Chestnut D H, Thompson C S, McLaughlin G L, Weiner C P
Department of Anesthesia, University of Iowa College of Medicine, Iowa City.
Am J Obstet Gynecol. 1988 Dec;159(6):1467-73. doi: 10.1016/0002-9378(88)90576-5.
The purpose of this study was to determine whether the intravenous infusion of ritodrine or magnesium sulfate alters the hemodynamic response to maternal hemorrhage in gravid ewes. Twenty-seven experiments were performed in 12 chronically instrumented animals at 0.8 of timed gestation. Each animal was subjected to hemorrhage (20 ml/kg over 60 minutes) during infusion of ritodrine (0.004 mg/kg/min), magnesium sulfate (4 gm/hour), or saline solution control. Infusion of magnesium sulfate increased the mean (+/- SEM) maternal serum magnesium concentration to 4.8 +/- 0.2 mg/dl before hemorrhage and 5.3 +/- 0.3 mg/dl after hemorrhage. At the end of hemorrhage maternal mean arterial pressures were 63% +/- 4%, 82% +/- 2%, and 79% +/- 6% of baseline in the magnesium sulfate, ritodrine, and control groups, respectively. The maternal mean arterial pressure response in the magnesium sulfate group differed significantly from the maternal mean arterial pressure responses in the ritodrine and control groups (p less than 0.01). Fetal pH was decreased significantly only in the magnesium sulfate group (p = 0.0001). Fetal PO2 was decreased significantly in the magnesium sulfate and ritodrine groups (p less than 0.001) but not in the control group. We conclude that magnesium sulfate but not ritodrine, worsened the maternal hypotensive response to hemorrhage in gravid ewes.
本研究的目的是确定静脉输注利托君或硫酸镁是否会改变妊娠母羊对母体出血的血流动力学反应。在12只妊娠0.8期的慢性仪器监测动物身上进行了27次实验。每只动物在输注利托君(0.004mg/kg/min)、硫酸镁(4g/小时)或生理盐水对照期间接受出血(60分钟内20ml/kg)。输注硫酸镁使出血前母体血清镁平均(±标准误)浓度升至4.8±0.2mg/dl,出血后升至5.3±0.3mg/dl。出血结束时,硫酸镁组、利托君组和对照组的母体平均动脉压分别为基线的63%±4%、82%±2%和79%±6%。硫酸镁组的母体平均动脉压反应与利托君组和对照组的母体平均动脉压反应有显著差异(p<0.01)。仅硫酸镁组胎儿pH值显著降低(p=0.0001)。硫酸镁组和利托君组胎儿PO2显著降低(p<0.001),而对照组未降低。我们得出结论,硫酸镁而非利托君会加重妊娠母羊对出血的母体低血压反应。