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异丙肾上腺素对胎儿氧合的影响。

The effects of isoproterenol on fetal oxygenation.

作者信息

Myers R E, Joelsson I, Adamsons K

出版信息

Acta Obstet Gynecol Scand. 1978;57(4):317-22. doi: 10.3109/00016347809154024.

Abstract

Infusion of isoproterenol (1 microgram/kg/min, i.v.) into the anesthetized pregnant rhesus monkey near term consistently reduced fetal oxygenation, despite diminishing myometrial activity. The decline in pO2 of fetal arterial blood (mean = 4.3 +/- 2.3 mmHg S.D.) was accompanied by an increase in pCO2 tension (mean = 4.6 +/- 2.7 mmHg) and a decline in pH (mean = 0.04 +/- 0.02 S.D.). There was an increase in heart rate and a widening of pulse pressure in the mother and also in the adequately oxygenated fetus providing evidence that the agent crosses the placenta. The poorly oxygenated fetuses developed bradycardia and hypotension. Administration of isoproterenol directly to the fetus elicited similar changes in the composition of blood, and in blood pressure and heart rate, to those observed after administration of the agent to the mother.

摘要

向接近足月的麻醉恒河猴孕妇静脉输注异丙肾上腺素(1微克/千克/分钟),尽管子宫肌层活动减弱,但始终会降低胎儿的氧合作用。胎儿动脉血的pO₂下降(平均值 = 4.3 ± 2.3 mmHg标准差),同时pCO₂张力升高(平均值 = 4.6 ± 2.7 mmHg),pH值下降(平均值 = 0.04 ± 0.02标准差)。母亲以及氧合充足的胎儿的心率增加,脉压增宽,这证明该药物可穿过胎盘。氧合不足的胎儿会出现心动过缓和低血压。直接给胎儿注射异丙肾上腺素会引起血液成分、血压和心率的变化,与给母亲注射该药物后观察到的变化相似。

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