Curry S C, Bond G R, Raschke R, Tellez D, Wiggins D
Department of Medical Toxicology, Good Samaritan Regional Medical Center, Phoenix, Arizona.
Ann Emerg Med. 1990 Jun;19(6):632-8. doi: 10.1016/s0196-0644(05)82466-7.
An ovine model of maternal iron poisoning in pregnancy was used to examine the placental transport of deferoxamine and ferrioxamine and to follow maternal and fetal serum iron concentrations when maternal serum iron levels exceeded total iron-binding capacity. Ewes in the third stage of gestation underwent hysterotomy and delivery of the fetal head through an abdominal incision while under ketamine and halothane anesthesia. The fetal external jugular vein was catheterized for sampling of venous blood while the fetus remained in utero. Administration of deferoxamine mesylate or ferrioxamine mesylate IV to ewes was not accompanied by measurable deferoxamine or ferrioxamine in fetal blood. In a final experiment, four gravid ewes in a control group received 2 mg/kg maternal body wt iron IV over 60 minutes. An experimental group comprising another four ewes received similar doses of iron but then received 50 mg/kg deferoxamine mesylate IV over 15 minutes. Control and deferoxamine ewes reached similar peak maternal serum iron concentrations (2,479 +/- 266 and 2,121 +/- 343 micrograms/dL, respectively). The markedly elevated maternal serum iron concentrations were not accompanied by meaningful elevations in fetal serum iron levels over baseline values. Maternal deferoxamine infusion resulted in a more rapid fall in maternal serum iron concentrations but had no effect on fetal serum iron levels. The ovine fetus appears to be protected from elevated maternal serum iron concentrations in the last trimester of pregnancy. It could not be demonstrated that meaningful quantities of deferoxamine or ferrioxamine cross the placenta in the last trimester.(ABSTRACT TRUNCATED AT 250 WORDS)
采用妊娠母羊铁中毒的绵羊模型,研究去铁胺和铁胺的胎盘转运情况,并在母血清铁水平超过总铁结合能力时,跟踪母胎血清铁浓度。妊娠晚期母羊在氯胺酮和氟烷麻醉下,通过腹部切口进行子宫切开术并娩出胎头。胎儿仍在子宫内时,将导管插入胎儿颈外静脉采集静脉血。给母羊静脉注射甲磺酸去铁胺或甲磺酸铁胺后,胎儿血液中未检测到可测量的去铁胺或铁胺。在最后一项实验中,对照组的四只妊娠母羊在60分钟内静脉注射2mg/kg母羊体重的铁。另一组由四只母羊组成的实验组接受相似剂量的铁,然后在15分钟内静脉注射50mg/kg甲磺酸去铁胺。对照组和去铁胺组母羊血清铁浓度达到的峰值相似(分别为2479±266和2121±343μg/dL)。母羊血清铁浓度显著升高,但胎儿血清铁水平并未比基线值有明显升高。母羊输注去铁胺导致母羊血清铁浓度下降更快,但对胎儿血清铁水平无影响。妊娠晚期的绵羊胎儿似乎受到保护,免受母羊血清铁浓度升高的影响。无法证明妊娠晚期有大量的去铁胺或铁胺穿过胎盘。(摘要截短于250字)