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Departments of 1 Obstetrics and Gynaecology, 2 Paediatrics, and 3 Medical Physics and Bioengineering, University College London, London WC1E 6HX, United Kingdom
The purpose of
this study was to investigate metabolic and hemodynamic responses in
two fetal tissues, hindlimb muscle and brain, to an episode of acute
moderate asphyxia. Near-infrared spectroscopy was used to measure
changes in total hemoglobin concentration ([tHb]) and the
redox state of cytochrome oxidase (COX) simultaneously in the brain and
hindlimb of near-term unanesthetized fetal sheep in utero. Oxygen
delivery (DO2) to, and consumption
(
O2) by, each tissue was
derived from the arteriovenous difference in oxygen content and blood
flow, measured by implanted flow probes. One hour of moderate asphyxia
(n = 11), caused by occlusion of the maternal common internal
iliac artery, led to a significant fall in DO2
to both tissues and to a significant drop in
O2 by the head. This was
associated with an initial fall in redox state COX in the leg but an
increase in the brain. [tHb], and therefore blood volume,
fell in the leg and increased in the brain. These data suggest the
presence of a fetal metabolic response to hypoxia, which, in the brain,
occurs rapidly and could be neuroprotective.
cytochrome oxidase; near-infrared spectroscopy; neuroprotection; blood flow
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