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This Article Full Text Full Text (PDF) All Versions of this Article: 548/2/333    most recent 2003.040527v1 Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nathanielsz, P. W. Articles by Hanson, M. A. Search for Related Content PubMed PubMed Citation Articles by Nathanielsz, P. W. Articles by Hanson, M. A. Related Collections Perspectives

The fetal dilemma: spare the brain and spoil the liver

Peter W. Nathanielsz and Mark A. Hanson

Extensive studies conducted in chronically instrumented fetal sheep have demonstrated pronounced redistribution of blood throughout the fetal and placental vasculature in response to challenges such as hypoxaemia. By redistributing blood flow, the fetus attempts to maintain the oxygen and nutrient supply to vital organs especially the brain, heart and adrenal glands. Since the major beneficiary of redistribution is the brain, these flow alterations have been designated as achieving 'brain sparing'. Sparing of the brain is only relative brain sparing since the brain does experience the insult as oxygen delivery usually falls. Nonetheless, redistribution of blood flow towards the brain, coupled with a reduction in cerebral metabolism, allows the brain to be less affected than other organs such as skeletal muscle, gastrointestinal tract and kidneys that are of lesser importance to immediate survival.

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