The Importance of Reperfusion Injury in Antenatal Hypoxia-Ischemia: Novel Fetal MRI Diagnostic Parameters & Novel Antioxidant Therapy

Alexander Drobyshevsky¹, Xinhai Ji¹, Matthew Derrick¹, Lei Yu¹, Ines Batinic-Haberle², Sidhartha Tan¹

We have previously shown the ability of diffusion weighted MR-derived index, using the nadir of ADC during hypoxia-ischemia (H-I) to predict postnatal motor deficits in survivors. The contribution of immediate reperfusion injury to motor deficits has not been fully understood. We used a novel lipophilic Mn porphyrin antioxidant in addition to ascorbate + trolox to test our hypothesis. In control saline-administered dams, the incidence of hypertonia in survivors (n=49) was 57% and the odds ratio of hypertonia to occur with a reperfusion drop in ADC was 8.8. Ascorbate + Trolox post-treatment decreased the incidence of hypertonia to 30% (n=30 survivors). MnTnHex-2-PyP post-treatment resulted in 63% hypertonia (n=22 survivors) and more mortality (48% compared to 23% for controls).