Yehuda Ginosar1, Yuval Gielchinsky2, Nathalie Nachmansson3, Lital Hagai4, Joel Shapiro5, Uriel Elchalal6, Rinat Abramovitch7. 1. Mother and Child Anesthesia Unit, Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, POB 12000, Ein Kerem, Jerusalem 91120, Israel; Division of Obstetric Anesthesia, Department of Anesthesiology, Washington University School of Medicine, 660 South Euclid - Campus Box 8054 St. Louis, MO 63110-1093, USA. Electronic address: ginosar@hadassah.org.il. 2. Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, POB 12000, Ein Kerem, Jerusalem 91120, Israel. Electronic address: yuvalgiel@gmail.com. 3. The Goldyne Savad Institute of Gene Therapy, MRI Laboratory, Human Biology Research Center, Hadassah Hebrew University Medical Center, POB 12000, Ein Kerem, Jerusalem 91120, Israel. Electronic address: nathaliec@hadassah.org.il. 4. Hebrew University-Hadassah Medical School, POB 12000, Ein Kerem, Jerusalem 91120, Israel. Electronic address: lital.hagai@mail.huji.ac.il. 5. Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, POB 12000, Ein Kerem, Jerusalem 91120, Israel. Electronic address: shapiro.joel@gmail.com. 6. Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, POB 12000, Ein Kerem, Jerusalem 91120, Israel. Electronic address: uriele@ekmd.huji.ac.il. 7. The Goldyne Savad Institute of Gene Therapy, MRI Laboratory, Human Biology Research Center, Hadassah Hebrew University Medical Center, POB 12000, Ein Kerem, Jerusalem 91120, Israel. Electronic address: rinat@hadassah.org.il.
Abstract
INTRODUCTION: We evaluated changes in placental and fetal hemodynamics in rodents during acute hypercapnia using BOLD-MRI and Doppler ultrasound. METHODS: Animals were anesthetized with pentobarbital and, in consecutive 4-min periods, breathed: air, 21%O2:5%CO2, and 95%O2:5%CO2. BOLD-MRI: Pregnant ICR mice (n = 6; E17.5) were scanned in a 4.7-T Bruker Biospec spectrometer. Placenta and fetal liver, heart and brain were identified on True-FISP images. Percent change in signal intensity (SI) were analyzed every 30 s from T2*-weighted GE images (TR/TE = 147/10 ms). Doppler: Pregnant Wistar rats (n = 6; E18-20) were anesthetized with pentobarbital and received abdominal Doppler ultrasound. Umbilical artery pulsatility index (PI) and fetal heart rate were assessed at baseline and after two minutes of both hypercapnic challenges. RESULTS: BOLD-MRI: Normoxic-hypercapnia caused immediate marked reduction in SI in placenta (-44% ± 5.5; p < 0.001), fetal liver (-32% ± 6.4; p < 0.001) and fetal heart (-53% ± 9.9; p < 0.001) but only minor changes in fetal brain (-13% ± 3.4; p < 0.01), suggesting fetal brain sparing. Doppler: Normoxic-hypercapnia caused a marked increase in umbilical artery PI (+27.4% ± 7.2; p < 0.001) and a reduction in fetal heart rate (-48 bpm; 95%CI -9.3 to -87.0; p = 0.02), suggesting acute fetal asphyxia. CONCLUSIONS: Brief maternal hypercapnic challenge caused BOLD-MRI changes consistent with acute placental and fetal hypoperfusion with fetal brain sparing. The same challenge caused increased umbilical artery PI and fetal bradycardia on Doppler ultrasound, suggestive for acute fetal asphyxia. BOLD-MRI may be a suitable noninvasive imaging strategy to assess placental and fetal organ hemodynamics.
INTRODUCTION: We evaluated changes in placental and fetal hemodynamics in rodents during acute hypercapnia using BOLD-MRI and Doppler ultrasound. METHODS: Animals were anesthetized with pentobarbital and, in consecutive 4-min periods, breathed: air, 21%O2:5%CO2, and 95%O2:5%CO2. BOLD-MRI: Pregnant ICR mice (n = 6; E17.5) were scanned in a 4.7-T Bruker Biospec spectrometer. Placenta and fetal liver, heart and brain were identified on True-FISP images. Percent change in signal intensity (SI) were analyzed every 30 s from T2*-weighted GE images (TR/TE = 147/10 ms). Doppler: Pregnant Wistar rats (n = 6; E18-20) were anesthetized with pentobarbital and received abdominal Doppler ultrasound. Umbilical artery pulsatility index (PI) and fetal heart rate were assessed at baseline and after two minutes of both hypercapnic challenges. RESULTS: BOLD-MRI: Normoxic-hypercapnia caused immediate marked reduction in SI in placenta (-44% ± 5.5; p < 0.001), fetal liver (-32% ± 6.4; p < 0.001) and fetal heart (-53% ± 9.9; p < 0.001) but only minor changes in fetal brain (-13% ± 3.4; p < 0.01), suggesting fetal brain sparing. Doppler: Normoxic-hypercapnia caused a marked increase in umbilical artery PI (+27.4% ± 7.2; p < 0.001) and a reduction in fetal heart rate (-48 bpm; 95%CI -9.3 to -87.0; p = 0.02), suggesting acute fetal asphyxia. CONCLUSIONS: Brief maternal hypercapnic challenge caused BOLD-MRI changes consistent with acute placental and fetal hypoperfusion with fetal brain sparing. The same challenge caused increased umbilical artery PI and fetal bradycardia on Doppler ultrasound, suggestive for acute fetal asphyxia. BOLD-MRI may be a suitable noninvasive imaging strategy to assess placental and fetal organ hemodynamics.
Authors: Sophie Couper; Alys Clark; John M D Thompson; Dimitra Flouri; Rosalind Aughwane; Anna L David; Andrew Melbourne; Ali Mirjalili; Peter R Stone Journal: J Physiol Date: 2021-01-18 Impact factor: 6.228
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Authors: Kristie Huda; Kenneth F Swan; Cecilia T Gambala; Gabriella C Pridjian; Carolyn L Bayer Journal: Ann Biomed Eng Date: 2021-04-28 Impact factor: 3.934