Lactate detection in the brain of growth-restricted fetuses with magnetic resonance spectroscopy

被引：34

作者：

Cetin, Irene ^{[3
,5
]}

Barberis, Barbara ^{[2
]}

Brusati, Valentina ^{[3
]}

Brighina, Erika ^{[1
,2
]}

Mandia, Luca ^{[3
,5
]}

Arighi, Andrea ^{[1
,2
]}

Radaelli, Tatjana ^{[3
,4
]}

Biondetti, Pietro ^{[2
]}

Bresolin, Nereo ^{[1
,2
]}

Pardi, Giorgio ^{[3
,4
]}

Rango, Mario ^{[1
,2
]}

机构：

[1] Univ Milan, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Dept Neurol Sci, Milan, Italy

[2] Univ Milan, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Magnet Resonance Spect Unit, Milan, Italy

[3] Univ Milan, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Ctr Fetal Res Giorgio Pardi, Milan, Italy

[4] Univ Milan, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Obstet & Gynecol Unit, Milan, Italy

[5] Univ Milan, Dept Clin Sci L Sacco, Obstet & Gynecol Unit, Milan, Italy

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2011年 / 205卷 / 04期

关键词：

brain sparing; fetal brain metabolism; fetal distress; placental insufficiency; pregnancy; HUMAN FETAL-BRAIN; PROTON MR SPECTROSCOPY; GESTATIONAL-AGE; IN-UTERO; MATURATION; PREGNANCIES; METABOLISM; MANAGEMENT; DIAGNOSIS; VIVO;

D O I：

10.1016/j.ajog.2011.06.020

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

OBJECTIVE: The objective of the study was to determine the feasibility of detecting fetal brain lactate, a marker of fetal metabolic acidemia, using a noninvasive technique, proton magnetic resonance spectroscopy (H-1 MRS), in intrauterine growth-restricted (IUGR) fetuses. STUDY DESIGN: In vivo human fetal brain lactate detection was determined by H-1 MRS in 5 fetuses with IUGR. Oxygenation and acid-base balance data were obtained at birth. RESULTS: H-1 MRS analysis showed the presence of a lactate peak in the brain of the most severely affected IUGR fetus, with abnormal umbilical artery Doppler and fetal heart rate tracing. This finding was consistent with the low oxygen content and high lactic acid concentration observed in umbilical blood obtained at delivery. CONCLUSION: H-1 MRS allows the noninvasive detection of cerebral lactate in IUGR fetuses. Lactate detected by H-1 MRS may represent a possible marker of in utero cerebral injury or underperfusion.

引用

页码：350.e1 / 350.e7

页数：7

共 37 条

[1]

[Anonymous], 2002, OBSTET GYNECOL, V99, P159

[2]

[Anonymous], 2007, AM J OBSTET GYNECOL, DOI DOI 10.1016/J.AJOG.2006.09.014

[3] Metabolic assessment of the brain using proton magnetic resonance spectroscopy in a growth-restricted human fetus: Case report [J].

Azpurua, Humberto ;

Alvarado, Arturo ;

Mayobre, Finita ;

Salom, Tamara ;

Copel, Joshua A. ;

Guevara-Zuloaga, Freddy .

AMERICAN JOURNAL OF PERINATOLOGY, 2008, 25 (05) :305-309

[4]

Barkovich AJ, 1999, AM J NEURORADIOL, V20, P1399

[5] Predictors of neonatal outcome in early-onset placental dysfunction [J].

Baschat, Ahmet A. ;

Cosmi, Erich ;

Bilardo, Catarina M. ;

Wolf, Hans ;

Berg, Christoph ;

Rigano, Serena ;

Germer, Ute ;

Moyano, Dolores ;

Turan, Sifa ;

Hartung, John ;

Bhide, Amarnath ;

Muller, Thomas ;

Bower, Sarah ;

Nicolaides, Kypros H. ;

Thilaganathan, Baskaran ;

Gembruch, Ulrich ;

Ferrazzi, Enrico ;

Hecher, Kurt ;

Galan, Henry L. ;

Harman, Chris R. .

OBSTETRICS AND GYNECOLOGY, 2007, 109 (02) :253-261

[6] Timing of delivery in fetal growth restriction and childhood development: some uncertainties remain [J].

Baschat, Ahmet A. ;

Odibo, Anthony O. .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2011, 204 (01) :2-3

[7] The Contribution of Blood Lactate to Brain Energy Metabolism in Humans Measured by Dynamic 13C Nuclear Magnetic Resonance Spectroscopy [J].

Boumezbeur, Fawzi ;

Petersen, Kitt F. ;

Cline, Gary W. ;

Mason, Graeme F. ;

Behar, Kevin L. ;

Shulman, Gerald I. ;

Rothman, Douglas L. .

JOURNAL OF NEUROSCIENCE, 2010, 30 (42) :13983-13991

[8] Human Fetal Brain Chemistry as Detected by Proton Magnetic Resonance Spectroscopy [J].

Brighina, Erika ;

Bresolin, Nereo ;

Pardi, Giorgio ;

Rango, Mario .

PEDIATRIC NEUROLOGY, 2009, 40 (05) :327-342

[9] Maternal concentrations and fetal-maternal concentration differences of plasma amino acids in normal and intrauterine growth-restricted pregnancies [J].

Cetin, I ;

Ronzoni, S ;

Marconi, AM ;

Perugino, G ;

Corbetta, C ;

Battaglia, FC ;

Pardi, G .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1996, 174 (05) :1575-1583

[10] Intrauterine Growth Restriction: Implications for Placental Metabolism and Transport. A Review [J].

Cetin, I. ;

Alvino, G. .

PLACENTA, 2009, 30 :S77-S82

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