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Arch Dis Child Fetal Neonatal Ed 1998;79:F180-F184 ( November )

Circulatory changes induced by isovolumic increase in red cell mass in fetal lambs

G Teyssier,a J C Fouron,a S E Sonesson,a P Bonnin,a A Skollb

a The Fetal Cardiology Unit Pediatric Cardiology Service Sainte-Justine Hospital 3175 Côte Ste Catherine University of Montreal Quebec Canada H3T 1C5, b Department of Obstetrics

Correspondence to: Dr Jean-Claude Fouron. Email: fouron{at}sympatico.ca


Accepted 17 May 1998

AIM---To verify whether extra uterine changes in total peripheral vascular resistance and cardiac output, caused by raised haematocrit, occur in fetal life and if they can be documented using conventional ultrasound techniques.
METHODS---An exchange transfusion with packed red cells was performed on five fetal lambs at 140 days of gestation (weight 3.44, SD 0.48 kg); three others were used as controls. The haematocrit was raised from 44 ± 3 to 64 (SD2)%.
RESULTS---Body temperature, blood gas, and pH remained within normal limits. Blood viscosity increased from 5.3 ( 0.3) to 9.6 (1.6) cps. Combined cardiac output fell to 30% of its initial value. The pulsatility index (PI) remained unchanged in the umbilical artery (0.66, SD 0.1) and descending aorta (1.3, SD 0.3). A significant positive correlation was found between haematocrit and PI only in the carotid artery (r=0.67, p<0.01).
CONCLUSION---In the fetus, as in adults, an increase in blood viscosity is associated with a fall in cardiac output. However, the low resistance and the relative inertia of the placental vascular bed blunt the velocimetric changes that could be induced in the lower body vascular system by an increase in resistance. Such changes were observed only in the carotid artery. These results could be of interest in the Doppler monitoring of human fetuses at risk of an abnormal increase in their haematocrit.

Keywords: haematocrit; viscosity;cerebral artery; umbilical artery


© 1998 by Archives of Disease in Childhood



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Arch. Dis. Child. Fetal Neonatal Ed.Home page
P Pladys, A Beuchée, E Wodey, L Tison, and P Bétrémieux
Haematocrit and red blood cell transport in preterm infants: an observational study
Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2000; 82(2): 150F - 155.
[Abstract] [Full Text]




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