Skip to main content
Log in

Neuroprotektion bei Frühgeborenen

Frühe Hirnschäden verhindern

  • Zertifizierte Fortbildung
  • Published:
Pädiatrie Aims and scope

Zusammenfassung

Frühchen, die vor der 30. Schwangerschaftswoche zur Welt kommen, sind in besonderem Maße von perinatalen Hirnschäden betroffen. Viele dieser Kinder sind schwerbehindert. Dies gilt es zu vermeiden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Abb. 1:
Abb. 2:
Abb. 3:

Literatur

  1. Volpe JJ (1995) Neurology of the newborn. WB Saunders, Philadelphia

  2. Behl C (2002) Oestrogen as a neuroprotective hormone. Nat Rev Neurosci 3(6):433–442

    CAS  PubMed  Google Scholar 

  3. Dammann O, Leviton A (1997) Maternal intrauterine infection, cytokines, and brain damage in the preterm newborn. Pediatr Res 42(1):1–8

    Article  CAS  PubMed  Google Scholar 

  4. Romero R, Savasan ZA, Chaiworapongsa T et al. (2011) Hematologic profile of the fetus with systemic inflammatory response syndrome. J Perinat Med 40(1):19–32

    PubMed  PubMed Central  Google Scholar 

  5. Garnier Y, Coumans A, Berger R et al (2001) Endotoxemia severely affects circulation during normoxia and asphyxia in immature fetal sheep. J Soc Gynecol Investig 8(3):134–142

    Article  CAS  PubMed  Google Scholar 

  6. Garnier Y, Coumans AB, Jensen A et al (2003) Infection-related perinatal brain injury: the pathogenic role of impaired fetal cardiovascular control. J Soc Gynecol Investig 10(8):450–459

    Article  CAS  PubMed  Google Scholar 

  7. Coumans AB, Middelanis JS, Garnier Y et al (2003) Intracisternal application of endotoxin enhances the susceptibility to subsequent hypoxic-ischemic brain damage in neonatal rats. Pediatr Res 53(5):770–775

    Article  CAS  PubMed  Google Scholar 

  8. Feldhaus B, Dietzel ID, Heumann R, Berger R (2004) Effects of interferon-gamma and tumor necrosis factor-alpha on survival and differentiation of oligodendrocyte progenitors. J Soc Gynecol Investig 11(2):89–96

    Article  CAS  PubMed  Google Scholar 

  9. Wu YW, Colford JM Jr (2000) Chorioamnionitis as a risk factor for cerebral palsy: a meta-analysis. JAMA 284(11):1417–1424

    Article  CAS  PubMed  Google Scholar 

  10. Shatrov JG, Birch SC, Lam LT et al (2010) Chorioamnionitis and cerebral palsy: a meta-analysis. Obstet Gynecol 116(2 Pt 1):387–392

    Article  PubMed  Google Scholar 

  11. Society for Maternal-Fetal Medicine Publications Committee, with assistance of Vincenzo Berghella (2012) Progesterone and preterm birth prevention: translating clinical trials data into clinical practice. Am J Obstet Gynecol 206(5):376–386

  12. Elovitz M, Wang Z (2004) Medroxyprogesterone acetate, but not progesterone, protects against inflammation-induced parturition and intrauterine fetal demise. Am J Obstet Gynecol 190(3):693–701

    Article  CAS  PubMed  Google Scholar 

  13. Elovitz MA, Mrinalini C (2005) Can medroxyprogesterone acetate alter Toll-like receptor expression in a mouse model of intrauterine inflammation? Am J Obstet Gynecol 193(3 Pt 2):1149–1155

    Article  CAS  PubMed  Google Scholar 

  14. Quasebarth A (2001) Periventrikulare Leukomalazie und Perinatale Telenzephale Leukoenzephalopathie. Ein und dieselbe Krankheit? Eine neuropathologische Studie anhand von 10 Falldarstellungen. Dissertation, Johann Wolfgang Goethe Universitat Frankfurt am Main

  15. American College of Obstetricians and Gynecologists Committee on Obstetric Practice Society for Maternal-Fetal Medicine (2013) Committee Opinion No. 573: magnesium sulfate use in obstetrics. Obstet Gynecol 122(3):727–728

  16. Doyle LW, Crowther CA, Middleton P et al (2009) Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database Syst Rev 1:CD004661

    PubMed  Google Scholar 

  17. Blauert C, Garnier Y, Berger R (2011) Neuroprotektion durch Magnesium. Ein Uberblick. Geburtsh Frauenheilk 71:79–82

    Article  Google Scholar 

  18. Rouse DJ, Hirtz DG, Thom E et al (2008) A randomized, controlled trial of magnesium sulfate for the prevention of cerebral palsy. N Engl J Med 359(9):895–905

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Conde-Agudelo A, Romero R (2009) Antenatal magnesium sulfate for the prevention of cerebral palsy in preterm infants less than 34 weeks’ gestation: a systematic review and metaanalysis. Am J Obstet Gynecol 200(6):595–609

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Cahill AG, Caughey AB (2009) Magnesium for neuroprophylaxis: fact or fiction? Am J Obstet Gynecol 200(6):590–594

    Article  CAS  PubMed  Google Scholar 

  21. Ow LL, Kennedy A, McCarthy EA, Walker SP (2012) Feasibility of implementing magnesium sulphate for neuroprotection in a tertiary obstetric unit. Aust N Z J Obstet Gynaecol 52(4):356–360

    Article  PubMed  Google Scholar 

  22. Experts for the Prediction and Prevention of Preterm Birth (X4PB) (2013) Pradiktion und Pravention der Fruhgeburt. Frauenarzt 54:1060–1071

  23. Hofmeyr GJ, Bolton KD, Bowen DC, Govan JJ (1988) Periventricular/intraventricular haemorrhage and umbilical cord clamping. Findings and hypothesis. S Afr Med J 73(2):104–106

    CAS  PubMed  Google Scholar 

  24. Salmeen KE, Jelin AC, Thiet MP (2014) Perinatal neuroprotection. F1000Prime Rep 6:6. doi:10.12703/P6-6

  25. Mercer JS, Vohr BR, McGrath MM et al (2006) Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics 117(4):1235–1242

    Article  PubMed  PubMed Central  Google Scholar 

  26. American College of Obstetricians and Gynecologists (2012) Committee Opinion No.543: timing of umbilical cord clamping after birth. Obstet Gynecol 120(6):1522–1526

  27. Rabe H, Jewison A, Alvarez RF et al (2011) Milking compared with delayed cord clamping to increase placental transfusion in preterm neonates: a randomized controlled trial. Obstet Gynecol 117(2 Pt 1):205–211

    Article  PubMed  Google Scholar 

  28. Berger R, Garnier Y (1999) Pathophysiology of perinatal brain damage. Brain Res Brain Res Rev 30(2):107–134

    Article  CAS  PubMed  Google Scholar 

  29. Bennet L, Roelfsema V, Pathipati P et al (2006) Relationship between evolving epileptiform activity and delayed loss of mitochondrial activity after asphyxia measured by near-infrared spectroscopy in preterm fetal sheep. J Physiol 572(Pt 1):141–154

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Velthoven CT van, Kavelaars A, Heijnen CJ (2012) Mesenchymal stem cells as a treatment for neonatal ischemic brain damage. Pediatr Res 71(4 Pt 2):474–481

    Article  PubMed  Google Scholar 

  31. Jellema RK, Wolfs TG, Lima Passos V et al (2013) Mesenchymal stem cells induce T-cell tolerance and protect the preterm brain after global hypoxia-ischemia. PLoS One 8(8):e73031

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Lai RC, Arslan F, Lee MM et al (2010) Exosome secreted by MSC reduces myocardial ischemia/reperfusion injury. Stem Cell Res 4(3):214–222

    Article  CAS  PubMed  Google Scholar 

  33. Trotter A, Bokelmann B, Sorgo W et al (2001) Follow-up examination at the age of 15 months of extremely preterm infants after postnatal estradiol and progesterone replacement. J Clin Endocrinol Metab 86(2):601–603

    Article  CAS  PubMed  Google Scholar 

  34. Muller MM, Middelanis J, Meier C et al (2013) 17β-estradiol protects 7-day old rats from acute brain injury and reduces the number of apoptotic cells. Reprod Sci 20(3):253–261

    Article  PubMed  Google Scholar 

  35. Nunez J, Yang Z, Jiang Y et al (2007) 17beta-estradiol protects the neonatal brain from hypoxia-ischemia. Exp Neurol 208(2):269–276

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Deutsch ER, Espinoza TR, Atif F et al (2013) Progesteronef’s role in neuroprotection, a review of the evidence. Brain Res 1530:82–105

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Richard Berger.

Additional information

Interessenkonflikt

Die Autoren erklären, dass sie sich bei der Erstellung des Beitrages von keinen wirtschaftlichen Interessen leiten ließen und dass keine potenziellen Interessenkonflikte vorliegen. Der Verlag erklärt, dass die inhaltliche Qualität des Beitrags von zwei unabhängigen Gutachtern geprüft wurde. Werbung in dieser Zeitschriftenausgabe hat keinen Bezug zur CME-Fortbildung. Der Verlag garantiert, dass die CME-Fortbildung sowie die CME-Fragen frei sind von werblichen Aussagen und keinerlei Produktempfehlungen enthalten. Dies gilt insbesondere für Präparate, die zur Therapie des dargestellten Krankheitsbildes geeignet sind.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Berger, R., Söder, S., Abele, H. et al. Frühe Hirnschäden verhindern. Pädiatrie 28, 26–34 (2016). https://doi.org/10.1007/s15014-016-0795-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15014-016-0795-7

Navigation