The pathogenesis of neonatal hypoxic-ischemic brain injury is still not completely understood. It is unclear why newborns
with similar degrees of perinatal depression can develop very diff
erent degrees of brain injury. More over, it is currently
not known why therapeutic hypothermia, which is the most widely accepted neuroprotective strategy to minimize brain injury
in asphyxiated term newborns, seems eff
ective in decreasing brain injury in some asphyxiated newborns but does not prevent
all brain injuries. Antenatal processes in the placenta (e.g, infl
ammation, hypoxia) and perinatal complications (e.g. abruptio
placenta, vasa praevia, shoulder dystocia) might contribute directly or indirectly to perinatal brain injury by impairing reser
altering fetal physiologic condition, and generating potentially neurotoxic mediators.
is lecture will review antenatal placental processes and perinatal complications, which appear to be a predisposing factor for
some of the adverse neonatal outcomes in term asphyxiated newborns, specifi
cally those meeting the criteria for therapeutic
is should permit to understand better the role of antenatal placental processes and perinatal complications in
the progression from perinatal hypoxic ischemic conditions to brain injury.
Dr. Pia Wintermark is an Assistant Professor of Pediatrics at McGill University and a Neonatologist at the Montreal Children?s Hospital. She trained in pediatrics and newborn medicine at Lausanne University in Lausanne, Switzerland and at Harvard Medical School in Bos ton, USA. Her research focuses on understanding causes and consequences of brain injuries in newborns. She is using both clinical research (i ncluding advanced neuroimaging techniques and bedside monitoring) and basic science techniques to understand mechanisms underlying these brain in juries, with the goal of developing innovative solutions to prevent or repair these injuries and to improve future neurodevelopmental outcome of these newborns.
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