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Volume 166 Number 1, Part 2

FETAL BEHAVIORAL STATE AND SWALLOWING RESPONSES TO ORAL WATER A Doddx, C, Agnew, Y, Fujino, M,G, Ervinx, M.G. Ross, Dept. of Ob/Gyn, Harbor-UCLA Med. Ctr., Torrance, CA.

Fetal swallowing is a major route of amniotic fluid resorption. Although absent swallowing may result in excess amniotic fluid, previous studies have suggested an Increased rate of fluid exchange and fetal swaUowing in polyhydramnios. To determine if fetal swallowing is influenced by increased accessibUity of fluid, seven ovine fetuses (127±2 d) were chronically instrumented with vascular catheters, fetal electrocortical (ECoG) and esophageal electromyogram electrodes, an esophageal flow probe and a sublingual catheter. Following a 2 h control period, distnled water (22°C) was infused sublingually at 10 and 20 mI/kg/hrfor 2 hours each. In response to the sublingual water infusions, fetal plasma NA (142±0.5 to 140.8±0.8 mEq/l) and osmolality (302±2 to 296±2 mOsmj decreased significantly whne fetal low voltage ECoG (42±3 to 56±5%) increased. Fetal swallowing rate (47±9 swaIIowsfhr), esophlgeaI tIoN (19.2±4.2 rnfhr), arterial blood gases, blood pressure and heart rate did not change. These results suggest (1) fetal plasma may be affected by the composition of swallowed fluid and (2) exposure of the fetus to altered amniotic fluid composition and temperature may influence fetal behavioral state, though not swallowing activity.

389 NONINVASIVE CARDIAC OUTPUT IN NORMAL AND HYPERTENSIVE PREGNANCY. GJ Gilson, JF Smith, LB Curet, LA Izquierdo, MS Cbatteljee, GO Del Valle", GM Joffe". University of New Mexico Hospital, Albuquerque, New Mexico

The objective of the current study was to confirm or refute the hypothesis that the pathophysiology of preeclampsia (PIH) is abnormally high cardiac output (CO). Methodology entailed study of 16 women diagnosed as pure PIH and 22 women with normal pregnancy, all in the third trimester. Hemodynamic data were obtained by pulsed doppler and 2-D echocardiography. All were studied in left lateral decubitus, and hypertensive patients were studied prior to any therapeutic interventions. Results:!l HR SV CO MAP TPR" (mean+SE) (hpm) (ml/min) (Umin) (mmHg) (dynes/sec/cm-5) Control 22 92±3 113±8 10.5±7 69±2 583±48 PIH 16 PO 9 84±3 120±11 1O.0±.8 103±3 883±88 Pl+ 7 79±7 121±9 8.9±.3107±4 966±57 P .019 NS NS .0001 .001 "Heart Rate (HR), Stroke Volume (SV), Mean Arterial Pressure (MAP), Total Peripheral Resistance (TPR), Nullipara (PO), Multipara (Pl+) Conclusions: Patients with normal pregnancy outcome and those with PIH both had elevated CO, which however were not significantly different. MAP was significantly elevated in PIH on the basis of elevated TPR. While this data is consistent with the classic theory of the pathophysiology of PIH, these patients were studied when they already had clinical manifestations of the disease and could have already crossed over into a state of elevated TPR.

SPO Abstracts 383

390 EFFECT OF MODE OF DELIVERY ON LYMPHOCYTE SUBSETS IN FULL TERM NEONATES. R.Samelson, D.LarkeyX,K.S.Amankwah,P.McConnachiex, South­ern III School of Med., Springfield,Il.

With the aid of monoclonal antibodies, im­munofluorescence, and flow cytometry, cord blood lymphocyte populations were studied in neonates, 6 delivered vaginally(V) and 6 by cesarean section without labor(C7S). These lymphocyte subsets, or phenotype-Irequencies (PF), were compared to normal adult values(A) and to each other(2 tail student t test, p -less than 0.05). A statistically significant difference did occur in the PF of helper T cells(C) (CD4) , more mature B-c(CD2l), Natural killer-C(CD16), and Killer C(CD56). Total T C (CD2) were decreased in V when compared to c7s. The PF of common thymocyte(CDl) co-expresse~ with-mature T C(CD2), suppressor cytotoxic C (CDS), B cells(Dr), early intermediate B C­(CD19), and activated T C(CD3/Dr) were the same in all neonates regardless of mode of de­livery and were no different from the PF in A. Thus a profile of elevated T and helper-T ~ and depressed Natural killer C is characteristic of cis; a profile of depressed T C and helper T C and elevated Natural killer C is characteristic of V. Depressed intermediate-B C is common to all-neonates compared to adult normal values.

391 THE FETUS DURING MATERNAL FEVER: BIOPHYSICAL EFFECTS ASSOCIATED WITH VIRAL SYNDROMES DIFFER FROM THOSE ASSOCIATED WITH PYLEONEPHRITIS. N. Wasserstrum, D.E. Patton Baylor College of Medicine, Dept OB/GYN, Houston, Texas.

We sought to determine if the marked suppre­sion of fetal breathing movements (FBM) and fetal body movements (FM) we preViously report­ed during fever in pyelonephritis (PYL) depend­ed on etiology. Gravida (GA~30+/-4wk) with viral syndromes (VS), were studied at least 24 hr. off antipyretics during fever T~102.9+/-0.8 C) and early convalescence (T~97.7+/-0.5 C) comparable to PYL.

Fever Convalescence Control

Results Temperature

102.9+/-0.8 97.7+/-0.5 97.3+/-0.3

in Patients % Time FBM

6.3+/-5.3 5.2+/-4.2

36.6+/-8.4

with VS Total FM in 30 min 9.6+/-5.5

24.4+/-10.2 19.5+/-2.2

1. In VS, FBM were depressed during fever, but much lees severely and with greater variability [range: 0-15%] than ill PYL [FBM ~ 0.9+/-1.1%; range: 0-3%] 2. In VS unlike PYL, FBM depres­sion showed no recovery in convalescence. 3. In contrast, FM in VS were depressed during fever and recovered during convalescence as in PYL. 4. The fetal biophysical effects of febrile illness reflect more than fever per se, and depend on etiology.