Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

122 cases of high risk pregnancies, consisting of mainly pregnancy-induced hypertension (PIH), medical complications, postmaturity and suspected distress were periodically monitored with 11 biophysical and biochemical assays. Positive prediction accuracy rate was analyzed with a neonatal UA pH less than 7.20 as the criterion of fetal hypoxia and ischemia. A number of predicting items together, namely: NST, the other Manning's 4 items, internal monitoring with abnormal Cardiotocography, meconium deeply stained amniotic fluid, FBS pH less than 7.2, uterine contraction time lasting greater than 37 sec and interval shorter than 70 sec, gave the best sensitivity, specificity, positive and negative prediction rates and total accuracy rate of 71.69%, 84.06%, 77.55%, 79.45% and 78.68% respectively. The causes for false positive and false negative cases were discussed. Special attention must be paid to those cases with low UA pH al though normal Apgar scores during the neonatal period.
 ...
PMID:[Early diagnosis of fetal distress and neonatal asphyxia]. 191 52

The dramatic reduction in perinatal morbidity and mortality over the last decade has not been accompanied by any diminution in the incidence of cerebral palsy. We investigated retrospectively the relationship of certain perinatal events to the subsequent development of cerebral palsy in 75 infants. Cerebral palsy occurred in association with acute intrapartum asphyxia in 8% and traumatic delivery in 11%. Thirty-five percent of cases were associated with chronic fetal distress, defined by a unique fetal heart rate (FHR) pattern consisting of a normal baseline rate with persistently absent variability and mild variable decelerations with overshoot. This pattern was found frequently in association with postmaturity, meconium staining, intrauterine growth retardation, and neonatal seizures. Acid-base studies, when available, did not reveal acidosis. Twenty-seven percent of the cases involved a combination of chronic fetal distress, acute intrapartum fetal asphyxia, and/or traumatic delivery. We postulate that antenatal intermittent umbilical cord compression secondary to oligohydramnios results in repetitive transient central nervous system ischemia, insufficient to cause death, but resulting in a characteristic FHR pattern and impaired neurologic development. If these data are confirmed, this FHR pattern may be an important marker for the development of subsequent neurologic handicap or other adverse outcome.
 ...
PMID:Perinatal antecedents of cerebral palsy. 270 35

Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator. The recent neonatal resuscitation program (NRP) recommends against suctioning but favors resuscitation with positive pressure ventilation of nonvigorous neonates with MSAF. This recommendation is aimed to prevent delay in resuscitation and minimize hypoxia-ischemia often associated with MSAF. In this review, we discuss the pathophysiology, evolution and the evidence, randomized control trials, observational studies, and translational research to support these recommendations. The frequency of ECMO use for neonatal respiratory indication of MAS has declined over the years probably secondary to improvements in neonatal intensive care and reduction of postmaturity. Changes in resuscitation practices may have contributed to reduced incidence and severity of MAS. Larger randomized controlled studies are needed among nonvigorous infants with MSAF. However, ethical dilemmas and loss of equipoise pose a challenge to conduct such studies.
 ...
PMID:Approach to Infants Born Through Meconium Stained Amniotic Fluid: Evolution Based on Evidence? 2934 Oct 45