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The fetus has no actual respiration, and the newborn begins to breathe after birth. We assume that the first breath dominantly generated by hypoxia. In this study, the changes and lowest limit of blood oxygen partial pressureof umbilical artery (PuaO) after chemoreceptor were analyzed to explore the mechanism of neonatal spontaneous breathing. With signed consent form by all fetal parents before birth, 14 newborns successfully completed the umbilical artery or vein catheterization and drawn blood according to the heartbeat. All blood samples analyzed by blood gas analyzer,calculated and analyzed the similarities and differences between umbilical vein(Puv) and umbilical artery(Pua). Although we completed 14 newborns, there were only 9 cases of umbilical artery samples and 8 cases of umbilical vein samples were collected. Only 3 cases collected both Pua and Puv blood samples at the same time (see serial paper II). PuaO in gradually decreased with time (heartbeat frequency), until Pua contracted after spontaneous breathing produced about 8~10 heartbeats, and then could not get enough blood samples. Only 3 newborns were able to take blood samples after spontaneous breathing for 8~10 heartbeats, and their PuaO were jumped to 186.0, 137.0 and 93.8 mmHg respectively. The mean value of PuaO was (25.94±6.79, 18.04~37.51)mmHg, the highest value was (29.11±6.46, 23.00~45.90)mmHg, and the lowest value was (21.34±5.54, 14.00~33.60)mmHg. Although PuvO decreased gradually with time (heartbeat) too, most of them also showed the tendency of alternately rising and falling with the regularity of mother's respiration. The mean value of PuvO was (53.35±21.35, 32.56~100.73)mmHg, the highest value was (90.38±48.44, 43.40~153.00)mmHg, and the lowest value was (36.96±14.90, 24.80~73.80)mmHg. Although there were large individual differences, the mean, highest and lowest values of PuvO were significantly higher than those of PuaO (P<0.05); although PuvCO slightly lower than PuaCO, it was no significant difference (P>0.05). PuaO decreases gradually with time before spontaneous breathing after the delivered fetus as a newborn, and it induces the first inhalation to start spontaneous breathing when it reaches the threshold of triggering breathing.
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http://dx.doi.org/10.12047/j.cjap.0099.2021.098 | DOI Listing |
Turk J Pediatr
September 2025
Department of Anesthesiology, All India Institute of Medical Sciences, Patna, India.
Background: Umbilical arterial catheterisation is a common intervention performed in the neonatal intensive care unit (NICU) especially in extremely preterm and extremely low birth weight neonates. Rarely catheter fracture or breakage can occur, leaving behind part of the catheter in the aorta. A handful of cases have been reported in the literature, with the majority being managed surgically.
View Article and Find Full Text PDFCureus
August 2025
Anesthesiology, Om Prakash (OP) Jindal Institute of Medical Sciences, Hisar, IND.
Congenital diaphragmatic hernia (CDH) is a serious congenital anomaly often associated with pulmonary hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Central vascular access such as umbilical arterial catheters (UACs) is routinely used in neonatal intensive care but is associated with the risk of vascular complications, including thromboembolic events. We present a case of preterm dichorionic diamniotic (DCDA) twins born at 34 weeks of gestation with antenatally diagnosed CDH.
View Article and Find Full Text PDFFront Med (Lausanne)
August 2025
Department of Neonatology and NICU, Wenling Maternal and Child Health Care Hospital, Wenling, Zhejiang, China.
Umbilical artery thrombosis (UAT) is an extremely rare but severe obstetric complication associated with adverse perinatal outcomes, including fetal growth restriction (FGR), fetal distress, and intrauterine fetal demise. This case report highlights the diagnostic challenges of UAT and its potential misdiagnosis as a single umbilical artery (SUA). A 32-year-old woman with a history of uncomplicated vaginal delivery was initially misdiagnosed with SUA at 29 3/7 weeks of gestation.
View Article and Find Full Text PDFClin Anat
September 2025
Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana, India.
Hyrtl's anastomosis, a transverse inter-arterial connection between the two umbilical arteries near their placental insertion, plays a vital role in maintaining hemodynamic stability in fetal circulation. Despite being a consistent finding in most term placentas, its functional role and clinical significance are underappreciated in perinatal medicine. This review explores the anatomy, physiological function, diagnostic assessment, and clinical implications of Hyrtl's anastomosis, with emphasis on its protective role in ensuring balanced placental perfusion and mitigating hemodynamic stress in compromised pregnancies.
View Article and Find Full Text PDFInt J Womens Health
August 2025
School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, People's Republic of China.
Background: Previous studies did not investigate the effect of gradually increasing the concentration of low-dose oxytocin on mother and newborn outcomes. The purpose of this study was to look at the relationship between oxytocin responsiveness and outcomes for both mothers and newborns during labor induction.
Methods: This retrospective cohort study was conducted at Nantong Maternal and Child Health Hospital, and participants were divided into the early reaction to oxytocin group and the later reaction to oxytocin group based on oxytocin response.