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At least 91 records · Page 5Linked to original sources
PubMed1997

Prenatal ischemia reduces neuronal injury caused by neonatal hypoxia-ischemia in rats.

To determine whether 'ischemic tolerance', first described in adult rodents, exists in fetal and neonatal rats, a comparison of brain injury was made between two groups of rat pups following neonatal hypoxia-ischemia (HI). One group of rat pups had previously been subjected to HI in utero (HI + HI); the other had been subjected to a sham operation (SH + HI). Brain infarct size and neuronal injury were measured 24 h after the neonatal HI insult. As indicated by 2,3,5-triphenyltetrazolium chloride staining and pathological examination, cerebral damage was significantly less in the HI+ HI group than in the SH + HI group. Induction of heat shock protein 70 (hsp70) was immunohistochemically detectable in both groups 24 h after the neonatal HI, and was proportional to the extent of tissue damage. The ischemic tolerance phenomenon observed in immature rats does not appear to be a result of induction of hsp70.

Animals↗
PubMed1994

CK-BB as indicator of prenatal brain-cell injury in fetuses with absent or reverse end-diastolic flow velocities of the umbilical arteries.

The purpose of this study is to determine the levels of brain type isoenzyme of creatine kinase (CK-BB) as a possible indicator of a pre-existing intrauterine brain-cell damage in cord blood sera of fetuses with preceding absent or reverse end-diastolic flow velocities of the umbilical arteries (AREDFV). CK-BB isoenzyme activities were determined in umbilical cord sera of 13 newborn infants with preceding AREDFV and in 14 fetuses with low end-diastolic flow velocities (LEDFV) of the umbilical arteries. 50 newborn infants with elective cesarean section and normal umbilical artery blood flow velocity waveforms were used as controls. Two-tailed Student's t-test and Fischer's exact test were used for statistical evaluation of the results. CK-BB isoenzyme activity did not depend on gestational age. Fetuses with AREDFV showed a significant increase in CK-BB values, whereas fetuses with LEDFV had CK-BB activities within the normal range of the controls. The elevated CK-BB values of the AREDFV group were not correlated with fetal acidosis at birth. Brain-cell injury with leakage of CK-BB isoenzyme might be present in fetuses with AREDFV even before (preterm) delivery.

Blood Flow Velocity↗
PubMed1998

Gunshot uterine rupture: a case report.

A case report of gunshot uterine rupture from which the mother and fetus survived is presented for the first time. Management was guided by pre-operative ultrasound diagnosis of traumatic anhydramnios.

Adult↗
PubMedDate not supplied

[Atrophy of the cervical spinal cord as a consequence of a prenatal ischemic infarct].

INTRODUCTION: Spinal cord injuries in newborn infants following a traumatic delivery are well known, but occasionally cord damage is appreciated in children whose birth did not involve any complications; in some of them there has been proof of an ischemic process that originated inside the uterus. CASE REPORT: We describe the case of a newborn female with atrophy of the cervical spinal cord compatible with an intrauterine ischemic infarct. It extended to the C4-C6 territory of the anterior spinal artery, with greater participation on the left side. Clinical symptoms were apparent from the moment of birth and took the form of an asymmetric pseudoarthrogryposis in the upper limbs. The left arm was held in abduction at the height of the shoulder, with complete flexion of the elbow and the hand at the height of the chin was hypotonic, inactive and hypotrophic; the right arm was extended and in adduction. The patient presented episodes of hyperthermia that remitted on cooling the body. CONCLUSIONS: When faced with a newborn infant with symptoms that are compatible with chronic cervical spinal cord damage and in the absence of any perinatal traumatic injury, other causes, including prenatal ischemic infarct, must be taken into account.

Cervical Vertebrae↗
PubMed1992

Tissue heating effect of pulsed Doppler ultrasound in the live fetal lamb brain.

A series of experiments in fetal lambs investigated the heating effects of pulsed Doppler ultrasound on fetal brain tissue. In dead lamb brain, tissue heating was observed at the skull bone-to-brain interface. Minimal or no temperature rise was found in the live lamb, suggesting that the intact circulation conducts away any potential heating. The choice of animal model and the state of the circulation influence the results obtained. This will of course have implications for clinical practice.

Animals↗
PubMed2005

Intrauterine penetrating direct fetal head trauma following gunshot injury: a case report and review of the literature.

CASE REPORT: An unusual case of an intrauterine penetrating head injury due to a pellet from an airgun is described. A 28-year-old pregnant woman, at term, shot herself intravaginally with a toy BB gun. Following a spontaneous precipitous vaginal delivery, the neonate presented with persistent seizure disorder, meningitis, cerebritis, and a right parietal region scalp swelling. Imaging studies revealed intracranial hemorrhage, and the metallic pellet was adjacent to the right lateral ventricle, which was removed through a parietal craniotomy. Computed tomography of the brain after 1 week demonstrated early abscess formation in the left frontal operculum and a subdural empyema in the posterior fossa. The abscesses were evacuated, and the meningitis was treated vigorously with broad-spectrum antibiotics. Although well for the past 6 years, the child demonstrates significant mental handicap and developmental delay. DISCUSSION: The pathogenesis, management, and medicolegal issues pertaining to the above case are discussed, and the relevant literature is briefly reviewed.

Adult↗
PubMed2000

[Head injury and pregnancy].

Even mild, head injury during pregnancy can threaten either the maternal or the fetal life. Traffic accidents are the main causes so head injury is often associated with other lesions, frequently abdominal trauma. Among all these possible lesions, head injury and hemorrhagic shock are the main sources of fatality in pregnant women. All kinds of trauma and especially head injuries have a potentially deleterious effect on fetal viability. This risk is associated with systemic and cerebral consequences of post-traumatic arterial hypotension, anoxia or anemia. Moreover, diagnostic procedures and medications can add their noxious secondary effects, contributing more or less to poor fetal outcome. Decision making is necessarily dictated by the severity of the consciousness disorders and/or the encephalic lesions. A convergent discussion between the intensive care physician, the neurosurgeon, the obstetrician and the anesthesiologist is needed. Severe or prolonged traumatic coma is highly dramatic situation because the maternal outcome remains largely unknown for days or weeks. Technically, for these severe comas, there are no substantial differences with what is usually done in a similar case without pregnancy. Neurosurgical indications follow the usual rules, except that some non-urgent indications should be delayed for a while. Usually, this simple rule of independency in indications also applies to the obstetrician. Special care must be taken for fetal monitoring required throughout the initial critical phase.

Brain Injuries↗
PubMed1994

An unexpected fetal outcome following a severe maternal motor vehicle accident.

BACKGROUND: Maternal motor vehicle injury occurs commonly and can cause serious fetal injury. Optimum pregnancy management at the time of maternal presentation following trauma requires reliable methods of fetal assessment. In this report, we present a case in which currently accepted methods of fetal assessment initially failed to demonstrate catastrophic fetal brain injury following a maternal motor vehicle accident. CASE: A 28-year-old primigravida woman at 27 weeks' gestation was in a pedestrian motor vehicle accident, suffering a closed head injury and multiple fractures. Initial fetal assessment included cardiotocographic monitoring for 24 hours fetal ultrasound, both of which were normal, as was a biophysical profile done on the fifth day after the accident. These were repeated at intervals, but definite evidence of fetal brain injury was not seen until unilateral ventricular dilatation was documented on ultrasound at 35 weeks' gestation. Postnatal imaging showed microcephaly, hydrocephalus ex vacuo, and multiple hemispheric hypodensities, likely representing post-traumatic hemorrhages with secondary infarction. At the age of 4 years, the child is cortically blind, epileptic, and quadriparetic. CONCLUSION: This pregnancy outcome was unexpectedly poor despite the reassuring initial assessment. We caution that these methods may not provide accurate early fetal assessment, especially when fetal brain stem function is spared.

Accidents, Traffic↗
PubMed2004

Fetal intracranial injuries in a preterm infant after maternal motor vehicle accident: a case report.

OBJECTIVE: To present a case of fetal intracranial injuries in a preterm infant after maternal motor vehicle accident and to review the relevant literature. DESIGN: Case report. SETTING: Neonatal and pediatric intensive care unit of a children's hospital. PATIENT: Preterm infant (gestational age, 30-6/7 wks) with intracranial injuries after maternal motor vehicle accident. RESULTS: Whereas the mother had only a closed femur fracture, her infant sustained subdural, subarachnoid, and intracerebral hemorrhages in the left parietal and temporal lobes most likely attributable to direct fetal trauma. Massive fetomaternal hemorrhage may have led additionally to hypoxia-ischemia contributing indirectly to the injury. At the last follow-up visit (chronological age, 20 months; corrected age, 18 months), there was evidence of a persistent right-sided hemiparesis in an otherwise normally developed infant. CONCLUSIONS: Motor vehicle accidents during pregnancy can be associated with fetal mortality and significant morbidity, even in the absence of severe maternal injuries. Direct (hemorrhagic) and indirect (hypoxic-ischemic) intracranial injuries should be actively sought with appropriate imaging studies.

Accidents, Traffic↗
PubMed2006

Predictors and correlates of high levels of depression and anxiety symptoms among children at age 10.

OBJECTIVE: To identify factors that predict or are correlated with symptoms of depression and anxiety in 10-year-olds. METHOD: Women and their offspring were followed from the fourth prenatal month through 10 years. There were 636 mother-child pairs at 10 years, a follow-up rate of 83% of the birth cohort. Cognitive, psychological, sociodemographic, and environmental factors were measured at each phase. High depression and anxiety were defined as having a number of symptoms >1 SD above the mean for each measure. These measures were combined to represent high depression and/or anxiety (D/A) at 10 years of age. RESULTS: Predictors from the prenatal period of D/A at 10 years were more maternal depression symptoms, African American race, less social support, greater household density, and prenatal marijuana exposure. From 18 months through 6 years, lower child IQ, child injuries at age 3, and attention problems predicted symptoms of D/A at age 10. Across all study phases, lower child IQ, household density during pregnancy, attention problems, early childhood injuries, and prenatal marijuana exposure predicted D/A. Maternal psychological and sociodemographic factors were not significant in the final model. CONCLUSIONS: Factors from gestation and early childhood predict high symptom levels of depression and anxiety at age 10. When gestational exposure, early environmental factors, and child characteristics were considered, maternal depression and socioeconomic status were not significantly associated with early onset D/A. Marijuana exposure during gestation marginally predicted depression/anxiety at age 10.

Adolescent↗