With the onset of ventilation at birth, cerebral blood flow decreases as oxygenation increases, but the mechanism of cerebral vasoconstriction is unknown. Cytochrome P-450 omega-hydroxylase activity metabolizes arachidonic acid to 20-HETE, a potent vasoconstrictor, in a physiologically relevant O(2)-dependent manner. We tested the hypothesis that the omega-hydroxylase inhibitor, 17-octadecynoic acid (17-ODYA), reduces cerebral vasoconstriction during in utero ventilation with O(2) in fetal sheep. In anesthetized pregnant sheep near term, the fetal head was exposed with the rest of the body remaining in utero. Pial arteriolar diameter was measured by intravital microscopy through a closed cranial window superfused with vehicle or 17-ODYA. Mechanical ventilation of the fetal lungs with a high O(2) mixture to increase arterial Po(2) from approximately 20 to approximately 90 Torr markedly decreased pial arteriolar diameter by 24 + or - 3% (+ or - SE) without a change in arterial pressure. In contrast, superfusion of 17-ODYA completely blocked the decrease in diameter (2 + or - 3%) with increased oxygenation. Vasoconstriction to hypocapnia was intact after returning to the baseline intrauterine oxygenation state, thereby indicating that the effect of 17-ODYA was selective for increased oxygenation. In cerebral arteries isolated from fetal sheep, increasing oxygenation increased 20-HETE production. We conclude that cytochrome P-450 omega-hydroxylase activity makes an important contribution to cerebral vasoconstriction associated with the onset of ventilation at birth.
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http://dx.doi.org/10.1152/japplphysiol.01090.2009 | DOI Listing |
Exp Physiol
January 2025
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
The mechanisms linking maternal asthma (MA) exposure in utero and subsequent risk of asthma in childhood are not fully understood. Pathological airway remodelling, including reticular basement membrane thickening, has been reported in infants and children who go on to develop asthma later in childhood. This suggests altered airway development before birth as a mechanism underlying increased risk of asthma in children exposed in utero to MA.
View Article and Find Full Text PDFBeijing Da Xue Xue Bao Yi Xue Ban
February 2025
Department of Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
This study reports the diagnosis and treatment of a 26-year-old pregnant woman with severe malnutrition combined with acute pyelonephritis causing sepsis, refractory septic shock and multiple organ failure. A female patient, 26 years old, was admitted to hospital mainly due to "menelipsis for more than 19 weeks, nausea and vomiting for 20 days, fever with fatigue for 3 days". At the end of 19 weeks of intrauterine pregnancy, the patient presented with fever accompanied by urinary tract irritation.
View Article and Find Full Text PDFJ Perinat Neonatal Nurs
January 2025
Author Affiliations: Department of Pediatric and Neonatal Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran (Mrs Mohseni and Dr Ramezani); Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mrs (Dr Ramezani); Department of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran (Dr Saki); and Neonatologist, NICU Department, Hakim Hospital, Neyshabur University of Medical Sciences, Neyshabur, Iran (Dr Poor-Alizadeh).
With the increasing survival rates of premature infants and their associated respiratory problems, noninvasive ventilation has gained popularity in neonatal intensive care units. On the other hand, this equipment can be stressful for infants. Objective: This study aimed to compare the effects of white noise and sound reduction on the behavioral responses of premature infants under noninvasive ventilation.
View Article and Find Full Text PDFPediatr Surg Int
January 2025
Division of Neonatology, The Hospital for Sick Children, Toronto, ON, Canada.
Introduction: Congenital diaphragmatic hernia (CDH) in the preterm population is increasingly common in the current era of fetal endoluminal tracheal occlusion (FETO) therapy. There remains a lack of clinical guidance for clinicians and surgeons regarding optimal management strategies for such infants. We aimed to describe our experience in managing preterm CDH in a single quaternary neonatal intensive care unit (NICU).
View Article and Find Full Text PDFObstet Gynecol
January 2025
Riley Children's, the Division of Maternal-Fetal Medicine, Indiana University Health Fetal Center, and the Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana; the Division of Maternal-Fetal Medicine and Surgery, Fetal Care and Surgery Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; the Department of Obstetrics and Gynecology, Brown University Medical School, Providence, Rhode Island; the Fetal Medicine Unit, St George's Hospital, St George's University of London, London, United Kingdom; the Division of Maternal-Fetal Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania; and the Division of Maternal-Fetal Medicine, The Ohio State University, Columbus, Ohio.
Objective: To investigate short-term maternal and neonatal outcomes in individuals with twin pregnancies and two prior cesarean deliveries who underwent trial of labor after cesarean (TOLAC).
Methods: A cross-sectional study of live-birth data was conducted between 2014 and 2021 in the United States. Individuals with more than two prior cesarean deliveries and multiple gestations higher than twins were excluded.
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