Spontaneous hypoxia in multiple pregnancies is associated with early fetal decompensation and enhanced T-wave elevation during brief repeated cord occlusion in near-term fetal sheep

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dc.contributor.author Westgate, Jennifer en
dc.contributor.author Wassink, Guido en
dc.contributor.author Bennet, Laura en
dc.contributor.author Gunn, Alistair en
dc.date.accessioned 2017-10-13T02:30:08Z en
dc.date.available 2005-03-07 en
dc.date.issued 2005-10 en
dc.identifier.citation American Journal of Obstetrics and Gynecology, 193(4):1526-1533, 01 Oct 2005 en
dc.identifier.issn 0002-9378 en
dc.identifier.uri http://hdl.handle.net/2292/36040 en
dc.description.abstract Objective The purpose of this study was to examine the hypothesis that fetuses from multiple pregnancies who exhibited spontaneous, stable hypoxia would show more rapid development of metabolic acidosis and hypotension during short repeated episodes of umbilical cord occlusion than normoxic singleton or twin fetuses and, if this proved to be true, to determine whether this deterioration could be identified by changes in T/QRS height or ST waveform shape. Study design Chronically instrumented near-term sheep fetuses (124 ± 1 day) were subjected to 1-minute umbilical cord occlusions every 5 minutes (normoxic group, 8 fetuses; hypoxic group, 10 fetuses) for a total of 4 hours or until mean arterial blood pressure fell below 20 mm Hg for 2 successive occlusions. Results The spontaneous hypoxic, but not normoxic, fetuses had progressive compromise during repeated umbilical cord occlusions, with severe, progressive metabolic acidosis (pH, 7.07 ± 0.14; base deficit,13 ± 1.5 mmol/L vs 7.34 ± 0.07 mmol/L; base deficit after the final occlusion, 1.1 ± 1.4 mmol/L; P < .001), and hypotension (24 ± 2 mm Hg vs 45.5 ± 3 mm Hg; P < .0001); 4 hypoxic fetuses were unable to complete the 4-hour series of occlusions. The hypoxic group showed a much greater increase in T/QRS ratio during (P < .001) and between occlusions. Biphasic ST segment waveforms were not seen in either group either during or between occlusions. Conclusion Exaggerated elevation of the T/QRS ratio during decelerations in early labor may be a useful marker of greater myocardial anaerobic stress (eg, because of pre-existing spontaneous hypoxia), but not of the development of fetal acidemia or hypotension. en
dc.description.uri http://www.ajog.org/article/S0002-9378(05)00414-X/abstract en
dc.language English en
dc.publisher Elsevier en
dc.relation.ispartofseries American Journal of Obstetrics and Gynecology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://sherpa.ac.uk/romeo/issn/0002-9378/ https://www.elsevier.com/about/our-business/policies/sharing en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Spontaneous hypoxia in multiple pregnancies is associated with early fetal decompensation and enhanced T-wave elevation during brief repeated cord occlusion in near-term fetal sheep en
dc.type Journal Article en
dc.identifier.doi 10.1016/j.ajog.2005.03.024 en
pubs.issue 4 en
pubs.begin-page 1526 en
pubs.volume 193 en
dc.rights.holder Copyright: Elsevier en
dc.identifier.pmid 16202751 en
pubs.author-url http://www.sciencedirect.com/science/article/pii/S000293780500414X en
pubs.end-page 1533 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 42130 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Medical Sciences en
pubs.org-id Physiology Division en
dc.identifier.eissn 1097-6868 en
pubs.record-created-at-source-date 2010-09-01 en
pubs.online-publication-date 2005-10-01 en
pubs.dimensions-id 16202751 en

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