Effect of maternal exposure to high altitude upon fetal oxygenation

Makowski, Edgar L.; Battaglia, Frederick C.; Meschia, Giacomo; Schruefer, John J.; Seeds, A. Elmore; Bruns, Paul D.

doi:10.1016/s0002-9378(15)33590-0

Cited by 41 publications

(13 citation statements)

References 2 publications

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“…Thus, it can be inferred from past and present observations that fetal growth retardation at high altitude may occur primarily in late gestation and may reflect maternoplacental insufficiency to meet the fetal oxygen demands at this time. Potential mechanisms may include a reduction in the transplacental oxygen partial pressure gradient (56) and/or depressed uteroplacental vasodilators (57,58) leading to reduced uterine blood flow (32,59), all of which have been reported in high-altitude pregnancy. It is possible that this unmatched fetal oxygen demand may trigger the release of fetoplacental hormones and factors that control tissue accretion and differentiation in the fetus during late gestation, such as insulin, thyroxine, cortisol, and IGF (60,61).…”

Section: Discussionmentioning

confidence: 99%

Effects of Altitude versus Economic Status on Birth Weight and Body Shape at Birth

et al. 2001

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Section: Discussionmentioning

confidence: 99%

Effects of Altitude versus Economic Status on Birth Weight and Body Shape at Birth

et al. 2001

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“…This study demonstrates that adult red cells present in the fetal circulation for some weeks retain a n 0, dissociation curve of the adult type. Similar to fetal hypoxia associated with acute exposure to altitude with a d u l t blood u p o n fetal oxygenation 65 [6], the markedly low saturation of umbilical vein blood after transfusion was still compatible with the production of a viable newborn in most of the single pregnancies. I n twin pregnancies, however, in which there might have been a less narrow margin of safety, three of the four pregnancies terminated in fetal death in utero.…”

mentioning

confidence: 86%

The Effect of Fetal Exchange Transfusions with Adult Blood upon Fetal Oxygenation

Battaglia

Bowes

et al. 1969

Pediatr Res

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ExtractIntrauterine exchange transfusions were conducted i n fetal sheep using a d u l t sheep a s donors. I ndwelling catheters i n t h e fetus permitted sampling of blood for 8 to 36 days following t h e transfusion.I n t h e first days after t h e procedure there was a decreased oxygen affinity of umbilical blood, a n increase of a b o u t 5 mm Hg i n umbilical venous 0, tension, and a decrease of a b o u t 30 % in 0, saturation. I n t h e following weeks there was a g r a d u a l r e t u r n of 0, a f i n i t y , PO,, a n d oxygen saturation to normal. In all of t h e experiments there was a good correlation between t h e 0, affinity of umbilical blood a n d t h e percentage of a d u l t cells present. T h i s correlation indicated t h a t a d u l t cells retained a n o r m a l 0, dissociation curve even after weeks of exposure to t h e n e w environment. Despite a n increased umbilical venous PO,, t h e fetal reticulocyte c o u n t increased significantly after transfusion, b u t t h e oxygen capacity of umbilical blood remained within n o r m a l limits. SpeculationThese studies suggest t h a t t h e correction of fetal a n e m i a i n erythroblastosis fetalis b y t h e use of fetal blood instead of a d u l t blood would produce a greater increase i n t h e a m o u n t of hemoglobin c a p a b l e of carrying oxygen a t t h e low oxygen tensions characteristic of t h e fetal circulation.The first successful intrauterine transfusion of a human fetus was reported by LILEY in 1963 [5]. Since that time many fetal transfusions have been performed for treatment of the fetus severely affected by erythroblastosis. Despite a n expanding literature about this procedure, there have been no studies reported in experimental animalsevaluatingsomeof thesurgical and physiological problems encountered. One of the most obviousphysiologic handicaps imposed upon the fetus that undergoes transfusion is the replacement of fetal cells with adult cells having a much lower oxygen affinity.This study was undertaken in order to determine the effects upon umbilical blood oxygenation of substituting adult whole blood for fetal blood within the circulation offetal lambs. Experiments were performed in animal preparations in which an indwelling catheter was implanted within the umbilical vein at the time of the exchange transfusion and in which the pregnancy was allowed to continue to the point of delivery. Such preparations made possible the determination of the changes in respiratory gases within the same fetus for some weeks following intrauterine exchange transfusion.

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“…3a), but there were no differences between groups for oestrone (Text- fig. 3b) (Metcalfe et al, 1962 ;Makowski et al, 1968) at high altitude in which a higher rate of uterine blood flow and differences in placental gas exchange were observed, which suggested an increased diffusion capacity of the placenta. 005).…”

Section: Chronic Experimentsmentioning

confidence: 98%

Adaptations to reduction of endometrial surface available for placental development in sheep

Caton¹,

Bazer²,

Kalra³

et al. 1984

Reproduction

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Summary. On Day 5 of pregnancy, before the blastocyst migrates to the uterus, one uterine horn was ligated to restrict the trophoblast to the lumen ipsilateral to the corpus luteum. The numbers of placentomes (caruncles and cotyledons) were reduced by half, but neither at 120 nor at 140 days of pregnancy (term 147 days) did the weights of placentae and fetuses of treated ewes differ significantly from those of control ewes. Amongst uterus-ligated animals prepared for chronic study, the rate of uterine blood flow (electromagnetic flow transducer, ml/min) to the pregnant horn was higher than in control ewes, as was the concentration of progestagens in maternal peripheral blood. There may be a compensatory response that causes hypertrophy of placentomes and that increases blood flow to the uterine horn containing placental tissue.

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Effect of maternal exposure to high altitude upon fetal oxygenation

Cited by 41 publications

References 2 publications

Effects of Altitude versus Economic Status on Birth Weight and Body Shape at Birth

Effects of Altitude versus Economic Status on Birth Weight and Body Shape at Birth

The Effect of Fetal Exchange Transfusions with Adult Blood upon Fetal Oxygenation

Adaptations to reduction of endometrial surface available for placental development in sheep

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