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Umbilical cord occlusion

Rosemary Townsend, Asma Khalil
PURPOSE OF REVIEW: Selective intrauterine growth restriction (sIUGR) in twin pregnancies presents a complex management problem for the fetal medicine specialist. This review summarizes what is currently known about sIUGR pathophysiology, particularly in monochorionic pregnancies and looks at the results of early trials of fetal intervention in high-risk sIUGR pregnancies. RECENT FINDINGS: sIUGR in monochorionic pregnancies is due to unequal placental sharing, but the clinical outcome is determined by the characteristics of the placental vascular anastomoses...
October 15, 2016: Current Opinion in Obstetrics & Gynecology
Ching-Chung Liang, Tsong-Hai Lee, Shuenn-Dhy Chang
OBJECTIVE: To demonstrate the effect of human umbilical cord blood-derived CD34(+) cells on bladder dysfunction induced by cerebral ischemia in rats. MATERIALS AND METHODS: Female rats were subjected to either 60 minute middle cerebral artery occlusion (MCAO) or a sham operation. Rats were divided into four groups: sham operation, MCAO without treatment, infusion with 1×10(6) CD34(+) cells 30 minutes before MCAO, and infusion with 1×10(6) CD34(+) cells 3 hours after MCAO...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
K V Schou, L N Jensen, C Jørgensen, K Søgaard, A Tabor, K Sundberg
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Miguel A Zarate, Eileen I Chang, Andrew Antolic, Charles E Wood
Umbilical cord occlusion (UCO) is a hypoxic insult that has been used to model birth asphyxia and umbilical cord compression in utero. UCO triggers vigorous neural and endocrine responses that include increased plasma ACTH and cortisol concentrations, increased blood pressure (BP), and decreased heart rate (HR). We have previously reported that ketamine, a noncompetitive N-methyl-D-aspartate receptor antagonist, can modify the fetal hemodynamic and ACTH responses to ventilatory hypoxia and cerebral ischemia-reperfusion...
September 2016: Physiological Reports
Jennifer R King, Charlotte L Conturie, Joseph G Ouzounian, Lisa M Korst, Arlyn Llanes, Ramen H Chmait
INTRODUCTION: Umbilical cord occlusion (UCO) utilizing laser photocoagulation is often not considered an option for selective termination after 20 weeks of gestation due to reported limitations of the procedure because of umbilical cord size. We compared outcomes after laser umbilical cord occlusion (L-UCO) before and after 20 weeks of gestation. MATERIALS AND METHODS: We examined all patients with monochorionic- diamniotic twins and higher-order multiples (monoamniotic excluded) that underwent L-UCO at our facility between 2006 and 2014...
August 31, 2016: Fetal Diagnosis and Therapy
M A Guven, O Koc, H Bodur, S Erkanli, T Bagis, D Usal
Twin reversed arterial perfusion (TRAP) sequence is a serious condition of monochorionic twin pregnancy, occurring in approximately one in 35,000 cases. First trimester treatment of TRAP sequence is controversial with higher incidence of procedure related complications. Present case demonstrates a TRAP sequence that was managed by intrauterine treatment with one-ml 100% pure alcohol injection into the abdominal part of the umbilical artery and obliteration of the acardiac twin at 14 weeks of gestation. Antenatal follow-up was uneventful and elective cesarean section was performed at 39 weeks' gestation...
2016: Clinical and Experimental Obstetrics & Gynecology
Jingang Li, Tamara Yawno, Amy Sutherland, Jan Loose, Ilias Nitsos, Robert Bischof, Margie Castillo-Melendez, Courtney A McDonald, Flora Y Wong, Graham Jenkin, Suzanne L Miller
Infants born very preterm are at high risk for neurological deficits including cerebral palsy. In this study we assessed the neuroprotective effects of umbilical cord blood cells (UCBCs) and optimal administration timing in a fetal sheep model of preterm brain injury. 50 million allogeneic UCBCs were intravenously administered to fetal sheep (0.7 gestation) at 12h or 5d after acute hypoxia-ischemia (HI) induced by umbilical cord occlusion. The fetal brains were collected at 10d after HI. HI (n=7) was associated with reduced number of oligodendrocytes (Olig2+) and myelin density (CNPase+), and increased density of activated microglia (Iba-1+) in cerebral white matter compared to control fetuses (P<0...
September 2016: Experimental Neurology
Maria Nikiforou, Carolin Willburger, Anja E de Jong, Nico Kloosterboer, Reint K Jellema, Daan R M G Ophelders, Harry W M Steinbusch, Boris W Kramer, Tim G A M Wolfs
Perinatal asphyxia, a condition of impaired gas exchange during birth, leads to fetal hypoxia-ischemia (HI) and is associated with postnatal adverse outcomes including intestinal dysmotility and necrotizing enterocolitis (NEC). Evidence from adult animal models of transient, locally-induced intestinal HI has shown that inflammation is essential in HI-induced injury of the gut. Importantly, mesenchymal stem cell (MSC) treatment prevented this HI-induced intestinal damage. We therefore assessed whether fetal global HI induced inflammation, injury and developmental changes in the gut and whether intravenous MSC administration ameliorated these HI-induced adverse intestinal effects...
April 11, 2016: Molecular Medicine
Guido Wassink, Joanne O Davidson, Simerdeep K Dhillon, Mhoyra Fraser, Robert Galinsky, Laura Bennet, Alistair J Gunn
Perinatal asphyxia in preterm infants remains a significant contributor to abnormal long-term neurodevelopmental outcomes. Recombinant human erythropoietin has potent non-haematopoietic neuroprotective properties, but there is limited evidence for protection in the preterm brain. Preterm (0.7 gestation) fetal sheep received sham asphyxia (sham occlusion) or asphyxia induced by umbilical cord occlusion for 25 min, followed by an intravenous infusion of vehicle (occlusion-vehicle) or recombinant human erythropoietin (occlusion-Epo, 5000 international units by slow push, then 832...
May 20, 2016: Journal of Cerebral Blood Flow and Metabolism
M G Frasch, M Szynkaruk, A P Prout, K Nygard, M Cao, R Veldhuizen, R Hammond, B S Richardson
BACKGROUND: Neuroinflammation in utero may contribute to brain injury resulting in life-long neurological disabilities. The pivotal role of the efferent cholinergic anti-inflammatory pathway (CAP) in controlling inflammation, e.g., by inhibiting the HMGB1 release, via the macrophages' α7 nicotinic acetylcholine receptor (α7nAChR) has been described in adults, but its importance in the fetus is unknown. Moreover, it is unknown whether CAP may also exert anti-inflammatory effects on the brain via the anatomically predominant afferent component of the vagus nerve...
2016: Journal of Neuroinflammation
Daan R M G Ophelders, Tim G A M Wolfs, Reint K Jellema, Alex Zwanenburg, Peter Andriessen, Tammo Delhaas, Anna-Kristin Ludwig, Stefan Radtke, Vera Peters, Leon Janssen, Bernd Giebel, Boris W Kramer
UNLABELLED: Preterm neonates are susceptible to perinatal hypoxic-ischemic brain injury, for which no treatment is available. In a preclinical animal model of hypoxic-ischemic brain injury in ovine fetuses, we have demonstrated the neuroprotective potential of systemically administered mesenchymal stromal cells (MSCs). The mechanism of MSC treatment is unclear but suggested to be paracrine, through secretion of extracellular vesicles (EVs). Therefore, we investigated in this study the protective effects of mesenchymal stromal cell-derived extracellular vesicles (MSC-EVs) in a preclinical model of preterm hypoxic-ischemic brain injury...
June 2016: Stem Cells Translational Medicine
Lan-Lan Zhang, Hong-Tian Zhang, Ying-Qian Cai, Yan-Jiang Han, Fang Yao, Zhao-Hu Yuan, Bing-Yi Wu
Here, we have investigated the synergistic effect of quercetin administration and transplantation of human umbilical cord mesenchymal stromal cells (HUMSCs) following middle cerebral artery occlusion in rat. Combining quercetin treatment with delayed transplantation of HUMSCs after local cerebral ischemia significantly (i) improved neurological functional recovery; (ii) reduced proinflammatory cytokines (interleukin(IL)-1β and IL-6), increased anti-inflammatory cytokines (IL-4, IL-10, and transforming growth factor-β1), and reduced ED-1 positive areas; (iii) inhibited cell apoptosis (caspase-3 expression); and (iv) improved the survival rate of HUMSCs in the injury site...
October 2016: Cellular and Molecular Neurobiology
Shalini Shenoy, Alexis A Thompson
Thalassemia major is characterized by severe anemia dependent on red cell transfusions from infancy. Conservative management requires a safe source of compatible blood throughout life, strategies to combat iron overload, monitoring and treatment of transfusion-related complications, and management of cardiac and/or hepatic dysfunction from iron accumulation. Complications can result in premature morbidity and mortality. Stem cell transplantation is curative, but outcomes depend on the availability of a histocompatible donor, recipient age, and disease-related complications...
March 2016: Annals of the New York Academy of Sciences
Laura L Hocum Stone, Feng Xiao, Jessica Rotschafer, Zhenhong Nan, Mario Juliano, Cyndy D Sanberg, Paul R Sanberg, Nicole Kuzmin-Nichols, Andrew Grande, Maxim C-J Cheeran, Walter C Low
Despite the high prevalence and devastating outcome, there remain a few options for treatment of ischemic stroke. Currently available treatments are limited by a short time window for treatment and marginal efficacy when used. We have tested a human umbilical cord blood-derived stem cell line that has been shown to result in a significant reduction in stroke infarct volume as well as improved functional recovery following stroke in the rat. In the present study we address the mechanism of action and compared the therapeutic efficacy of high- versus low-passage nonhematopoietic umbilical cord blood stem cells (nh-UCBSCs)...
2016: Cell Transplantation
Zoya Gordon, Lilia Glaubach, David Elad, Uri Zaretsky, Ariel J Jaffa
OBJECTIVES: The purpose of this study was to develop an ex vivo placental perfusion model to assess changes in the umbilical artery systolic-to-diastolic (S/D) ratio due to progressive occlusion of the placental arterial system. METHODS: Ex vivo human placentas were connected to a computerized pulse duplicator mimicking pulsatile flow from the fetal heart. Doppler sonographic measurements were conducted on the umbilical and chorionic arteries of 25 mature placentas...
March 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Naoki Tajiri, Jea Young Lee, Sandra Acosta, Paul R Sanberg, Cesar V Borlongan
Blood-brain barrier (BBB) permeabilizers, such as mannitol, can facilitate peripherally delivered stem cells to exert therapeutic benefits on the stroke brain. Although this BBB permeation-aided stem cell therapy has been demonstrated in the acute stage of stroke, such BBB permeation in the chronic stage of the disease remains to be examined. Adult Sprague-Dawley rats initially received sham surgery or experimental stroke via the 1-h middle cerebral artery occlusion (MCAo) model. At 1 month after the MCAo surgery, stroke animals were randomly assigned to receive human umbilical cord stem cells only (2 million viable cells), mannitol only (1...
2016: Cell Transplantation
Alex Zwanenburg, Ben Jm Hermans, Peter Andriessen, Hendrik J Niemarkt, Reint K Jellema, Daan Rmg Ophelders, Rik Vullings, Tim Gam Wolfs, Boris W Kramer, Tammo Delhaas
BACKGROUND: Current methods for assessing perinatal hypoxic conditions did not improve infant outcomes. Various waveform-based and interval-based ECG markers have been suggested, but not directly compared. We compare performance of ECG markers in a standardized ovine model for fetal hypoxia. METHODS: Sixty-nine fetal sheep of 0.7 gestation had ECG recorded 4 h before, during, and 4 h after a 25-min period of umbilical cord occlusion (UCO), leading to severe hypoxia...
June 2016: Pediatric Research
Matthias Seehase, Patrick Houthuizen, Jennifer J P Collins, Luc J Zimmermann, Boris W Kramer
BACKGROUND: Little is known about the effects of propofol on oxidative stress and its effect on key structures of the contractile apparatus as the myosin light chain 2 (MLC2) and the p38MAPK survival pathway in the preterm heart. We hypothesized that propofol administration could attenuate the hypoxic myocardial injury after birth asphyxia. METHODS: Pregnant ewes were randomized to receive either propofol or isoflurane anesthesia. A total of 44 late-preterm lambs were subjected to in utero umbilical cord occlusion (UCO), resulting in asphyxia and cardiac arrest, or sham treatment...
May 2016: Pediatric Research
Ching-Chung Liang, Ho-Ling Liu, Shuenn-Dhy Chang, Sheng-Hsien Chen, Tsong-Hai Lee
Human umbilical cord blood derived CD34+ stem cells are reported to mediate therapeutic effects in stroke animal models. Estrogen was known to protect against ischemic injury. The present study wished to investigate whether the protective effect of CD34+ cells against ischemic injury can be reinforced with complemental estradiol treatment in female ovariectomized rat and its possible mechanism. Experiment 1 was to determine the best optimal timing of CD34+ cell treatment for the neuroprotective effect after 60-min middle cerebral artery occlusion (MCAO)...
2016: PloS One
N Brew, A Azhan, I den Heijer, M Boomgardt, G I Davies, I Nitsos, S L Miller, A M Walker, D W Walker, F Y Wong
Dopamine is often used to treat hypotension in preterm infants; these infants are at risk of developing brain injury due to impaired autoregulation and cerebral hypoperfusion. However the effects of dopamine on the immature brain under conditions of cerebral hypoxia are not known. We hypothesized that pretreatment with dopamine would protect the immature brain from injury caused by cerebral hypoxia. Preterm fetal sheep were used to determine the effects of intravenous dopamine on hypoxia-induced brain injury...
March 1, 2016: Neuroscience
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