Abudu O O, Sofola O A
J Natl Med Assoc. 1988 Aug;80(8):906-12.
In a comparative study of physiological changes in pregnant Nigerians, plasma volume measurements were performed in 75 healthy Nigerian women. They comprised 40 women with hemoglobin genotype AA (20 pregnant and 20 nonpregnant) and 35 women with hemoglobin genotype SS or SC (15 pregnant and 20 nonpregnant). Plasma volume was determined in the left lateral position using the Evans blue dye dilution technique (described by Dacie and Lewis) in the nonpregnant, at 16 and 36 weeks of gestation, and at 8 weeks postpartum.The mean plasma volume of 2044 ± 77.4 mL (SEM) in normal nonpregnant women with Hb AA was not significantly different from the mean plasma volume of 1931 ± 115 mL (SEM) found in nonpregnant sicklers. At 16 weeks' gestation there was no significant difference in the mean plasma volume of 2712 ± 209.8 mL (SEM) in pregnant women with HB AA and 2948 ± 165.8 mL (SEM) in pregnant sicklers. However, at 36 weeks the mean plasma volume of 3440 ± 223.7 mL (SEM) (68 percent increase compared with nonpregnant) in pregnant women with Hb AA was significantly higher (P < .02) than the mean plasma volume of 2312 ± 214.8 mL (SEM) (17 percent increase compared with nonpregnant) in sicklers.The mean birthweight of 3.17 ± 0.08 kg (SEM) in women with Hb AA was higher (P < .01) than that of 2.58 ± 0.15 kg (SEM) in sicklers. The perinatal mortality in sicklers was 133/thousand total births, while there was no fetal loss in the control. These data suggest a decrease or lack of intravascular volume expansion and evidence of uteroplacental insufficiency in sicklers.
在一项关于尼日利亚孕妇生理变化的对比研究中，对75名健康的尼日利亚女性进行了血浆容量测量。她们包括40名血红蛋白基因型为AA的女性（20名孕妇和20名非孕妇）以及35名血红蛋白基因型为SS或SC的女性（15名孕妇和20名非孕妇）。采用伊文思蓝染料稀释技术（由达西和刘易斯描述），在非孕期、妊娠16周和36周以及产后8周时，于左侧卧位测定血浆容量。血红蛋白AA型的正常非孕妇血浆平均容量为2044±77.4毫升（标准误），与镰刀型贫血非孕妇血浆平均容量1931±115毫升（标准误）相比，差异无统计学意义。妊娠16周时，血红蛋白AA型孕妇血浆平均容量为2712±209.8毫升（标准误），镰刀型贫血孕妇血浆平均容量为2948±165.8毫升（标准误），两者差异无统计学意义。然而，在妊娠36周时，血红蛋白AA型孕妇血浆平均容量为3440±223.7毫升（标准误）（相较于非孕期增加68%），显著高于镰刀型贫血孕妇血浆平均容量2312±214.8毫升（标准误）（相较于非孕期增加17%）（P<0.02）。血红蛋白AA型女性的平均出生体重为3.17±0.08千克（标准误），高于镰刀型贫血女性的2.58±0.15千克（标准误）（P<0.01）。镰刀型贫血患者的围产期死亡率为每千例总出生数133例，而对照组无胎儿丢失。这些数据表明镰刀型贫血患者血管内容量扩张减少或缺乏，并有子宫胎盘功能不全的证据。
