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Continuous Telemetric In Utero Tracheal Pressure Measurements in Fetal Lambs
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Circulating prostaglandin E2 concentrations decrease at birth in premature lambs.

Timothy J R Panneflek1, Janneke Dekker1, Kelly J Crossley2,3

  • 1Division of Neonatology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Leiden, Netherlands.

Frontiers in Pediatrics
|December 15, 2025
PubMed
Summary
This summary is machine-generated.

Umbilical cord clamping and lung aeration both reduce prostaglandin E2 (PGE2) levels after birth, which is crucial for initiating breathing. While both factors are important, lung aeration

Keywords:
cord clampingperinatal transitionpreclinicalprostaglandinsventilation

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Area of Science:

  • Neonatal Physiology
  • Cardiovascular Research
  • Respiratory Regulation

Background:

  • Prostaglandin E2 (PGE2) is present at high concentrations in fetal circulation, where it suppresses breathing.
  • A decrease in PGE2 levels after birth is necessary to facilitate the transition to independent respiration.
  • The precise mechanisms and timing of PGE2 reduction post-birth remain unclear.

Purpose of the Study:

  • To investigate the roles of umbilical cord clamping and lung aeration in reducing fetal PGE2 concentrations after birth.
  • To determine the independent and combined effects of these interventions on PGE2 levels in premature lambs.

Main Methods:

  • Premature lambs were studied, undergoing either immediate cord clamping (ICC) or physiological-based cord clamping (PBCC; clamping after ventilation onset).
  • PGE2 concentrations were measured in pulmonary and carotid arteries at specific time points post-birth.
  • Data were analyzed relative to pre-birth fetal PGE2 concentrations.

Main Results:

  • Ventilation onset significantly decreased PGE2 concentrations in both arterial locations in PBCC lambs.
  • In ICC lambs, umbilical cord clamping reduced PGE2 levels, with subsequent ventilation onset causing a further decrease.
  • The effect of cord clamping on PGE2 reduction was diminished when ventilation onset preceded it.

Conclusions:

  • Both umbilical cord clamping and ventilation onset independently contribute to the reduction of PGE2 concentrations after birth.
  • These reductions are likely essential for enhancing neonatal breathing activity.
  • The timing of interventions matters, as ventilation onset can influence the effectiveness of cord clamping in lowering PGE2.