Cerebral hemodynamics during the induction of antenatal periventricular leukomalacia by hemorrhagic hypotension in chronically instrumented fetal sheep

Tadashi Matsuda, Kazuhiko Okuyama, Kazutoshi Cho, Satoru Okajima, Yoshiyasu Kobayashi, Yoko Hoshi, Kunihiko Kobayashi

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Our purpose was to determine the characteristics of cerebral ischemia during the induction of antenatal periventricular leukomalacia by hemorrhagic hypotension in premature fetal sheep. Study design: The hemorrhage group received an acute withdrawal of 40% of the fetoplacental blood volume (n = 7), whereas an isovolemic exchange transfusion was performed in the control group (n = 7). Changes in the total hemoglobin, oxy-hemoglobin, and deoxy-hemoglobin levels in the cerebral tissue were assessed with the use of near-infrared spectroscopy and compared statistically. Results: Of 7 fetuses in the hemorrhage group, 5 exhibited periventricular leukomalacia but none in the control group (P < .05). In the hemorrhage group, both brain total-hemoglobin and deoxy-hemoglobin decreased seriously after insult, and the decreased levels persisted even after recovery of systemic blood pressure, whereas such drastic changes were not observed in the control group, suggesting the occurrence of reperfusion failure in the fetal brain in the hemorrhage group. Conclusion: The no-reflow phenomenon and successive reperfusion injuries after cerebral ischemia could be closely involved in the induction of antenatal periventricular leukomalacia in this experimental condition.

Original languageEnglish
Pages (from-to)1057-1063
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume194
Issue number4
DOIs
Publication statusPublished - 2006 Apr

Keywords

  • Cerebral blood volume
  • Near-infrared spectroscopy
  • No-reflow phenomenon
  • Reperfusion injury

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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