Does Furosemide Alter the Hemodynamic Response to Rapid Intravascular Transfusion of the Anemic Fetal Lamb?

Chestnut,; Pollack,; Weiner,; Robillard,

doi:10.1097/00000542-198909001-00859

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“…Brace [10] also noted a significant increase in fetal arterial pressure during the transfusion of ovine fetuses, which correlated with the change in blood volume. Finally, Chestnut et al [11] detected a small but significant increase in fetal arterial pressure after IVT in anemic fetal lambs which persisted up to 120 min posttransfusion. However, these pressures were measured in the femoral or jugular arteries of the fetus, not the umbilical artery as was the case in the current investigation.…”

Section: Discussionmentioning

confidence: 95%

Effects of Intravascular Transfusion for Red Cell Alloimmunization on Fetal Arterial Blood Pressure

et al. 1997

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Objective: To evaluate the effects of intravascular transfusion (IVT) on the fetal umbilical arterial pressure (UAP) in pregnancies complicated by red cell alloimmunization. Study Design: UAP and amniotic fluid pressures (AFP) were measured immediately before and after IVT. Mean UAP was calculated by computing 1/3 (systolic blood pressure – diastolic blood pressure) + diastolic blood pressure. The fractional increase in fetoplacental blood volume with transfusion was calculated by dividing the net volume of blood transfused by the sum of the net volume transfused and the fetoplacental volume based on the estimated fetal weight by ultrasound. Statistical techniques included paired t-test, and the Pearson product correlation. Significance was defined as p < 0.05. Results: The fetal umbilical artery was punctured during a total of 27 procedures in 21 patients. Pre- and posttransfusion mean UAPs were recorded in 16 of these procedures. Mean UAP increased from 34.0 ± 14.2 mm Hgpretransfusion to 38.6 ± 12.8 mm Hgposttransfusion (p = 0.34). There was no correlation between the fractional change in fetoplacental blood volume and the calculated difference between pre- and posttransfusion blood pressure. Bradycardia occurred during 5 procedures (31.2%). Fetal demise occurred after 2 procedures (12.5%). Conclusion: IVT appears to have a minimal effect on the fetal UAP. Fetal bradycardia occurs in a significant percentage of these cases.

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Section: Discussionmentioning

confidence: 95%