Acute cord occlusion increases blood ionized magnesium concentration in preterm fetal sheep during maternal magnesium sulfate exposure

2000 ◽  
Vol 78 (4) ◽  
pp. 301-306 ◽  
Author(s):  
James D Reynolds ◽  
Elizabeth G Grubbs ◽  
Franklin Dexter ◽  
Santi Punnahitananda ◽  
Tracy A Dense ◽  
...  
Keyword(s):  
Magnesium Sulfate ◽  
Umbilical Cord ◽  
Recovery Period ◽  
Magnesium Concentration ◽  
Fetal Blood ◽  
Fetal Sheep ◽  
Ionized Magnesium ◽  
Arterial Blood ◽  
Blood Ph ◽  
Pregnant Sheep

This study tested the hypothesis that a pathophysiologic insult to the fetus that decreases pH (umbilical cord occlusion) produces an increase in physiologically active (i.e., ionized) magnesium concentration. Preterm pregnant sheep (n = 7) were instrumented with maternal and fetal catheters and an inflatable vascular occluder was placed around the umbilical cord. After a 2-day recovery period, each ewe received a 4-g loading dose, followed by continuous intravenous infusion of 1 g magnesium sulfate/h. After 48 h, an episode of acute fetal distress was produced by inflation of the umbilical occluder for 10 min. Maternal and fetal arterial blood samples were collected at regular intervals to quantitate ionized magnesium concentration and monitor physiologic status. Magnesium sulfate infusion increased maternal and fetal blood ionized magnesium concentration. In vitro blood analysis demonstrated that there was a linear inverse correlation (r2= 0.99) between fetal sheep blood pH and ionized magnesium concentration. In vivo, 10 min of umbilical cord occlusion produced an increase in fetal blood ionized magnesium concentration in all animals (P = 0.02) that was temporally related to the decrease in fetal blood pH. Whether this increase in physiologically active magnesium concentration is beneficial (via neuroprotection) or deleterious (via suppression of stress response) to the distressed fetus remains to be determined.Key words: fetal, hypoxia, ionized magnesium, magnesium sulfate, sheep.

Blood Ionized Magnesium Concentration in Preterm Fetal Sheep Increases during Umbilical Cord Occlusion 

2000 ◽  
Vol 2000 (4) ◽  
pp. NA-NA
Author(s):  
J D Reynolds ◽  
S. Punnahitananda ◽  
Y. Wang ◽  
M. Hopkins ◽  
F. Dexter ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Magnesium Concentration ◽  
Fetal Sheep ◽  
Ionized Magnesium

Correlation between Intrapartum Cardiotocogram findings and cord blood pH in term and preterm labors

2021 ◽  
Vol 17 ◽  
Author(s):  
Shubha Rao ◽  
Himanshi Jain ◽  
Anjali Suneel ◽  
Roopa Padavagodu Shivananda ◽  
Akhila Vasudeva
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Preterm Labor ◽  
Fetal Monitoring ◽  
Cord Blood Sample ◽  
Arterial Blood ◽  
Blood Ph ◽  
Preterm Group ◽  
Fetal Acidosis

Background: The purpose of intrapartum fetal monitoring by cardiotocograph (CTG) is to identify early signs of developing hypoxia so that appropriate action can be taken to improve the perinatal outcome. Although CTG findings are well known to monitor the progress of the labor due to the paucity of recommendations, there has always been a clinical dilemma as the term fetuses respond differently than a preterm fetus. However, umbilical cord blood pH can distinguish the infant at high risk for asphyxia and related sequel. Therefore, because of differences in fetal physiology in term and preterm fetuses, CTG findings vary, and hence the validity of CTG to determine fetal acidosis should be different. Aims and Objectives: This study aimed to correlate abnormal intrapartum CTG findings with umbilical cord blood pH in term and preterm labor and thus evaluate the success of CTG in predicting fetal acidosis during labor. Methods: The present study included 210 women in labor (70 preterm and 140 term) with abnormal intrapartum CTG that was classified as per 2015 revised International Federation of Gynecologists and Obstetrician (FIGO) guidelines. Immediately after delivery 2 ml Umbilical artery cord blood sample was taken in a pre-heparinized syringe for analysis, pH <=7.2 was taken as acidosis and pH >7.2 was taken as normal. The measured data were maternal general characteristics which included gravida status, associated comorbidities, method of induction and character of liquor, the intrapartum CTG tracings recorded the cord arterial blood pH and the neonatal characteristics such as APGAR score and neonatal outcome. Results: Data from 70 preterm labor was compared with 140 term labor. In this study, 20.9 % of the babies had acidosis. Suspicious CTG due to decreased variability were more common in the preterm group than in the term group (21.4% vs. 8.6% p<0.05). Positive predictive value (PPV) of abnormal CTG for fetal acidosis in the preterm group was found to be higher than that in term group, PPV of pathological CTG being even higher than suspicious CTG. Women with suspicious CTG had 82 % less risk of fetal acidosis as compared to pathological CTG. Women with Bradycardia had 5.9 times the risk of fetal acidosis as compared with normal and tachycardia. Conclusion: Abnormal CTG should be managed appropriately without any delay to prevent acidosis and cord blood pH should be done in all labors with abnormal CTG. However, our findings of a higher incidence of lower cord blood pH and suspicious CTG due to decreased variability alone, highlight the limitation of criteria currently used for interpretation of CTG in preterm labors.

PSV-1 Effects of Induction on Piglet Blood Parameters at Time of Farrowing

2021 ◽  
Vol 99 (Supplement_1) ◽  
pp. 207-207
Author(s):  
Kayla M Mills ◽  
Larissa K Shirley ◽  
Katharine G Sharp ◽  
Ricardo M Garcia ◽  
Kara R Stewart
Keyword(s):  
Umbilical Cord ◽  
Oxygen Supply ◽  
Base Excess ◽  
Blood Parameters ◽  
Total Carbon ◽  
Low Doses ◽  
Fetal Blood ◽  
Blood Ph ◽  
Postnatal Mortality ◽  
Umbilical Cords

Abstract Typically, sows are induced to farrow using prostaglandin followed by an injection of oxytocin 24 hours later. Benefits of induction can include decreased rate of stillbirths, dystocia, and postnatal mortality along with increasing the likelihood of farrowings being attended. Several studies have indicated that oxytocin administration may negatively impact fetal oxygen supply during parturition, potentially from umbilical cords breaking prior to birth, resulting in increased preweaning mortality. Therefore, the objective of this study was to determine if various induction protocols impact umbilical cord breakage and fetal blood parameters at birth. Fifty-eight primiparous and multiparous sows were assigned to one of three treatments: no induction (NO; n=24), or 2 cc Lutalyse administered on d114 of gestation followed by either 1 cc of oxytocin 24 hours later (OXY24; n=13) or 0.5 cc of oxytocin at 6 and 12 hours after Lutalyse (OXY6; n=21). Details of the farrowing process were recorded, and umbilical cord blood was collected from piglets at birth and evaluated on an iSTAT machine using an Abbott EC8+ test cartridge. There were no differences in total born, number born alive, stillborns, mummies, or assistance needed during farrowing. Sows in the OXY24 treatment tended to have longer farrowings when compared to both NO and OXY6 (5.6 vs 3.7 vs 3.7 hours; P=0.09). OXY24 gilts (38%) and NO sows (33%) tended to have more piglets born with broken umbilical cords than other parities and treatments (OXY24 sows: 19%; NO gilts: 18%; OXY6 gilts: 25%; OXY6 sows: 18%; P=0.07). Piglets born from NO sows had higher base excess, total carbon dioxide, and glucose which suggests that these piglets had prolonged moments of asphyxiation (P&lt; 0.01). OXY24 piglets had the lowest blood pH which is indicative of hypoxic birthing conditions (P&lt; 0.01). There were no signs of asphyxia in the blood parameters of piglets born from OXY6 sows. Therefore, multiple low doses of oxytocin to induce farrowing may be more beneficial for the welfare of the piglet during farrowing.

scholarly journals Effects of acute hypoxemia on insulin-like growth factors and their binding proteins in fetal sheep

2006 ◽  
Vol 263 (6) ◽  
pp. E1151-E1156 ◽  
Author(s):  
H. S. Iwamoto ◽  
M. A. Murray ◽  
S. D. Chernausek
Keyword(s):  
Fetal Growth ◽  
Recovery Period ◽  
Fetal Blood ◽  
Fetal Sheep ◽  
Oxyhemoglobin Saturation ◽  
Subsequent Recovery ◽  
Factor I ◽  
Igf I ◽  
Vascular Catheters ◽  
Insulin Like Growth Factors

It has been proposed that insulin-like growth factor I (IGF-I) regulates fetal growth and differentiation. Plasma IGF-I concentrations correlate positively with fetal nutrient availability and newborn birth weights. To explore the hypothesis that hypoxemia decreases fetal growth by decreasing fetal IGF-I availability, we instrumented 14 fetal sheep with vascular catheters. At least 4 days after surgery, 10 fetuses were made acutely hypoxemic by infusing nitrogen into the maternal trachea for 3 h. Fetal blood oxyhemoglobin saturation decreased from 53 +/- 6 (SD) to 31 +/- 9%. Concomitantly, plasma IGF-I concentrations decreased from 91 +/- 11 to 67 +/- 10 ng/ml and IGF-I binding protein-1 concentration increased significantly, as assessed by ligand and Western blot analysis. Fetal IGF-I concentrations remained below control values throughout a subsequent recovery period (68 +/- 12 ng/ml at 6 h). In four control fetuses and in the ewes, plasma IGF-I concentrations were not significantly different from control values (97 +/- 18 and 181 +/- 18 ng/ml, respectively). These data support the hypothesis that decreases in fetal oxygen availability may decrease fetal growth by decreasing IGF-I production and availability.

scholarly journals Study of intrapartum fetal distress with the help of cardiotocography and its correlation with umbilical cord blood sampling

2020 ◽  
Vol 9 (4) ◽  
pp. 1580
Author(s):  
S. Neeraja ◽  
Sugathi Parimala ◽  
Naima Fathima
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Risk Groups ◽  
Normal Vaginal Delivery ◽  
Arterial Blood ◽  
Blood Ph ◽  
Fetal Acidosis

Background: Even in low risk mothers, fetal acidosis occurs as in high risk groups. Aim of fetal monitoring is to detect early response to intrauterine hypoxia and prevent irreversible neurological damage and death. Objective of this study was to correlate the intrapartum fetal distress with the help of cardiotocography CTG with umbilical cord blood sampling.Methods: A total 100 consecutive patients attending the labor ward were studied. Immediately at birth, before the baby’s first breath and before delivery of the placenta, the umbilical cord blood was collected as per the standard guidelines laid down in the standard textbooks. Fetal acidosis was assessed by umbilical cord arterial blood pH. Fetal acidosis was considered when umbilical artery pH <7.2. Cardiotocography features were used to clinically diagnose fetal distress.Results: Most of the mothers were multigravida. They belonged to the age group of 20-25 years. Only 18% had abnormal CTG. Out of 50 mothers with normal vaginal delivery, all had normal CTG. Out of 43 mothers who were delivered by LSCS, no one had normal CTG, 25 had indeterminate CTG and 18 had abnormal CTG. As CTG became abnormal, proportion of mothers with the thick meconium increased. NICU admission proportion increased as CTG changed from normal to the abnormal. There was a significant association between the abnormal CTG and the umbilical cord blood pH being acidic.Conclusions: CTG is a simple test, easy to perform and can alert obstetrician for necessary interventions in case of an abnormal CTG. It can detect fetal distress in labor thus helping to reduce neonatal morbidity by early intervention in cases of abnormal tracing.

scholarly journals A Study on Correlation of Umbilical Cord Arterial Blood pH with Perinatal Asphyxia & Early Neonatal Outcome

2020 ◽  
Vol 8 (2) ◽  
pp. 30-35
Author(s):  
Nutan Singh ◽  
Asheesh Kumar Gupta ◽  
Ajay Kumar Arya
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Neonatal Outcome ◽  
Outcome Measurement ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Arterial Blood ◽  
Blood Ph

Background: Perinatal asphyxia is one of the major causes of neonatal morbidity & mortality. Asphyxia can damage almost every organ of neonate. Our purpose was to determine the correlation of cord blood pH with birth asphyxia & early neonatal outcome. Subjects and Methods: A prospective study was conducted over a period of one year at STH Haldwani. We enrolled 108 term neonates with signs of fetal distress, thick MSL, non-reassuring NST & there were subjected for estimation of umbilical cord blood pH, APGAR score, outcome looked were resuscitation needed, NICU admission, delay in feed & encephalopathy (sarnat & sarnat stage). Results: In our study, cord blood pH had significant correlation with perinatal asphyxia(R=-0.926). Area under ROC curved showed that mean pH <7.1 (ROC=0.998) is very significant in predicting the adverse outcome. Conclusion: Cord blood pH is very sensitive and specific & has good correlation in predicting the birth asphyxia & adverse neonatal outcome. Measurement of cord blood pH is recommended in all the neonates with signs of fetal distress.

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