FETAL HEART-RATE-VARIABILITY AND CEREBRAL OXYGEN-CONSUMPTION IN FETAL SHEEP DURING ASPHYXIA

被引:4
作者
FIELD, DR
PARER, JT
AUSLENDER, R
BAKER, BW
ROSS, BK
LEICHT, CH
机构
[1] UNIV CALIF SAN FRANCISCO,CARDIOVASC RES INST,SAN FRANCISCO,CA 94143
[2] UNIV CALIF SAN FRANCISCO,DEPT OBSTET GYNECOL & REPROD SCI,SAN FRANCISCO,CA 94143
[3] UNIV CALIF SAN FRANCISCO,DEPT ANESTHESIOL,SAN FRANCISCO,CA 94143
来源
EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY | 1991年 / 42卷 / 02期
关键词
FETAL CEREBRAL METABOLISM; FETAL ASPHYXIA; FETAL HEART RATE VARIABILITY; FETAL BLOOD FLOW; UTERINE BLOOD FLOW;
D O I
10.1016/0028-2243(91)90175-K
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
This study was designed to examine the relationship between fetal heart rate variability and fetal cerebral oxygen uptake. Fetal sheep were chronically prepared with catheters and electrodes to determine cerebral blood flow (microsphere method), cerebral arteriovenous oxygen difference, and the electrocardiogram. An adjustable occluder was placed on the maternal common internal iliac artery to induce fetal asphyxia by reducing uterine blood flow. Fetal heart rate variability tended to decrease in the first 11 min of asphyxia, when cerebral oxygen consumption was approximately 53% of control. Despite stable cerebral oxygen consumption and worsening metabolic acidosis, however, fetal heart rate variability progressively returned towards normal by 36 min. There was no relationship between the depression of FHR variability and the degree of reduction of cerebral oxygen consumption. Nor was there any relationship between an alteration in regional cerebral blood flow or myocardial blood flow and the return of FHR variability with increasing duration of asphyxia. We conclude that there is an association between loss of fetal heart rate variability and reduced cerebral oxygen consumption, but the reduced variability does not persist with time at this degree of reduced cerebral metabolism in fetal sheep. This appears to be at variance with human clinical experience. Among the explanations for this may be insufficiently severe asphyxia, a species difference, removal of an inhibitor to FHR variability, or progressive use of other substrates for metabolism.
引用
收藏
页码:145 / 153
页数:9
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