Allopurinol reduces oxidative stress in the ovine fetal cardiovascular system after repeated episodes of ischemia-reperfusion.
In complicated labor, neonatal outcome may depend not only on the extent of fetal asphyxia and acidosis but also on the effects on the fetal cardiovascular system of reactive oxygen species (ROS) generated during the ischemia-reperfusion (I/R) associated with repeated compressions of the umbilical cord. This study tested the hypothesis that maternal treatment with clinical doses of the antioxidant allopurinol in the setting of fetal asphyxia would reduce oxidative stress in the fetal cardiovascular system. The hypothesis was tested in chronically instrumented fetal sheep in late gestation by investigating the effects of maternal treatment with therapeutic doses of allopurinol or vehicle on the fetal cardiovascular system during and after episodes of I/R. The latter were produced by repeated, measured compressions of the umbilical cord. The data show that maternal treatment with allopurinol helped maintain umbilical blood flow and it reduced fetal cardiac oxidative stress after I/R of the type associated with clinically relevant acidemia and repetitive fetal heart rate decelerations. The data support the hypothesis tested and suggest that maternal treatment with allopurinol may offer plausible clinical intervention in the management of perinatal asphyxia in complicated labor.
Derks
Jan B
JB
Department of Perinatology, University Medical Centre, 100 3584 CX Utrecht, The Netherlands.
Oudijk
Martijn A
MA
Torrance
Helen L
HL
Rademaker
Carin M A
CM
Benders
Manon J
MJ
Rosen
Karl G
KG
Cindrova-Davies
Tereza
T
Thakor
Avnesh S
AS
Visser
Gerard H A
GH
Burton
Graham J
GJ
van Bel
Frank
F
Giussani
Dino A
DA
D000493:Allopurinol / Q000097:blood / Q000494:pharmacology*; D000818:Animals; D001794:Blood Pressure; D002319:Cardiovascular System / Q000187:drug effects / Q000503:physiopathology; D004791:Enzyme Inhibitors / Q000097:blood; D005260:Female; D005333:Fetus / Q000033:anatomy & histology / Q000187:drug effects / Q000502:physiology; D016166:Free Radical Scavengers / Q000097:blood / Q000494:pharmacology*; D007511:Ischemia / Q000503:physiopathology*; D018384:Oxidative Stress / Q000187:drug effects; D010117:Oxypurinol / Q000097:blood; D011247:Pregnancy; D017382:Reactive Oxygen Species / Q000378:metabolism; D015424:Reperfusion; D034561:Sheep, Domestic
D004791:Enzyme Inhibitors; D016166:Free Radical Scavengers; D017382:Reactive Oxygen Species; D000493:Allopurinol; D010117:Oxypurinol