 ± 1.24 kg, and 78.16 ± 2.71, 82.52 ± 3.28, and 82.29 ± 3.68 %, for G1, G2 and G3, respectively. Significant differences (P < 0.001) were found only for BW, with calves of G3 exhibiting the lowest BW in comparison to calves within G1 and G2, which were not statistically different among themselves (P > 0.05). Results of this study indicated that intrauterine HS exposures of >40 d strive deleterious effects on fetal growth and reduce the BW of newborn Holstein calves from northwest México.

Etiology of stillbirth in a tertiary care center: a retrospective cohort study assessing ultrasound, laboratory, and pathology investigations

Background Canadian stillbirth data are limited, and a significant proportion of pregnancies resulting in stillbirth have no attributable cause. The objective of this study was to characterize stillbirth case investigations and management at a tertiary care hospital in Ontario, Canada. Methods This was a retrospective chart review study of all cases of singleton stillbirth at The Ottawa Hospital between 1 January 2012 and 31 December 2017. Terminations and multiples stillbirths were excluded. Chart reviews were conducted to extract maternal sociodemographic, obstetrical, and fetal characteristics, including results from antenatal ultrasounds, autopsy, placenta pathology, and laboratory investigations. Results A total of 155 eligible cases of stillbirth were identified, resulting in a 6-year stillbirth rate of 4.2 per 1000 total births. The median maternal age was 31.0 years (IQR: 29.0, 35.0) and the median gestational age at delivery was 28 weeks (IQR: 24, 35). A total of 9 (5.8%) pregnant individuals had a history of previous stillbirth. Of the 155 stillbirths, 35% underwent the full suite of post-loss laboratory, placental, and fetal autopsy investigations. 63.2% of cases had post-loss laboratory investigations completed. 76% and 71% of cases had fetal autopsy and placenta pathology evaluations completed, respectively. Antenatal characteristics associated with stillbirth included fetal anomalies/genetic markers (27.1%), umbilical cord and placental anomalies (24.5%), fetal growth abnormalities (27.7%), cervical/uterine abnormalities (11.6%), and amniotic fluid abnormalities (25.1%). The most common autopsy findings included evidence of infection (22.7%), fetal anomalies (12.6%), and fetal hypoxia (10%). The most common placental pathology findings included features of placental insufficiency (21.8%), retroplacental abnormalities (16.3%), and umbilical cord accident/infarct (15.4%). Conclusions Our findings demonstrate that as many as two-thirds of singleton stillbirth cases at our center did not receive the post-perinatal loss investigations recommended by clinical practice guidelines. More thorough collection of post-stillbirth data at all levels (institutional, provincial, national) is warranted to improve our understanding of stillbirth epidemiology, etiology, and management in Canada.

Utilization of Phyo Referral Score in assessing maternal referral quality in emergency cesarean section of maternal COVID-19 cases in Pekanbaru, Indonesia

Link of Video Abstract: https://youtu.be/H8GILKBIJwo Introduction: During the Coronavirus disease 2019 (COVID-19) pandemic, basic and emergency obstetric healthcare was hampered due to health service protocol changes. The reduced coverage of antenatal service during the COVID-19 pandemic increased the number of undetected high-risk pregnancies and the likelihood of obstetric emergency cases. This study assessed maternal referral quality using the Phyo Referral Score (PRS) on emergency cesarean section (ECS) patients infected by SARS-CoV-2. Methods: This retrospective cohort study used secondary data originating from patient medical records who went through ECS from 1 January 2021 to 31 December 2021. The subject was chosen purposively by the inclusion criteria. A Total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The data were described by frequencies, percentages, and mean ± standard deviation. The data was analyzed by Levene’s test and Chi-square test using IBM SPSS version 26.0. Results: During the retrospective year, a total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The most common indications of ECS were persistent fetal hypoxia (50.0%), placenta previa (13.5%), and maternal respiratory failure (13.5%). Most of the patients had good referral quality. From the parameters of PRS, patients are more likely to have good referral quality if accompanied by medical staff, receiving stabilization procedures, and communicating with the hospital by phone before being referred, and transported by ambulance within the same cities. Conclusion: Accessibility is a critical component of obstetric emergency cases. Even during the COVID-19 pandemic, ensuring that mothers have a good referral quality to access advanced obstetrical care can help the survival of both mothers and fetuses.

Role of colour Doppler in predicting foetal outcome in maternal anaemia.

Anaemia is the most common nutritional deficiency in Indian pregnant females. It ensues foetal hypoxia resulting in different compensatory mechanisms in the foetus which may result in adverse perinatal outcomes. Colour Doppler can be used to measure these hemodynamic changes of the foetus ahead of the clinical manifestations, guiding the obstetrician for the appropriate management and circumventing any dire complication. The aim of this study is to detect foetal haemodynamic changes associated with maternal anaemia and assess the parameters which predict these changes accurately. Prospective cohort study. Two hundred and forty pregnant females in the third trimester, divided into four groups based on their haemoglobin levels in the non-anaemic, mild, moderate and severe anaemic groups, were included in the study. These patients were followed up for foetal outcome in terms of effective foetal weight, APGAR score and neonatal intensive care unit admission. Analysis of Variance Appearance, Pulse, Grimace, Activity and Respiration (ANOVA) test was used to compare the quantitative variables. SPSS software was used. The middle cerebral artery (MCA) Doppler indices and cerebroplacental ratio (CPR) values were increasing while umbilical Doppler indices were decreasing with the increasing severity of anaemia. CPR was found to be the most sensitive predictor for foetal outcome. Maternal anaemia results in foetal hypoxia which can be measured in terms of foetal Doppler indices. CPR was found to be more sensitive than the umbilical or MCA in predicting foetal hypoxia and in turn the perinatal outcome of foetuses of anaemic pregnant females. The foetuses with low CPR values will require urgent intervention to improve the outcomes.

Cardioprotective Activity of Pharmacological Agents Affecting NO Production and Bioavailability in the Early Postnatal Period after Intrauterine Hypoxia in Rats.

Intrauterine hypoxia in newborns leads to a multifaceted array of alterations that exert a detrimental impact on the cardiovascular system. The aim of this research was to assess the cardioprotective effects of modulators of the nitric oxide (NO) system, including L-arginine, Thiotriazoline, Angiolin, and Mildronate, during the early postnatal period following intrauterine hypoxia. Methods: The study involved 50 female white rats. Pregnant female rats were given a daily intraperitoneal dose of 50 mg/kg of sodium nitrite starting on the 16th day of pregnancy. A control group of pregnant rats received saline instead. The resulting offspring were divided into the following groups: Group 1-intact rats; Group 2-rat pups subjected to prenatal hypoxia (PH) and daily treated with physiological saline; and Groups 3 to 6-rat pups exposed to prenatal hypoxia and treated daily from the 1st to the 30th day after birth. Nitrotyrosine levels, eNOS, iNOS, and NO metabolites were evaluated using ELISA; to measure the expression levels of iNOS mRNA and eNOS mRNA, a PCR test was utilized. Results: Angiolin enhances the expression of eNOS mRNA and boosts eNOS activity in the myocardium of rats with ischemic conditions. Arginine and particularly Thiotriazoline exhibited a consistent impact in restoring normal parameters of the cardiac nitroxidergic system following PH. Mildronate notably raised iNOS mRNA levels and notably reduced nitrotyrosine levels, providing further support for its antioxidative characteristics.

Pregnancy Complications and Feto-Maternal Monitoring in Rabbits.

Rabbit production holds significant relevance in modern agriculture due to its potential as a sustainable source of high-quality protein and efficient feed conversion, contributing to food security and economic diversification. Nevertheless, studies incorporating feto-maternal monitoring in this species are uncommon. This review gathers research on the monitoring and evaluation of factors affecting rabbit gestation, providing a better understanding of the causes of prenatal development abnormalities. These include studies regarding how chronic maternal hypertension, gestational diabetes, maternal stress, ectopic gestation, maternal uterine ischemia and fetal hypoxia, intrauterine growth restriction, superfetation, maternal age, maternal nutritional status, maternal physical condition, maternal and embryonic genotype, and the intrauterine location of rabbit fetuses can potentially impact rabbits' reproduction and maternal and fetal health. Among other monitoring techniques, ultrasonography, considered one of the best tools for diagnosing pregnancy and conducting follow-up, is also reviewed. Details on measurable fetal-development parameters in rabbits and precautions to be considered before and during the examination are also provided. Additional studies are required to understand why some events occur and their consequences throughout gestation, allowing the determination of new biomarkers or cut-offs that can be helpful for early diagnosis and improve reproductive efficiency.

THE EFFECT OF ENOS GENE POLYMORPHISM AND NITRIC OXIDE METABOLISM INDICATORS ON THE NEONATAL CONSEQUENCES IN PREMATURE BABIES BORN FROM MOTHERS WITH METABOLIC SYNDROME

Metabolic syndrome is considered to be a cluster of disorders that directly contribute to the development of cardiovasculardisease and are characterized by chronic systemic infl ammation. Numerous epidemiological data indicate that an adverseintrauterine environment, caused by the peculiarities of the nutritional status or placental insuffi ciency in a woman with metabolic syndrome, can “program” the susceptibility of the fetus to further development of cardiovascular and metabolic diseases, has an impact on cognitive and behavioral development. Nitric oxide (NO) plays a critical role in the pathogenesis of components of the metabolic syndrome. Children born prematurely have a high incidence of brain damage, which can lead to motor, cognitive, behavioral, social and sensory disorders.The purpose the research was the study of the effect of the eNOS gene polymorphism and indicators of nitric oxidemetabolism on the neonatal consequences in prematurely born children from mothers with metabolic syndrome.Material and methods. A study was conducted in which 100 premature infants were included. Two groups were formed: the main group (n=34), which included preterm infants (birth weight 2145.29±148.19 g and gestational age 33.18±0.55 weeks) of mothers with metabolic syndrome, and the comparison group (n=66), which included preterm infants (birth weight 2295.99±101.45 and gestational age 34.03±0.45 weeks) of mothers without metabolic syndrome. The children underwent a genetic study – determination of the polymorphism of the eNOS gene, as well as the level of nitrites, nitrates and nitrosothiols in the urine.By decision of the bioethics commission No. 217 dated 12.06.2023, the materials of the scientifi c work comply with the Rulesof Humane Treatment of Patients.Traditional methods of parametric and nonparametric statistics were used; nonparametric methods were used to analyzequalitative characteristics expressed mainly in percentages. The methods of parametric statistics were used to check the normality of the distribution of quantitative characteristics using the Kolmogorov- Smirnov criterion.Statistical processing of the obtained results was carried out using the package of application programs EXCEL-2003® andSTATA version 11 for Windows (StataCorp, Texas, USA).The work was carried out as part of the scientifi c and experimental work of the Department of Pediatrics #1 with Neonatologyof the Poltava State Medical University “To develop clinical and laboratory criteria, methods of predicting and preventingmetabolic disoders in young children (state registration number 0120U102856).Results. The most common diseases in the infants of the studied groups were the consequences of intrauterine hypoxia(44.1%) and respiratory failure requiring artifi cial lung ventilation (50.0%), although no signifi cant diff erences were foundin the prevalence of these conditions. We identifi ed the presence of signifi cant associations between the consequences ofintrauterine hypoxia and the levels of nitrates (OR 1.19; 95% CI 1.01-1.40; p=0.042), nitrosothiols (OR 1.19; 95% CI 0.99-1.42;p=0.050) and the polymorphic genotype 4aa/ab of the eNOS gene (OR 0.28; 95% CI 0.12-0.67; p=0.004). Analysis of systemichemodynamics revealed no signifi cant diff erences in baseline values between preterm infants with and without intrauterinehypoxia, but we did observe an association with urine output on day 3 of life.To fi nally clarify the complex infl uence of indicators of nitrate metabolism on the development of intrauterine hypoxia andto predict the development of consequences of this condition in premature infants, the following indicators are included in theregression prognostic model: the level of nitrates, nitrites, 4aa/4ab genotype and urine output on the third day of life. As theresearch results show, there is a direct reliable relationship with nitrates and an inverse relationship with nitrites, 4aa/4abgenotype and urine output. This prediction model has high operating characteristics – the area under the ROC curve is 0.8168.Some mechanisms of the infl uence of maternal metabolic syndrome on the development of relevant disorders in newborns areknown, including disorders of nitric oxide synthesis, endothelial dysfunction, and oxidative stress. In our study, the consequences of intrauterine hypoxia were reliably associated with an increase in the concentration of urinary nitrates and a decrease in nitrites, as well as the absence of the 4aa/ab genotype, which is associated with reduced release of nitric oxide. There is evidence that nitric oxide can have both protective and deleterious eff ects, depending on factors such as nitric oxide synthase isoform and duration of exposure to hypoxia.Conclusions. In preterm infants born to mothers with metabolic syndrome, elevated urinary nitrate levels and the absenceof the eNOS 4aa/ab genotype increase the likelihood of suff ering the consequences of intrauterine hypoxia.

The role of the infectious factor in the genesis of perinatal losses in pregnant women who have birth in maternity hospitals in St. Petersburg and Leningrad Region in 2009–2018

BACKGROUND: One of the tasks of modern medicine is to reduce the level of perinatal losses, for which it is necessary to know their main causes.
 AIM: To determine the course of an infectious disease in the genesis of perinatal losses.
 MATERIALS AND METHODS: In order to determine the role of infection in the genesis of perinatal losses, a retrospective study was conducted with two groups: the main group 307 women with perinatal fetal death, the control group 357 women without perinatal losses. An analysis was also made of the data of the statistical form No. 32 (annual) Information on medical care for pregnant women, women in childbirth and puerperas, presented by the Medical Information and Analytical Centers of St. Petersburg and the Leningrad Region for 20062018 and annual reports of the Leningrad Regional Pathological Anatomical Bureau for 20062016.
 RESULTS: In 20062018, the leading causes of perinatal death were intrauterine hypoxia and asphyxia during childbirth (ICD 10: P20, P21), that is, not diseases, but symptomatic conditions. Such features of reporting documentation complicate the analysis of the causes of perinatal losses and the implementation of a set of preventive measures, including at the state level. Also, according to the official report, it is impossible to assess the contribution of a specific virus and a specific localization of the lesion to the genesis of perinatal losses. In the main group, hematogenous viral and ascending bacterial infection of the placenta was detected 4 times more often. With a combination of bacterial and viral infection of the placenta, the risk of a fatal outcome increases. Infectious pathogens most frequently encountered in perinatal losses have been established.
 CONCLUSIONS: The cause of more than half of the cases of perinatal losses in women who gave birth in maternity hospitals in St. Petersburg and Leningrad Region in 20092018 is an infectious pathology: viral, bacterial and viral-bacterial, and not intrauterine hypoxia/asphyxia during childbirth, as stated by the official statistics. In this regard, the main direction in the prevention of perinatal losses is the timely detection and treatment of infectious pathology.

Polystyrene micro- and nanoplastics cause placental dysfunction in mice†.

Maternal exposure to microplastics and nanoplastics has been shown to result in fetal growth restriction in mice. In this study, we investigated the placental and fetal hemodynamic responses to plastics exposure in mice using high-frequency ultrasound. Healthy, pregnant CD-1 dams were given either 106ng/L of 5μm polystyrene microplastics or 106ng/L of 50nm polystyrene nanoplastics in drinking water throughout gestation and were compared with controls. Maternal exposure to both microplastics and nanoplastics resulted in evidence of placental dysfunction that was highly dependent on the particle size. The umbilical artery blood flow increased by 48% in the microplastic-exposed group and decreased by 25% in the nanoplastic-exposed group compared to controls (p < 0.05). The microplastic- and nanoplastic-exposed fetuses showed a significant decrease in the middle cerebral artery pulsatility index of 10% and 13%, respectively, compared to controls (p < 0.05), indicating vasodilation of the cerebral circulation, a fetal adaptation that is part of the brain sparing response to preserve oxygen delivery. Hemodynamic markers of placental dysfunction and fetal hypoxia were more pronounced in the group exposed to polystyrene nanoplastics, suggesting nanoplastic exposure during human pregnancy has the potential to disrupt fetal brain development, which in turn may cause suboptimal neurodevelopmental outcomes.

Ultrasound Doppler Findings in Fetal Vascular Malperfusion Due to Umbilical Cord Abnormalities: A Pilot Case Predictive for Cerebral Palsy.

Fetal Vascular Malperfusion (FVM), a pathologic condition in the feto-placental circulation, is a chronic vaso-occlusive disorder in the umbilical venous blood flow. Microthrombi are caused by the umbilical cord's blood flow deficiency in a congested umbilical vein, which also causes microvascular damage to fetal organs, especially the brain, resulting in cerebral palsy. Thrombo-occlusive events also adversely affect the upstream chorionic or stem vessels in the placenta, resulting in fetal growth restriction and fetal hypoxia. An umbilical cord structural anomaly or multiple entanglements may involve FVM. In the present report, we demonstrate a case of FVM caused by multiple umbilical cord abnormalities obtained from antenatal ultrasound Doppler findings, and we also discuss FVM, which is chronically associated with CP, comparing the ultrasonographic findings to the pathologic findings.

The state of health and adaptation of children with the identified abnormally attached chords of the left ventricle

Annotation. In recent years, there has been a growing focus among medical professionals and researchers on examining and understanding the various manifestations of connective tissue dysplasia syndrome (CTD). A common anatomical defect of the heart is the presence of abnormally attached chords (AAC) within its chambers. The aim of the work is to conduct a clinical examination of children with AAC in the left ventricle to identify symptoms that will allow predicting of possible diseases and preventing their occurrence. A clinical examination of 92 children aged 13 to 17 was carried out. The main group consisted of 62 children with confirmed additional AAC, identified through Doppler echocardiography. The AAC had a transverse orientation in the left ventricle of the heart. The control group consisted of 30 practically healthy children. The examination included a thorough collection of medical history (compulsory communication with parents) and the assessment of autonomic regulation (AR) using the tilt table test (TTT). To assess the research findings, we utilized both absolute and relative statistical indicators using the Microsoft Excel program on an IBM PC/AT computer. Differences between the results of the two samples, which followed a normal distribution, were evaluated using the parametric Student's t-test. Analysis of the obtained anamnesis data showed that mothers of children with AAC had various extragenital pathologies before and during pregnancy. The reported data primarily consisted of information regarding the presence of cardiovascular diseases, as well as conditions such as pyelonephritis, chronic gastritis, and allergic diseases. Additionally, multiple types of hereditary connective tissue disorders were confirmed among the family members of the children being examined. The antenatal anamnesis was mainly aggravated by early toxicosis of pregnancy and the occurrence of intrauterine hypoxia. Among the most common complaints in children with AAC were: increased fatigue, weakness, reduced work capacity, lack of endurance during physical exertion, periodic cardiac pain, increased heartbeat, headache, dizziness, and intermittent abdominal pain. In the examined individuals, the excessive AR was mainly determined in the form of a hyperadrenergic variant. Insufficient involvement of the sympathoadrenal system was manifested mostly in the form of an asympaticotonic variant. Mixed variants (sympathicoasthenic and asthenosympathetic) occurred rarely. So, the state of vegetative homeostasis in this group of children requires more detailed study to further correct and prevent the occurrence of cardiovascular diseases.

Sex-Specific Effects of Prenatal Hypoxia and a Placental Antioxidant Treatment on Cardiac Mitochondrial Function in the Young Adult Offspring.

Prenatal hypoxia is associated with placental oxidative stress, leading to impaired fetal growth and an increased risk of cardiovascular disease in the adult offspring; however, the mechanisms are unknown. Alterations in mitochondrial function may result in impaired cardiac function in offspring. In this study, we hypothesized that cardiac mitochondrial function is impaired in adult offspring exposed to intrauterine hypoxia, which can be prevented by placental treatment with a nanoparticle-encapsulated mitochondrial antioxidant (nMitoQ). Cardiac mitochondrial respiration was assessed in 4-month-old rat offspring exposed to prenatal hypoxia (11% O2) from gestational day (GD)15-21 receiving either saline or nMitoQ on GD 15. Prenatal hypoxia did not alter cardiac mitochondrial oxidative phosphorylation capacity in the male offspring. In females, the NADH + succinate pathway capacity decreased by prenatal hypoxia and tended to be increased by nMitoQ. Prenatal hypoxia also decreased the succinate pathway capacity in females. nMitoQ treatment increased respiratory coupling efficiency in prenatal hypoxia-exposed female offspring. In conclusion, prenatal hypoxia impaired cardiac mitochondrial function in adult female offspring only, which was improved with prenatal nMitoQ treatment. Therefore, treatment strategies targeting placental oxidative stress in prenatal hypoxia may reduce the risk of cardiovascular disease in adult offspring by improving cardiac mitochondrial function in a sex-specific manner.

Clinical and laboratory study of premature infants with hypoxic-ischemic encephalopathy

We conducted a comprehensive clinical and laboratory study of 102 preterm infants with hypoxic-ischemic encephalopathy (HIE) of varying gestational ages. All preterm infants were born to mothers with a complicated obstetric history. Clinical manifestation of CNS hypoxic-ischemic injury was observed in 100% of this cohort. Intracranial hemorrhages (ICH) of grades I-IV were registered in 38 (37.2%) cases, while periventricular leukomalacia (PVL) was present in 5 (4.9%) cases. Intrauterine growth restriction (IUGR) was observed in 36 (35.3%) cases, and respiratory distress syndrome (RDS) in 65 (63.7%) cases. Mild cerebral ischemia was diagnosed in 51 (50%) cases, moderate-severity cases in 32 (31.4%) cases, and severe CI in 19 (18.6%) preterm infants. The severity of clinical progression of HIE in preterm infants was shown to be dependent on gestational age, intrauterine hypoxia, and birth asphyxia. The health status of their mothers plays a crucial role in the development of CNS and other systemic injuries in preterm infants. Therefore, premature births remain a pertinent issue in modern society.

Value of brain injury-related indicators based on neural network in the diagnosis of neonatal hypoxic-ischemic encephalopathy.

Neonatal hypoxic ischemic encephalopathy is a common disease, which is caused by fetal hypoxia, asphyxia, and other reasons. It may cause sequelae of the nervous system and even death in children. Computer tomography examination can clarify the scope and location of the disease and provide the basis for clinical treatment and prognosis. Relevant personnel analyzed the symptoms of ischemic hypoxia and found that ischemia and hypoxia were the main causes of encephalopathy. Neonatal ischemia and hypoxia are easy to cause serious damage. At present, with the development of medicine, the function of the human brain is the most important issue in natural science. The law of neural activity and the role of molecular cells, organs, and systems have fundamental construction significance for the prevention and treatment of nerve and mental diseases. By analyzing the value of the diagnosis of neonatal hypoxic-ischemic encephalopathy in the analysis of experimental data, by setting the newborns in the controlled group and the trial group as experimental subjects, this paper analyzed the situation of newborns in terms of body temperature, body weight, and respiratory rate, and used Apgar score to score these standards. It was found that the score of the controlled group was 7 and above, and the score of the trial group was below 7. It was found that the Apgar scoring method was more simple. Then, the newborns were analyzed by cord blood gas analysis. It was found that most of the data in the control group were between 7.8 and 8.4, and the data in the trial group were between 5.8 and 7.1. The umbilical blood gas analysis score of the experimental group was lower than that of the control group. By comparing the satisfaction of cord blood gas analysis and the Apgar score, it was found that the satisfaction of cord blood gas analysis was 24.06% higher than that of the Apgar score.

Duration of parturition in ewes and its consequences on behavioural traits in mother-lamb bond: Doctoral thesis abstract

Lamb mortality within the first 72 hours of life greatly affects sheep breeding, especially in extensive rearing, resulting in important economic losses and involving animal welfare. Prolonged fetal expulsion phase can influence maternal behaviour, and the extended period of hypoxia during birth can also affect the behaviour of the neonate. Limited information exists regarding the necessary duration of the fetal expulsion phase for these changes in maternal behaviour to occur or for the resulting hypoxia from prolonged delivery to either be reversed or cause sequelae that affect lamb viability. Behavioural disturbances of both the mother and the neonate prevent establishing a proper mother-lamb bond. This thesis aims to investigate the required time for the duration of the fetal expulsion phase to have consequences on both maternal and offspring behaviour. For early detection of foetal hypoxia, the effectiveness of a non-invasive and easy-to-use tool, a pulse oximeter, was evaluated and compared with venous blood gas analysis. The prolonged duration of parturition affected the behaviour of both dams and lambs, disrupting the mother-lamb bond and leading to a higher percentage of abandonment. A linear correlation between the duration of delivery and poor maternal behaviour was observed in primiparous ewes, but not in multiparous ones. The pulse oximeter successfully detected lambs with low oxygenation at birth, which would allow to establish therapeutic or management measures to improve survival. Reducing the duration of the foetal expulsion phase through programmed parturition assistance improved maternal behaviour and lamb vigour in primiparous ewes, enabling the establishment of an appropriate mother-lamb bond and potentially enhancing neonatal survival.

Potentially traumatic experiences pre-migration and adverse pregnancy and childbirth outcomes among women of Somali- and Kurdish-origin in Finland

BackgroundWomen in precarious conditions in their countries of origin, especially those who have left the country as refugees, may have been victims of serious mental and physical violence. These potentially traumatic experiences may threaten women’s reproductive health. This study examines the prevalence of potentially traumatic experiences pre-migration and female genital mutilation/cutting (FGM/C) and their associations with adverse reproductive outcomes among migrant women of Somali- and Kurdish-origin who have been pregnant in Finland.MethodsSurvey and register data of the participants of the Finnish Migrant Health and Wellbeing Study (Maamu), conducted in 2010–2012, were used. Women of 18 to 64 years of age, 185 Somali- and 230 Kurdish-origin, who had at least one pregnancy or birth in Finland were included in the analysis. The survey data were linked to the Finnish Medical Birth Register, the Register of Induced Abortions, and the Care Register for Health Care until 2018. For each outcome, logistic regression was used and adjusted for age, body mass index, time lived in Finland, and the number of births.ResultsA total of 67% of Somali-origin and 71% of Kurdish-origin women had experienced potentially traumatic experiences pre-migration and 64% of Somali- and 32% of Kurdish-origin women had also undergone FGM/C. In Kurdish-origin women, complications during pregnancy (e.g. bleeding in the first trimester, known or suspected fetal abnormality, signs of fetal hypoxia, death of the fetus and other problems) were significantly more common among women without potentially traumatic experiences (70%) than among women with potentially traumatic experiences (48%) (p-value 0.005). No associations between potentially traumatic experiences or FGM/C and other adverse reproductive outcomes were observed among Somali- or Kurdish-origin women.ConclusionPast trauma is common among Somali- and Kurdish-origin women and this needs to be evaluated in maternity care. However, we found no association between potentially traumatic experiences pre-migration and adverse reproductive outcomes.

Analysis of the perinatal mortality rate in the metropolitan region of grande Vitória, Espírito Santo, Brazil, between 2008 and 2017

Introduction: perinatal mortality is characterized by fetal deaths that occur after the 22nd week of management and neonatal deaths that precede six full days of life. This indicator has been a matter of concern and discussion on the part of entities and organizations involved in comprehensive health care for women and children. Objective: to characterize perinatal deaths in the Metropolitan Region of Greater Vitória (RMGV) in Espírito Santo and identify associated maternal factors in the period between 2008 and 2017. Methods: ecological and descriptive study with a quantitative approach, carried out in 2019 on perinatal mortality from 2008 to 2017 at RMGV. Data collection was performed by extracting data from the SIM, SINASC, IBGE databases of the Espírito Santo State Health Department, about perinatal deaths and associated maternal factors. The research respects the ethical precepts of resolution 466/12 of the National Health Council. Results: the distribution of deaths did not occur homogeneously in the municipalities in the RMGV. The municipality of Vitória had the lowest perinatal mortality rates during the study period, on the other hand, in the comparative analysis between the different municipalities that make up the RMGV, the municipality of Fundão presents the worst scenario regarding perinatal mortality over the years. Regarding the underlying causes of death, it is noted that in this study, the three causes with the highest number of occurrences are complications of the placenta, umbilical cord and maternal affections, not necessarily related to the current pregnancy and intrauterine hypoxia. Conclusion: there were no significant changes in mortality rates in the Metropolitan Region of Greater Vitória. However, the main deaths occurred in neighborhoods with greater socioeconomic inequalities. Maternal causes were highly representative of deaths, raising issues associated with the improvement of public health policies.

Predictive value of the sFlt‑1/PlGF ratio in women with suspected preeclampsia: An update (Review).

Preeclampsia (PE) is a major complication of pregnancy with an incidence rate of 2‑8% and is a leading cause of maternal mortality and morbidity. The various consequences of severe preeclampsia for the fetus, neonate and child include intrauterine growth retardation (IUGR), fetal hypoxia, oligohydramnios, intrauterine fetal demise, increased perinatal mortality and morbidity, neurodevelopmental disorders and even irreversible brain damage (cerebral palsy). A number of studies have demonstrated that differences in maternal serum concentrations of angiogenic factors between preeclampsia and normotensive pregnancies can be used as biomarkers, either alone or in combination with other markers, to predict the development of PE. The presence in the maternal circulation of two proteins of placental origin, placental growth factor (PlGF) and soluble fms‑like tyrosine kinase 1 (sFlt‑1), has been shown to be of clinical value, as the sFlt‑1/PlGF ratio appears to be the optimal predictive tool for the development of PE. The measurement of their concentration in maternal serum in screening models, serves as predictive marker for the development of PE or IUGR later in gestation. However, further research is required to improve its clinical applicability and provide guidelines for its use worldwide to achieve more consistent clinical management of women with PE.

FETAL METABOLIC PROGRAMMING IN THE ETIOLOGY OF POLYCYSTIC OVARIAN SYNDROME

Polycystic ovary syndrome (PCOS) is an endocrine dysfunction, which can be characterized by hyperandrogenism and chronic anovulation. The main signs of PCOS are amenorrhea and polycystic forms in the ovaries, being the most common disorder in women in menacme and very commonly associated with other metabolic syndromes. Studies suggest that one of the etiological factors of the syndrome is related to fetal metabolic programming, maternal, nutritional, genetic and environmental influences are determinant in the emergence of diseases, including PCOS. The objective of this work is to relate the fetal metabolic programming with the development of PCOS. The study methodology consists in a literature review, through research in PubMed and Scielo databases. It is concluded that factors such as placental pathologies and maternal metabolism, fetal hypoxia, intrauterine growth restriction, low birth weight, maternal hyperandrogenism state and pathologies that corroborate this, hyperinsulinemia, and insulin resistance (IR), in addition to maternal exposure to plastic components, such as bisphenol A, are factors associated with the etiology of PCOS. Thus, during pregnancy, care must be taken to minimize the chances of future adolescents developing the syndrome and the various comorbidities that are associated with it.