Fetal circulatory responses to maternal blood loss.
We examined the fetal circulatory responses to maternal blood loss in pregnant women during the third trimester. Seven healthy women with placenta previa and singleton pregnancies underwent phlebotomies in an autologous donation program. Four hundred milliliters of blood was collected within 15 min at 34 and 35 weeks of gestation. Continuous electric recordings of fetal heart rate were performed during the first blood collection, and the maternal uterine artery (UtA), umbilical artery (UmA) and fetal middle cerebral artery (MCA) Doppler velocity waveforms were recorded before, immediately after and 24 h after the second collection in each patient. The average fetal heart rate, maternal UtA and UmA pulsatility indices did not change measurably during or after maternal blood collections. However, the average fetal MCA pulsatility index decreased significantly 24 h after maternal blood loss. The observation of a decrease in fetal MCA pulsatility index may indicate delayed fetal asphyxia following mild maternal hemorrhage.
Suzuki
S
S
Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi,Bunkyo-ku, Tokyo 113-8603, Japan.
Tateoka
S
S
Yagi
S
S
Ishikawa
G
G
Ohshita
T
T
Sawa
R
R
Yoneyama
Y
Y
Asakura
H
H
Araki
T
T
D000328:Adult; D001158:Arteries; D001804:Blood Transfusion, Autologous; D005260:Female; D005333:Fetus / Q000098:blood supply*; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D006863:Hydrogen-Ion Concentration; D017078:Laser-Doppler Flowmetry; D020768:Middle Cerebral Artery / Q000196:embryology / Q000502:physiology; D018962:Phlebotomy / Q000009:adverse effects*; D010923:Placenta Previa / Q000628:therapy; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011673:Pulsatile Flow; D014469:Umbilical Arteries / Q000502:physiology; D014599:Uterus / Q000098:blood supply