Abstract
We conducted a chronic preparation experiment involving near term fetal sheep to evaluate
the contribution of umbilical cord occlusion to fetal brain injury. In experimental
groups (n=11), complete cord occlusion for 3 min followed by 5 min release, repeated 5 times
were performed at 3 days after initial surgery. Instrumental cases without cord occlusion
(n=3) and uninstrumental twins (n=6) were also examined as controls. Multiple necrotic foci predominantly in the periventricular
white matter were found in the fetal brains examined at 1–3 days after cord occlusion.
To estimate the contribution of early axonal and glial reaction to brain injury the
following immunohistochemical study was performed. In the lesions, coagulation necrosis,
axonal swelling and microglial activation were demonstrated with amyloid precursor
protein or ionized calcium binding adapter molecule 1 immunohistochemistry. The induction
of tumor necrosis factor alpha and inducible nitric oxide synthase were also detected
immunohistochemically in the microglia at 1 and 3 days after cord occlusion. In contrast,
the reaction of glial fibrillary acidic protein positive astrocytes was faint at 1
day after occlusion, but the induction of cyclooxygenase-2 was observed. These findings
suggest the glial reaction of cytokines and free radicals induced by fetal hypoxia
may contribute to the occurrence of brain injury.
Keywords
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Article info
Publication history
Accepted:
January 18,
1999
Received in revised form:
January 11,
1999
Received:
August 13,
1998
Identification
Copyright
© 1999 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
