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The fetus at the tipping point: modifying the outcome of fetal asphyxia

Dhillon, SK; Lear, CA; Galinsky, R; Wassink, G; Davidson, JO; Juul, S; Robertson, NJ; ... Bennet, L; + view all (2018) The fetus at the tipping point: modifying the outcome of fetal asphyxia. Journal of Physiology , 596 (23) pp. 5571-5592. 10.1113/JP274949. Green open access

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Abstract

Brain injury around birth is associated with nearly half of all cases of cerebral palsy. Although brain injury is multifactorial, particularly after preterm birth, acute hypoxia-ischaemia is a major contributor to injury. It is now well established that the severity of injury after hypoxia-ischaemia is determined by a dynamic balance between injurious and protective processes. In addition, mothers who are at risk of premature delivery have high rates of diabetes and antepartum infection/inflammation and are almost universally given treatments such as antenatal glucocorticoids and magnesium sulphate to reduce the risk of death and complications after preterm birth. We review evidence that these common factors affect responses to fetal asphyxia, often in unexpected ways. For example, glucocorticoid exposure dramatically increases delayed cell loss after acute hypoxia-ischaemia, largely through secondary hyperglycaemia. This critical new information is important to understand the effects of clinical treatments of women whose fetuses are at risk of perinatal asphyxia.

Type: Article
Title: The fetus at the tipping point: modifying the outcome of fetal asphyxia
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1113/JP274949
Publisher version: https://doi.org/10.1113/JP274949
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: brain injury, fetus, hypoxia
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Neonatology
URI: https://discovery.ucl.ac.uk/id/eprint/10062635
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