Fetal blood volume responses to fetal haemorrhage: autonomic nervous contribution

The purpose of this study was to determine whether the autonomic nervous system contributes to short-term fetal blood volume restitution following fetal haemorrhage. Unanaesthetized, chronically catheterized fetal sheep averaging 130 days gestation (term = 145-150 days) were studied 5 days after catheter implantation. Blockade of the autonomic nervous system was produced with a bolus intravenous injection of hexamethonium. In 7 blocked fetuses, an average of 17.6% of the initial blood volume was removed over 5 min and this was not different from the 16.5% blood volume removed in 7 control fetuses. However, blood volume restoration averaged 44.6% after 30 min in the blocked fetuses and this was significantly less than the 60.2% volume restoration in the control fetuses (P less than 0.05). Thus blood volume restoration averaged 74% of control in the blocked fetuses. Following blood reinfusion over 5 min, blood volume was transiently elevated in the control group, but averaged 3.4, 4.7, and 5.3% below normal (P less than 0.05) at 10, 20 and 30 min post reinfusion in the blocked group. In addition, arterial pressure was lower after haemorrhage in the blocked group and increased twice that in the control group during reinfusion. Thus, the present data suggest that the fetal autonomic nervous system plays a significant role in mediating the short-term changes in fetal blood volume and vascular pressures following fetal haemorrhage and reinfusion.