Abstract
The effects of two hours of fetal acidosis (mean pH 6.93) on fetal and maternal blood coagulation were measured. Coagulation test results from 10 fetal lambs and mother ewes (127 ± 2 days mean gestation) before and after fetal lactic acid infusion were compared with test results from 8 control fetal lambs and mother ewes (127 ± 3 days mean gestation) before and after control glucose infusion. Tests included Hb, Hct, WBC, platelet count, pH, pCO2, pO2, PT, PTT, thrombin time, fibrinogen, factors II, V, VII, VIII, IX, X, XI, XII activities, fibrin monomer (FM), AT III, and FDP levels. Significant changes in acidotic fetal lambs not seen in controls included increased WBC (mean 2800/mm3 to 3600/mm3; p=.0009), shortened thrombin time (mean 17.8 sec to 11.2 sec; p=.0001), decreased factor V (mean 57% to 37%; p=.0014), factor IX (mean 35% to 29%; p=.0128), and fibrinogen (mean 147 mg % to 125 mg %; p=.0492). There were no increases in FM or FDP and no decreases in platelet counts or AT III levels. Although there was no change in pH or lactate, a decrease in factor V was found in ewes with acidotic fetuses (mean 141% to 113%; p=.006) and a decrease in factor IX (mean 119% to 102%) approached significance (p=.0564). Fetal acidosis thus induces a hypercoagulable state in the fetus by shortening the thrombin time. Decreases in the levels of factor V and IX are also observed in both fetus and mother, suggesting the liberation of a mediator capable of crossing the placenta.
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Kisker, C., Clarek, W. & Bohlken, D. EFFECTS OF FETAL ACIDOSIS ON FETAL & MATERNAL BLOOD COAGULATION (A FETAL LAMB MODEL). Pediatr Res 18 (Suppl 4), 243 (1984). https://doi.org/10.1203/00006450-198404001-00901
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DOI: https://doi.org/10.1203/00006450-198404001-00901