Document Detail


Effects of acute acidemia on the fetal cardiovascular defense to acute hypoxemia.
MedLine Citation:
PMID:  18922958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In complicated pregnancy, fetal hypoxemia rarely occurs in isolation but is often accompanied by fetal acidemia. There is growing clinical concern about the combined effects of fetal hypoxemia and fetal acidemia on neonatal outcome. However, the effects on the fetal defense responses to acute hypoxemia during fetal acidemia are not well understood. This study tested the hypothesis that fetal acidemia affects the fetal defense responses to acute hypoxemia. The hypothesis was tested by investigating, in the late-gestation sheep fetus surgically prepared for long-term recording, the in vivo effects of acute fetal acidemia on 1) the fetal cardiovascular responses to acute hypoxemia and 2) the neural and endocrine mechanisms mediating these responses. Under general anesthesia, five sheep fetuses at 0.8 gestation were instrumented with catheters and Transonic flow probes around the femoral and umbilical arteries. After 5 days, animals were subjected to an acute hypoxemia protocol during intravenous infusion of saline or treatment with acidified saline. Treatment with acidified saline reduced fetal basal pH from 7.35 +/- 0.01 to 7.29 +/- 0.01 but did not alter basal cardiovascular variables, blood glucose, or plasma concentrations of catecholamines, ACTH, and cortisol. During hypoxemia, treatment with acidified saline increased the magnitude of the fetal bradycardia and femoral vasoconstriction and concomitantly increased chemoreflex function and enhanced the increments in plasma concentrations of catecholamines, ACTH, and cortisol. Acidemia also reversed the increase in umbilical vascular conductance during hypoxemia to vasoconstriction. In conclusion, the data support our hypothesis and show that acute acidemia markedly alters fetal hemodynamic, metabolic, and endocrine responses to acute hypoxemia.
Authors:
A S Thakor; D A Giussani
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-15
Journal Detail:
Title:  American journal of physiology. Regulatory, integrative and comparative physiology     Volume:  296     ISSN:  0363-6119     ISO Abbreviation:  Am. J. Physiol. Regul. Integr. Comp. Physiol.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-30     Completed Date:  2009-02-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100901230     Medline TA:  Am J Physiol Regul Integr Comp Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  R90-9     Citation Subset:  IM    
Affiliation:
Dept. of Physiology, Development & Neuroscience, Univ. of Cambridge, Cambridge CB2 3EG, UK.
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MeSH Terms
Descriptor/Qualifier:
Acidosis / blood,  complications,  physiopathology*
Acute Disease
Adrenocorticotropic Hormone / blood
Animals
Blood Glucose / metabolism
Blood Pressure
Bradycardia / etiology,  physiopathology
Carbon Dioxide / blood
Catecholamines / blood
Chemoreceptor Cells / metabolism
Disease Models, Animal
Female
Femoral Artery / embryology,  physiopathology*
Fetal Hypoxia / blood,  complications,  physiopathology*
Gestational Age
Heart Rate
Hemodynamics*
Hydrocortisone / blood
Hydrogen-Ion Concentration
Oxygen / blood
Pregnancy
Reflex
Regional Blood Flow
Sheep
Time Factors
Umbilical Arteries / physiopathology*
Vascular Resistance
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Catecholamines; 124-38-9/Carbon Dioxide; 50-23-7/Hydrocortisone; 7782-44-7/Oxygen; 9002-60-2/Adrenocorticotropic Hormone
Comments/Corrections
Comment In:
Am J Physiol Regul Integr Comp Physiol. 2009 Jan;296(1):R88-9   [PMID:  19020289 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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