The effect of placental lesions on the multisite neonatal tissue oxygenation in IUGR-infants during the first five days after birth

Fennema, S. (Susanna) (2017) The effect of placental lesions on the multisite neonatal tissue oxygenation in IUGR-infants during the first five days after birth. thesis, Medicine.

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Abstract

Placental lesions, such as maternal vascular underperfusion (MVU), fetal thrombotic vasculopathy (FTV) and ascending intrauterine infection (AIUI), are often found in IUGR fetuses. This could result in a redistribution of their circulation in utero (also known as the brain sparing effect), in which vital organs, like the brain, will have a greater perfusion compared to other. It is still unclear whether placental lesions also affect the infant’s circulation during the first days after birth. Therefore, the aim of our study was to explore whether placental lesions are related to multisite neonatal tissue oxygenation in IUGR infants during the first five days after birth. We measured in 39 IUGR-neonates the regional tissue oxygenation using near-infrared spectroscopy. We calculated the mean cerebral, renal and splanchnic tissue oxygen extraction (cFTOE, rFTOE and sFTOE) for the first five days after birth. We studied the effect of various placental lesions on cFTOE, rFTOE and sFTOE using the student t-test and Mann-Whitney U test and evaluated the possible effect of confounders on our outcomes with a multiple regression analysis. MVU infants had a higher rFTOE on day 3 (0.29, p = 0.039) and 5 (0.46, p = 0.032) after birth compared to no MVU infants (0.16 and 0.25, respectively). We found on day 2 and 3 a lower cFTOE in neonates with FTV (0.11, p = 0.049) and AIUI (0.06, p = 0.000), compared to no FTV (0.16) and AIUI (0.17) respectively. Furthermore, neonates with placental signs of malperfusion (MVU and FTV) showed a higher rFTOE on day 5 compared to neonates without placental malperfusion (0.43 versus 0.16, p = 0.018). In conclusion, placental lesions may influence multisite neonatal tissue oxygenation of IUGR infants during their first days after birth. We speculate that only results with respect to malperfusion of the placenta seem to be explained by an ongoing brain sparing effect after birth.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor and Kooi, E.M.W. and Second supervisor and Richter, A.E. and Location Department of Neonatology, University Medical Cente
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:56
Last Modified:	25 Jun 2020 10:56
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1678

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