Dodic M, Tangalakis K, Moritz K, McFarlane A, Wintour E M
Howard Florey Institute of Experimental Physiology and Medicine, University of Melbourne, Parkville, Australia.
Pediatr Res. 1998 Dec;44(6):894-9. doi: 10.1203/00006450-199812000-00012.
Hydrops fetalis, with or without oligo- or polyhydramnios, is associated with very high fetal mortality. In many cases the causes are unknown. Chronically cannulated ovine fetuses have been used as animal models to study the regulation of fetal fluid balance. This study reports that the mid-gestation ovine fetus (70 +/- 1 d of gestation; term = 145-150 d) is susceptible to the development of fetal abnormalities (excess allantoic fluid--hydrallantois, with or without hydrops and hydranencephaly), when blood vessels in the neck are cannulated. Cannulation of one carotid artery and one jugular vein, or cannulation of a single jugular vein resulted in 5 out of 12 fetuses having abnormalities 1 wk later. In contrast, six fetuses at 115 d of gestation that had both carotids and one jugular vein ligated cranially and cannulated, developed hydranencephaly but no hydrops or hydrallantois. In the mid-gestation fetus hydrallantois [760 +/- 140 mL (n = 5) versus 104 +/- 23 mL (n = 7 controls), p < 0.001] occurred without alterations in the plasma concentrations of ACTH, cortisol, atrial natriuretic peptide, or aldosterone, as well as without anemia. Although the causes of the fluid abnormalities were not resolved, it is important to note the developmental differences in vulnerability.
胎儿水肿,无论有无羊水过少或过多,都与极高的胎儿死亡率相关。在许多情况下,病因不明。长期插管的绵羊胎儿已被用作动物模型来研究胎儿液体平衡的调节。本研究报告称,妊娠中期的绵羊胎儿(妊娠70±1天;足月为145 - 150天)在颈部血管插管时易发生胎儿异常(过多的尿囊液——积水性尿囊,有无水肿和积水性无脑畸形)。一条颈动脉和一条颈静脉插管,或单条颈静脉插管后,12只胎儿中有5只在1周后出现异常。相比之下,115天妊娠的6只胎儿,其双侧颈动脉和一条颈静脉在颅侧结扎并插管后,出现了积水性无脑畸形,但没有水肿或积水性尿囊。在妊娠中期胎儿中,积水性尿囊[760±140 mL(n = 5)对104±23 mL(n = 7对照),p < 0.001]出现时,促肾上腺皮质激素、皮质醇、心钠素或醛固酮的血浆浓度没有改变,也没有贫血。尽管液体异常的原因尚未解决,但注意到易感性的发育差异很重要。