title: Circulatory changes induced by isovolumic increase in red cell mass in fetal lambs.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: Fetal Cardiology Unit, Sainte-Justine Hospital, Catherine University of Montreal, Quebec, Canada.
authors: G
authors: G
authors: Teyssier
authors: J C
authors: JC
authors: Fouron
authors: S E
authors: SE
authors: Sonesson
authors: P
authors: P
authors: Bonnin
authors: A
authors: A
authors: Skoll
mesh_terms: D000818:Animals; D001809:Blood Viscosity / Q000502:physiology*; D002302:Cardiac Output / Q000502:physiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000196:embryology; D005260:Female; D005333:Fetus / Q000502:physiology*; D006400:Hematocrit; D012756:Sheep; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000196:embryology