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School of Physiology and Pharmacology, University of New South Wales, Sydney, New South Wales 2052, Australia
To study the
effects of elevated maternal levels of adrenocorticotropic hormone
(ACTH) on the fetus, nine chronically catheterized pregnant ewes (132 ± 0.9 days of gestation) were infused intravenously for 3 days with
Synacthen (5 µg · kg
1 · day
1).
Four ewes were given 0.15 M saline intravenously over the same period.
ACTH induced hypertension in the ewe. Mean arterial pressure (MAP)
increased from 101 ± 4.4 to 114 ± 3.9 mmHg at 48 h
(P < 0.05); cardiac output increased
from 8.6 ± 0.5 to 10.4 ± 1.0 l/min after 24 h
(P < 0.05). Within 2-4 h,
maternal cortisol levels increased from 24.6 ± 6.3 to 287 ± 30 nM (P < 0.05) and remained high.
Fetal plasma cortisol levels increased from 20 ± 4.5 to 60 ± 4.5 nM (P < 0.05) within 2-4 h
and then increased further. Fetal MAP was increased at 24 h. There was
no effect on fetal blood gases or pH. Ewes became hyperglycemic and
lactacidemic by 24 h (P < 0.05), and
the fetuses were also hyperglycemic and lactacidemic
(P < 0.05) at this time.
There were no changes in fetuses carried by saline-infused ewes. Both
ewes and fetuses had raised plasma osmolalities and, since hematocrit
fell, retained fluid. Ewes became hypokalemic; the fetuses did not, but
there was an increase in fetal K excretion. Thus ACTH-induced
hypertension in the ewe had minimal effects on fetal MAP, fetal blood
gas status, and pH. The fetus, however, did show many of the other
effects of maternal glucocorticoid and mineralocorticoid excess, partly because its cortisol levels were increased but also as a consequence of
metabolic and endocrine changes in the ewe.
adrenocorticotropic hormone; cortisol; blood pressure; fetal; glucose; lactate
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