title: Measurement of maternal cerebral tissue hemoglobin on near-infrared time-resolved spectroscopy in the peripartum period.
abstract: OBJECTIVE
  To measure cerebral tissue hemoglobin in uncomplicated and complicated pregnant women during the peripartum period.
  
  
  METHODS
  Time-resolved spectroscopy (TRS-20) can measure absolute concentration of oxygenated, deoxygenated, and total tissue hemoglobin based on the transit time of individual photons. Therefore, we used TRS-20 to measured tissue hemoglobin in the hemi-prefrontal lobes of normotensive pregnant women with (n = 51) or without (n = 19) epidural anesthesia, hypertensive pregnant women with pre-eclampsia (n = 10), a pregnant woman with acute onset of hypertension soon after delivery, and a hypertensive woman after hemorrhagic stroke in delivery.
  
  
  RESULTS
  Cyclic labor concomitant with intra-abdominal pressure caused synergistic elevation in cerebral tissue hemoglobin. In contrast, epidural anesthesia reduced the amplitude of the cyclic increase of cerebral tissue hemoglobin in normotensive pregnant women. Hypertension in labor due to pre-eclampsia increased the amplitude of synergistic elevation of cerebral tissue hemoglobin caused by cyclic labor and intra-abdominal pressure. A prolonged high basal level of cerebral tissue hemoglobin was observed in a case of acute onset of hypertension soon after delivery. A decrease in cerebral tissue hemoglobin in the hemi-prefrontal lobe was observed in a woman 2 h after the onset of hemorrhagic stroke in labor.
  
  
  CONCLUSIONS
  TRS-20 can detect specific changes in maternal cerebral tissue hemoglobin level in response to physiological and pathophysiological changes in delivery. Thus, it represents a promising new conventional tool for maternal cerebral monitoring in the peripartum period.
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Kazunao
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Itoh
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Mukai
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Yamazaki
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Hamamatsu Photonics, Hamamatsu, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Hamamatsu Photonics, Hamamatsu, Japan.
authors.forename: Motoki
authors.initials: M
authors.lastname: Oda
authors.affiliation: Hamamatsu Photonics, Hamamatsu, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Yamaki
authors.affiliation: Hamamatsu Photonics, Hamamatsu, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Kanayama
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D002560:Cerebrovascular Circulation; D005260:Female; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism*; D006474:Hemorrhagic Disorders / Q000097:blood / Q000378:metabolism; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000378:metabolism; D018810:Magnetic Resonance Angiography; D009419:Nerve Tissue Proteins / Q000378:metabolism*; D059906:Neuroimaging; D009474:Neurons / Q000378:metabolism*; D007744:Obstetric Labor Complications / Q000097:blood / Q000378:metabolism; D058725:Peripartum Period; D011225:Pre-Eclampsia / Q000378:metabolism*; D017397:Prefrontal Cortex / Q000098:blood supply / Q000378:metabolism*; D011247:Pregnancy; D019265:Spectroscopy, Near-Infrared; D020521:Stroke / Q000097:blood / Q000378:metabolism
chemical_list: D006454:Hemoglobins; D009419:Nerve Tissue Proteins
keywords: delivery; eclampsia; hypertension; near-infrared spectroscopy; pregnancy