Fetalna hipoksija i perinatalno oštećenje mozga

master's thesis

• Title (english): Fetal hypoxia and perinatal brain damage
• Author: Ivona Pleša
• Mentor: Aida Salihagić-Kadić (mentor)
• Committee member: Berivoj Mišković (predsjednik povjerenstva)
• Committee member: Dora Višnjić (član povjerenstva)
• Committee member: Aida Salihagić-Kadić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Physiology and Immunology); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Human Physiology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Immunology

Abstract

Fetalna hipoksija stanje je smanjene opskrbe fetalnih tkiva kisikom. Iako fetalnu hipoksiju može uzrokovati mnogo čimbenika, najčešće nastaje zbog napredovanja insuficijencije posteljice i udružena je sa zastojem u rastu fetusa. U stanju fetalne hipoksije uključuju se adaptacijski mehanizmi i dolazi do centralizacije krvotoka u korist fetalnog mozga (tzv. efekt poštede mozga), srca i nadbubrežnih žlijezda, dok periferija ostaje lišena adekvatne količine kisika. Važno je naglasiti da su razvijeni dijagnostički alati kojima se mjeri redistribucija protoka krvi u korist fetalnog mozga, a njihove temelje čine doplerski indeksi pupčane i srednje moždane arterije. Praćenje doplerskih indeksa, osobito cerebroumbilikalnog omjera, čini do sada najvažniji prenatalni alat za prognozu neurorazvojnih poremećaja. Novije spoznaje temelje se na činjenici da funkcionalna i strukturna oštećenja mozga postoje i kod održanih hemodinamskih kompenzacijskih mehanizama, pa se smatra da efekt poštede mozga nije potpuno fiziološki odgovor. Posljedice fetalne hipoksije i zastoja u rastu fetusa mogu biti periventrikularna leukomalacija, intrakranijalno krvarenje i široki spektar funkcionalnih neuroloških oštećenja. Stoga bi istraživanja moderne perinatalne medicine trebalo temeljiti na pronalaženju novih kvalitetnih dijagnostičkih testova ili kombinacije već postojećih kako bi se omogućila rana dijagnoza potencijalno ugroženih fetusa i definiralo vrijeme dovršenja trudnoće. Time bi se preveniralo perinatalno oštećenje mozga i njegove dugoročne posljedice na zdravlje djece.

Abstract (english)

Fetal hypoxia is a condition characterized by a reduced oxygen supply of fetal tissues. Although fetal hypoxia can be caused by many factors, it usually occurs due to progressive placental insufficiency and is associated with intrauterine growth restriction. In a state of fetal hypoxia, adaptation mechanisms are activated, and bloodstream centralization occurs, which is beneficial to the fetal brain (brain sparing effect), heart, and adrenal glands, while the periphery remains deprived of adequate amounts of oxygen. It is important to emphasize that diagnostic tools for measuring blood flow redistribution in favor of the fetal brain have been developed, and their bases are Doppler indices of the umbilical and middle cerebral arteries. Monitoring of the Doppler indices, particulary cerebroumbilical ratio, is the most important prenatal diagnostic tool for the prognosis of neurodevelopmental disorders. New findings are based on the fact that functional and structural brain damage occurs even in stable hemodynamic compensatory mechanisms, so the brain sparing effect is not considered to be an entirely physiological response. The consequences of fetal hypoxia and intrauterine growth restriction can be periventricular leukomalacia, intracranial bleeding, and a wide range of functional neurological damage. Therefore, research in modern perinatal medicine should be based on finding a new high-quality diagnostic tests or using a combination of the existing ones to allow early diagnosis of potentially endangered fetuses and define the time of delivery. This would prevent perinatal brain damage and its long-term effects on the health of children.

• Keywords: insuficijencija posteljice; kronična hipoksija; perinatalno oštećenje mozga; doplerski indeksi; IUGR
• Keywords (english): placental insufficiency; chronic hypoxia; perinatal brain damage; doppler indices; IUGR
• Language: croatian
• URN:NBN: urn:nbn:hr:105:185359
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-10-24 12:55:44