dinoprost and Asphyxia-Neonatorum

Hypoxic-ischemic encephalopathy (HIE) has deleterious neurological consequences. To identify patients at risk of neuronal damage deserving implementation of neuroprotective strategies clinicians have relied on prenatal sentinel events, postnatal clinical assessment (Apgar score), and blood gas analysis. This feasibility study aimed to assess if lipid peroxidation byproducts associated with neuronal damage correlated with cord blood metabolic acidemia in patients with HIE.. This is a case/control study in which cases were newborn infants with severe acidemia (pH<7.00; base excess ≥12mmol/L) while control babies exhibited normal gases (pH=7.20-7.40; base excess=-4 to +4mmol/L) in the first cord blood analysis performed immediately after birth. Concomitantly, lipid peroxidation byproducts were determined using ultra performance liquid chromatography coupled to mass spectrometry in the same cord blood sample.. A total of 19 controls and 20 cases were recruited. No differences in gestational characteristics were present. However, cases exhibited profound metabolic alterations as compared to controls (Cases vs.. pH=6.90±0.1 vs. 7.33±0.03; base excess=-15±3 vs. -1±2mmol/L), 85% were admitted to the NICU, and 50% developed symptoms of HIE. 8-iso-15(R)-PGF2α (P=0.01) and total isoprostanes (P=0.045) presented statistically significant differences between cases and control groups and correlated with level of HIE.. The 8-iso-15(R)-PGF2α and isoprostanes reflecting oxidative damage are significantly increased in severe postnatal acidemia. Follow up studies with adequate power are necessary to confirm if these biomarkers measured in cord blood serum could be predictive of neonatal encephalopathy.

Topics: Adult; Area Under Curve; Asphyxia Neonatorum; Biomarkers; Case-Control Studies; Dinoprost; Female; Fetal Blood; Humans; Hypoxia-Ischemia, Brain; Isoprostanes; Limit of Detection; Lipid Peroxidation; Male; ROC Curve

Topics: Acidosis; Asphyxia Neonatorum; Dinoprost; Female; Fetal Blood; Humans; Hypoxia-Ischemia, Brain; Infant, Newborn; Isoprostanes; Lipid Peroxides; Pregnancy; Pregnancy Outcome; Prognosis

Topics: Asphyxia Neonatorum; Biomarkers; Dinoprost; Disease Progression; Female; Humans; Hypoxia-Ischemia, Brain; Infant, Newborn; Male; Predictive Value of Tests; Severity of Illness Index; Time Factors

In the course of 12 months 141 deliveries were induced with peroral tablets of Prostin. Only patients with cervix score greater than or equal to 5 were induced after previous rupture of membranes Tablets were administered in the scheme of 1-2-3 in the intervals of 30 minutes. Further doses were applied according to the onset of uterine contractions and the development of side effects. The single dosis of 3 tablets was never exceeded. Successful induction was reached in 136 cases (96.5%), unsuccessful one in 5 cases (3.5%). Vomiting occurred in 15 cases. Neither uterine hyperstimulation nor any other serious side effects were recorded. The average consumption for successful induction was 12 tablets.

Topics: Administration, Oral; Adult; Asphyxia Neonatorum; Dinoprost; Dinoprostone; Dose-Response Relationship, Drug; Female; Humans; Infant, Newborn; Labor, Induced; Pregnancy; Uterine Contraction

Lumbar CSF eicosanoids were measured in 11 neonates with perinatal asphyxia and 12 neonates with suspected sepsis. In the asphyxia group low levels of thromboxane B2 and prostaglandin F2a were detected in five neonates, all of which had had a lumbar puncture prior to 4 hours of age. In the group with suspected sepsis two infants had positive blood cultures and one had strep meningitis. CSF eicosanoids were nondetectable in all patients in this second group with the exception of the infant with meningitis. With meningitis CSF eicosanoids were markedly elevated. These findings suggest that lumbar CSF eicosanoids do not appear to be a clinically useful tool. The data further suggest that eicosanoids are involved in the inflammatory response to meningitis.

Topics: Asphyxia Neonatorum; Dinoprost; Eicosanoic Acids; Humans; Infant, Newborn; Lumbosacral Region; Radioimmunoassay; Sepsis; Thromboxane B2