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Blood coagulation changes after hypoxemia: a fetal lamb model

C T Kisker, J E Robillard, W R Clarke

    Pediatric Research
    |January 1, 1982
    PubMed
    Summary

    Severe fetal hypoxemia did not alter blood coagulation factors in lambs without hypotension or acidosis. This study found no significant acute or chronic changes in coagulation in stressed fetuses.

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    Area of Science:

    • Perinatal Medicine
    • Fetal Physiology
    • Hematology

    Background:

    • Fetal hypoxemia is a critical condition impacting fetal development.
    • Understanding its effects on blood coagulation is crucial for perinatal care.
    • Previous research has yielded conflicting results on fetal coagulation responses to stress.

    Purpose of the Study:

    • To investigate the impact of severe fetal hypoxemia on a comprehensive panel of blood coagulation parameters in fetal lambs.
    • To determine if hypoxemia, in the absence of other stressors like hypotension or acidosis, causes acute or chronic coagulation alterations.
    • To assess changes in specific coagulation factors, platelet count, and fibrinolytic markers.

    Main Methods:

    • Utilized chronically catheterized fetal lambs in the third trimester.
    • Induced controlled hypoxemia (pO2 14 mm Hg) for 1 hour in experimental group.
    • Monitored coagulation factors (II, V, VIII, IX, X, XI, XII, XIII, fibrinogen, vWF), platelet count, fibrin degradation products, and fibrin monomer.
    • Compared results with a control group of fetal lambs.

    Main Results:

    • Severe fetal hypoxemia did not significantly alter most blood coagulation factor activities.
    • Minimal changes in PCO2, arterial pressure, heart rate, and pH were observed during hypoxemia.
    • Increased epinephrine and norepinephrine levels indicated a stress response.
    • Slight increases in factors VIII, XII, and von Willebrand activity occurred in both groups, potentially due to blood sampling.
    • No significant differences in coagulation factor activities were found between hypoxemic and control groups during an 18-day follow-up.

    Conclusions:

    • Severe fetal hypoxemia, when not accompanied by hypotension, acidosis, or hypercarbia, does not induce acute or chronic alterations in fetal lamb blood coagulation.
    • The observed minor coagulation factor changes were likely related to procedural stress (blood loss) rather than hypoxemia itself.
    • This suggests fetal lambs have a robust coagulation system resistant to isolated hypoxic insults.

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