Acute reduction of uterine blood flow and fetal heart rate changes in pregnant sheep near term

Junge, H. D.; Künzel, W.; Klöck, F. K.

doi:10.1515/jpme.1977.5.1.39

Cited by 7 publications

(1 citation statement)

References 22 publications

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“…4 It is well documented that the fetus experiences significant reductions in oxygen saturation and short periods of moderate hypoxia-ischemia during the process of birth. 5,6 What is unclear is whether this degree of intermittent physiologic fetal hypoxemiaischemia during normal delivery is associated with quantifiable increases in hypoxanthine, xanthine, uric acid and malondialdehyde. More importantly, it is also unclear whether mode of birth or labor augmentation with oxytocin alters purine and malondialdehyde production in normal term deliveries.…”

Section: Introductionmentioning

confidence: 99%

Effect of mode of birth on purine and malondialdehyde in umbilical arterial plasma in normal term newborns

Calderon

Rawson

et al. 2008

J Perinatol

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Objective: To examine the effect of mode of birth on plasma purine and malondialdehyde levels in normal term infants.Study Design: Umbilical arterial cord blood was obtained immediately after birth from a convenience sample of 119 normal term newborns born by vaginal delivery, with or without oxytocin augmentation or by elective cesarean delivery. Plasma was analyzed for purine and/or malondialdehyde levels. Numeric data were analyzed utilizing independent samples t-test and ordinal data were analyzed using MannWhitney test. Correlation coefficients were obtained using Spearman's r.Result: Uric acid levels were significantly elevated (P<0.001) in neonates undergoing vaginal birth, compared to neonates born by elective cesarean delivery. When the effect of oxytocin and length of labor was analyzed, neonates born to mothers on oxytocin had lower hypoxanthine, significantly lower xanthine (P ¼ 0.05) and higher uric acid levels. In addition, malondialdehyde levels were significantly higher (P<0.006) in neonates born to mothers who received oxytocin compared to neonates born to mothers without oxytocin augmentation. We also found significant correlations between malondialdehyde (MDA) and hypoxanthine (r ¼ À0.465, P<0.039) and between MDA and xanthine (r ¼ À0.753, P ¼ 0.003) in neonates born via oxytocin-augmented birth. Mode of birth had no statistically significant effect on clinical outcomes, although infants born by elective cesarean had higher incidence of acute respiratory distress and transient tachypnea of the newborn compared to those born vaginally. Conclusion:Neonates born by elective cesarean had the lowest purine levels in cord blood compared to neonates born vaginally. Oxytocin augmentation is associated with some degree of uterine hyperstimulation which may enhance the ATP degradation pathway resulting in the rapid conversion of hypoxanthine to xanthine and xanthine to uric acid. Significantly higher MDA levels in neonates whose mothers received oxytocin as well as significant correlation between MDA and the purines hypoxanthine and xanthine, suggest free-radical production, most likely due to xanthine oxidase activation. However, despite differences in plasma purine and malondialdehyde levels, no significant differences were seen in neonatal outcome. Further studies are required to fully characterize the effect of mode of birth on purine metabolism and free-radical production.

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Section: Introductionmentioning

confidence: 99%