Gilbert W M, Newman P S, Brace R A
Department of Reproductive Medicine, University of California at San Diego, USA.
Am J Obstet Gynecol. 1995 May;172(5):1471-6. doi: 10.1016/0002-9378(95)90480-8.
Our purpose was to determine whether intraamniotically injected furosemide could be absorbed directly into fetal circulation by the ovine intramembranous pathway.
Nine chronically catheterized fetal sheep, five with an intact and four with a surgically ligated esophagus, were studied for 7 hours on 2 consecutive days. Day 1 was a control day in which the fetal parameters of arterial, venous, and amniotic fluid pressures; heart rate; and urine flow were measured continuously. Fetal and maternal blood, amniotic fluid, and fetal urine were sampled for osmolality, electrolytes, blood gases, and pH twice during the first hour and hourly thereafter. On day 2, 15 mg of furosemide was injected into the amniotic cavity after 1 hour and fetuses were monitored in the same fashion as on the control day.
On day 2, both intact and ligated fetuses demonstrated a rapid and prolonged increase in urine flow (p < 0.01) compared with control day fetuses. Esophageal ligation decreased, but did not eliminate, the diuresis. Free water clearance increased equally (p < 0.05) in both groups compared with control fetuses. Sodium and chloride excretion increased significantly in intact (sodium 591% +/- 220% and chloride 763% +/- 295%) and ligated fetuses (sodium 234% +/- 70% and chloride 409% +/- 74%) compared with control fetuses.
Diuresis after esophageal ligation demonstrates that furosemide is absorbed by the ovine intramembranous pathway.
我们的目的是确定羊膜腔内注射的呋塞米是否能通过绵羊的膜内途径直接吸收进入胎儿循环。
对9只长期插管的胎羊进行研究，连续2天，每天观察7小时。其中5只食管完整，4只食管经手术结扎。第1天为对照日，连续监测胎儿的动脉压、静脉压、羊水压力、心率和尿流量等参数。在第1小时内，每隔半小时采集胎儿和母体的血液、羊水及胎儿尿液样本，检测渗透压、电解质、血气和pH值，之后每小时采集一次。第2天，在第1小时后向羊膜腔内注射15毫克呋塞米，并以与对照日相同的方式监测胎儿。
与对照日相比，第2天，食管完整和结扎的胎羊均出现尿流量迅速且持续增加（p < 0.01）。食管结扎使利尿作用减弱，但并未消除。与对照胎羊相比，两组的自由水清除率均同等增加（p < 0.05）。与对照胎羊相比，食管完整的胎羊（钠591% ± 220%，氯763% ± 295%）和食管结扎的胎羊（钠234% ± 70%，氯409% ± 74%）的钠和氯排泄量显著增加。
食管结扎后的利尿作用表明呋塞米可通过绵羊的膜内途径被吸收。
