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Jakovac MB, Etrusco A, Mikuš M, Roje D, Marusic J, Palada I, Kosovic I, Aracic N, Sunj M, Laganà AS, Chiantera V, Dujic Z. Evaluation of placental oxygenation by near-infrared spectroscopy in relation to ultrasound maturation grade in physiological term pregnancies. Open Med (Wars) 2023; 18:20230843. [PMID: 38025545 PMCID: PMC10655680 DOI: 10.1515/med-2023-0843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
A prospective observational study (ClinicalTrial ID: NCT05771415) was conducted to compare placental oxygenation in low-risk, uncomplicated term pregnancies measured by near-infrared spectroscopy (NIRS) in relation to the placental maturity grade determined by ultrasound assessment according to the Grannum scale. We included 34 pregnancies divided into two groups according to placental maturation. For each pregnancy, measurements were taken at the site above the central part of the placenta (test) and at the site outside of the placenta on the lower abdomen (control). Student's t-test was used to compare tissue oxygenation index (TOI) values among the study groups. The normality of distribution was proven by the Kolmogorov‒Smirnov test. In women with low placental maturity grade, the mean TOI value above the placenta was 70.38 ± 3.72, which was lower than the respective value in women with high placental maturity grade (77.99 ± 3.71; p < 0.001). The TOI values above the placenta and the control site were significantly different in both groups (70.38 ± 3.72 vs 67.83 ± 3.21 and 77.99 ± 3.71 vs 69.41 ± 3.93; p < 0.001). The results offer a new perspective on placental function based on specific non-invasive real-time oxygenation measurements. Unfortunately, and because of technical limitations, NIRS cannot yet be implemented as a routine clinical tool.
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Affiliation(s)
| | - Andrea Etrusco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133Palermo, Italy
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, 90127Palermo, Italy
| | - Mislav Mikuš
- Department of Obstetrics and Gynecology, Clinical Hospital Center, 10000Zagreb, Croatia
| | - Damir Roje
- Department of Health Studies, University of Split, 21000Split, Croatia
- University of Split School of Medicine, 21000Split, Croatia
- Department of Obstetrics and Gynecology, University Hospital Center, 21000Split, Croatia
| | - Jelena Marusic
- Department of Health Studies, University of Split, 21000Split, Croatia
- University of Split School of Medicine, 21000Split, Croatia
- Department of Obstetrics and Gynecology, University Hospital Center, 21000Split, Croatia
| | - Ivan Palada
- Department of Health Studies, University of Split, 21000Split, Croatia
- Roda Polyclinic, 21000Split, Croatia
| | - Indira Kosovic
- Department of Obstetrics and Gynecology, University Hospital Center, 21000Split, Croatia
| | - Nadja Aracic
- Department of Health Studies, University of Split, 21000Split, Croatia
- Cito Polyclinic, 21000Split, Croatia
| | - Martina Sunj
- Department of Health Studies, University of Split, 21000Split, Croatia
- Department of Obstetrics and Gynecology, University Hospital Center, 21000Split, Croatia
| | - Antonio Simone Laganà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133Palermo, Italy
- Unit of Obstetrics and Gynecology, “Paolo Giaccone” Hospital, 90127Palermo, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133Palermo, Italy
- Unit of Gynecologic Oncology, National Cancer Institute – IRCCS – Fondazione “G. Pascale”, 80131Naples, Italy
| | - Zeljko Dujic
- University of Split School of Medicine, 21000Split, Croatia
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Uzianbaeva L, Yan Y, Joshi T, Yin N, Hsu CD, Hernandez-Andrade E, Mehrmohammadi M. Methods for Monitoring Risk of Hypoxic Damage in Fetal and Neonatal Brains: A Review. Fetal Diagn Ther 2021; 49:1-24. [PMID: 34872080 PMCID: PMC8983560 DOI: 10.1159/000520987] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/16/2021] [Indexed: 11/19/2022]
Abstract
Fetal, perinatal, and neonatal asphyxia are vital health issues for the most vulnerable groups in human beings, including fetuses, newborns, and infants. Severe reduction in oxygen and blood supply to the fetal brain can cause hypoxic-ischemic encephalopathy (HIE), leading to long-term neurological disorders, including mental impairment and cerebral palsy. Such neurological disorders are major healthcare concerns. Therefore, there has been a continuous effort to develop clinically useful diagnostic tools for accurately and quantitatively measuring and monitoring blood and oxygen supply to the fetal and neonatal brain to avoid severe consequences of asphyxia HIE and neonatal encephalopathy. Major diagnostic technologies used for this purpose include fetal heart rate monitoring, fetus scalp blood sampling, ultrasound imaging, magnetic resonance imaging, X-ray computed tomography, and nuclear medicine. In addition, given the limitations and shortcomings of traditional diagnostic methods, emerging technologies such as near-infrared spectroscopy and photoacoustic imaging have also been introduced as stand-alone or complementary solutions to address this critical gap in fetal and neonatal care. This review provides a thorough overview of the traditional and emerging technologies for monitoring fetal and neonatal brain oxygenation status and describes their clinical utility, performance, advantages, and disadvantages.
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Affiliation(s)
- Liaisan Uzianbaeva
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Yan Yan
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Tanaya Joshi
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
| | - Nina Yin
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
- Department of Anatomy, School of Basic Medical Science, Hubei University of Chinese Medicine, Wuhan, China
| | - Chaur-Dong Hsu
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA
- Department of Physiology, Wayne State University School of Medicine, Detroit, Michigan, USA
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, University of Arizona, College of Medicine, Tucson, Arizona, USA
| | - Edgar Hernandez-Andrade
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Texas Health Science Center, Houston, Texas, USA
| | - Mohammad Mehrmohammadi
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, USA
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services (NICHD/NIH/DHHS), Bethesda, MD, and Detroit, MI, USA
- Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Cho E, Kim YY, Noh K, Ku S. A new possibility in fertility preservation: The artificial ovary. J Tissue Eng Regen Med 2019; 13:1294-1315. [DOI: 10.1002/term.2870] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 04/02/2019] [Accepted: 04/22/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Eun Cho
- College of MedicineSeoul National University Seoul South Korea
| | - Yoon Young Kim
- College of MedicineSeoul National University Seoul South Korea
- Department of Obstetrics and GynecologySeoul National University Hospital Seoul South Korea
| | - Kevin Noh
- College of Human EcologyCornell University Ithaca New York USA
| | - Seung‐Yup Ku
- College of MedicineSeoul National University Seoul South Korea
- Department of Obstetrics and GynecologySeoul National University Hospital Seoul South Korea
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Kintiraki E, Dipla K, Triantafyllou A, Koletsos N, Grigoriadou I, Poulakos P, Sachpekidis V, Vrabas IS, Zafeiridis A, Bili E, Douma S, Goulis DG. Blunted cerebral oxygenation during exercise in women with gestational diabetes mellitus: associations with macrovascular function and cardiovascular risk factors. Metabolism 2018; 83:25-30. [PMID: 29410188 DOI: 10.1016/j.metabol.2018.01.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 01/03/2018] [Accepted: 01/17/2018] [Indexed: 01/23/2023]
Abstract
AIM/HYPOTHESIS This cross-sectional, observational, controlled study examined cerebral oxygenation during exercise, an index of cerebrovascular function and cortical activation, in pregnancies complicated by gestational diabetes mellitus (GDM) and unaffected pregnancies. The association of cerebral oxygenation with macrovascular and cardiovascular function indices was also evaluated. MATERIAL AND METHODS Vascular function and structure [aortic pulse-wave-velocity (PWV), augmentation index (AI), carotid intima-media thickness], as well as 24-hour ambulatory blood pressure (BP) were assessed in women with GDM (n = 21) and uncomplicated pregnancies (n = 16), at 26-32 gestational weeks. Changes in cerebral oxygenation [oxy- (O2Hb), deoxy- (HHb) and total- (tHb) hemoglobin] were continuously recorded by near-infrared spectroscopy (NIRS) during intermittent handgrip exercise. Beat-by-beat BP and systemic vascular resistance (SVR) were assessed (Finapres). RESULTS Women with GDM had higher AI than controls. During exercise, women with GDM maintained a smaller force (p < 0.05), despite similar ratings of perceived exertion. Despite similar increases in BP during exercise, the GDM group exhibited a lower average and total (AUC) increase in cerebral-O2Hb than controls (p < 0.05). In addition, GDM exhibited a slower rate of cerebral-O2Hb decay during recovery (p < 0.05). SVR was lower in GDM compared to controls throughout the protocol (p < 0.01). Cerebral oxygenation indices were correlated with PWV and AI (p < 0.05). CONCLUSIONS This study provided novel evidence for blunted cerebral oxygenation during exercise in women with GDM compared to uncomplicated pregnancies, suggesting a link between reduced cerebrovascular function with exercise intolerance in GDM. Cerebral oxygenation during physical stress was correlated with macrovascular function and cardiovascular risk factors. More studies are needed to examine whether this impaired cerebral oxygenation reflects early cerebrovascular disease.
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Affiliation(s)
- Evangelia Kintiraki
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece.
| | - Konstantina Dipla
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Areti Triantafyllou
- Third Department of Internal Medicine, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece
| | - Nikolaos Koletsos
- Third Department of Internal Medicine, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece
| | - Iris Grigoriadou
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Pavlos Poulakos
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece
| | - Vasileios Sachpekidis
- Second Department of Cardiology, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece
| | - Ioannis S Vrabas
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Andreas Zafeiridis
- Laboratory of Exercise Physiology and Biochemistry, Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Eleni Bili
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece
| | - Stella Douma
- Third Department of Internal Medicine, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, "Papageorgiou" General Hospital, Ring Road, Nea Efkarpia, Thessaloniki, Greece
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