Correction of hemorrhage-induced anemia with intra-amniotic iron in the ovine fetus

R. A. Brace, A. Gruslin, A. D. Hull, J. A. Widness, Cecilia Cheung

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVE: This study tested the hypothesis that intra-amniotic iron treatment would enhance fetal red blood cell production after an acute, severe fetal hemorrhage of 40% of estimated blood volume over 2 hours. STUDY DESIGN: Three groups of late-gestation ovine fetuses were studied for 10 days: (1) control fetuses (n = 8), (2) fetuses hemorrhaged on day 3 (n = 11), and (3) similarly hemorrhaged fetuses supplemented with a single bolus of 60 mg of iron injected intra-amniotically immediately after the hemorrhage (n = 7). Statistical analysis was by 3-factor analysis of variance. RESULTS: At 24 hours after hemorrhage, red blood cell mass increased 5% in the control group and was reduced equally in both hemorrhage groups by 32% below day 3 prehemorrhage values. At 7 days after hemorrhage, red blood cell mass increased 27.8% ± 2.6% (SE) above day 3 baseline values in the control fetuses. In the nonsupplemented hemorrhaged fetuses, red blood cell mass was not different from prehemorrhage values after 7 days (±3.7% ± 4.1%), whereas red blood cell mass increased by 29.9% ± 6.1% above prehemorrhage values in the iron-supplemented hemorrhage group (P <.001). CONCLUSION: Intra-amniotic iron supplementation resulted in full restoration of red blood cell mass within 7 days after a large loss of blood in fetal sheep, whereas restoration failed without iron supplementation. Intra-amniotic iron treatment may be of therapeutic value in restoring red blood cell mass in human fetuses with certain types of anemia such as that resulting from fetal or fetomaternal hemorrhage.

Original languageEnglish (US)
Pages (from-to)214-220
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume180
Issue number1 I
DOIs
StatePublished - 1999
Externally publishedYes

Fingerprint

Erythrocyte Volume
Anemia
Sheep
Fetus
Iron
Erythrocytes
Hemorrhage
Fetal Blood
Fetomaternal Transfusion
Blood Volume
Statistical Factor Analysis
Analysis of Variance
Pregnancy
Control Groups

Keywords

  • Erythropoietin
  • Fetal hemorrhage
  • Intra-amniotic injection
  • Iron
  • Red blood cell mass
  • Sheep

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Correction of hemorrhage-induced anemia with intra-amniotic iron in the ovine fetus. / Brace, R. A.; Gruslin, A.; Hull, A. D.; Widness, J. A.; Cheung, Cecilia.

In: American Journal of Obstetrics and Gynecology, Vol. 180, No. 1 I, 1999, p. 214-220.

Research output: Contribution to journalArticle

Brace, R. A. ; Gruslin, A. ; Hull, A. D. ; Widness, J. A. ; Cheung, Cecilia. / Correction of hemorrhage-induced anemia with intra-amniotic iron in the ovine fetus. In: American Journal of Obstetrics and Gynecology. 1999 ; Vol. 180, No. 1 I. pp. 214-220.
@article{137446f2ca3542dd8793be30c87f4c00,
title = "Correction of hemorrhage-induced anemia with intra-amniotic iron in the ovine fetus",
abstract = "OBJECTIVE: This study tested the hypothesis that intra-amniotic iron treatment would enhance fetal red blood cell production after an acute, severe fetal hemorrhage of 40{\%} of estimated blood volume over 2 hours. STUDY DESIGN: Three groups of late-gestation ovine fetuses were studied for 10 days: (1) control fetuses (n = 8), (2) fetuses hemorrhaged on day 3 (n = 11), and (3) similarly hemorrhaged fetuses supplemented with a single bolus of 60 mg of iron injected intra-amniotically immediately after the hemorrhage (n = 7). Statistical analysis was by 3-factor analysis of variance. RESULTS: At 24 hours after hemorrhage, red blood cell mass increased 5{\%} in the control group and was reduced equally in both hemorrhage groups by 32{\%} below day 3 prehemorrhage values. At 7 days after hemorrhage, red blood cell mass increased 27.8{\%} ± 2.6{\%} (SE) above day 3 baseline values in the control fetuses. In the nonsupplemented hemorrhaged fetuses, red blood cell mass was not different from prehemorrhage values after 7 days (±3.7{\%} ± 4.1{\%}), whereas red blood cell mass increased by 29.9{\%} ± 6.1{\%} above prehemorrhage values in the iron-supplemented hemorrhage group (P <.001). CONCLUSION: Intra-amniotic iron supplementation resulted in full restoration of red blood cell mass within 7 days after a large loss of blood in fetal sheep, whereas restoration failed without iron supplementation. Intra-amniotic iron treatment may be of therapeutic value in restoring red blood cell mass in human fetuses with certain types of anemia such as that resulting from fetal or fetomaternal hemorrhage.",
keywords = "Erythropoietin, Fetal hemorrhage, Intra-amniotic injection, Iron, Red blood cell mass, Sheep",
author = "Brace, {R. A.} and A. Gruslin and Hull, {A. D.} and Widness, {J. A.} and Cecilia Cheung",
year = "1999",
doi = "10.1016/S0002-9378(99)70177-8",
language = "English (US)",
volume = "180",
pages = "214--220",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "1 I",

}

TY - JOUR

T1 - Correction of hemorrhage-induced anemia with intra-amniotic iron in the ovine fetus

AU - Brace, R. A.

AU - Gruslin, A.

AU - Hull, A. D.

AU - Widness, J. A.

AU - Cheung, Cecilia

PY - 1999

Y1 - 1999

N2 - OBJECTIVE: This study tested the hypothesis that intra-amniotic iron treatment would enhance fetal red blood cell production after an acute, severe fetal hemorrhage of 40% of estimated blood volume over 2 hours. STUDY DESIGN: Three groups of late-gestation ovine fetuses were studied for 10 days: (1) control fetuses (n = 8), (2) fetuses hemorrhaged on day 3 (n = 11), and (3) similarly hemorrhaged fetuses supplemented with a single bolus of 60 mg of iron injected intra-amniotically immediately after the hemorrhage (n = 7). Statistical analysis was by 3-factor analysis of variance. RESULTS: At 24 hours after hemorrhage, red blood cell mass increased 5% in the control group and was reduced equally in both hemorrhage groups by 32% below day 3 prehemorrhage values. At 7 days after hemorrhage, red blood cell mass increased 27.8% ± 2.6% (SE) above day 3 baseline values in the control fetuses. In the nonsupplemented hemorrhaged fetuses, red blood cell mass was not different from prehemorrhage values after 7 days (±3.7% ± 4.1%), whereas red blood cell mass increased by 29.9% ± 6.1% above prehemorrhage values in the iron-supplemented hemorrhage group (P <.001). CONCLUSION: Intra-amniotic iron supplementation resulted in full restoration of red blood cell mass within 7 days after a large loss of blood in fetal sheep, whereas restoration failed without iron supplementation. Intra-amniotic iron treatment may be of therapeutic value in restoring red blood cell mass in human fetuses with certain types of anemia such as that resulting from fetal or fetomaternal hemorrhage.

AB - OBJECTIVE: This study tested the hypothesis that intra-amniotic iron treatment would enhance fetal red blood cell production after an acute, severe fetal hemorrhage of 40% of estimated blood volume over 2 hours. STUDY DESIGN: Three groups of late-gestation ovine fetuses were studied for 10 days: (1) control fetuses (n = 8), (2) fetuses hemorrhaged on day 3 (n = 11), and (3) similarly hemorrhaged fetuses supplemented with a single bolus of 60 mg of iron injected intra-amniotically immediately after the hemorrhage (n = 7). Statistical analysis was by 3-factor analysis of variance. RESULTS: At 24 hours after hemorrhage, red blood cell mass increased 5% in the control group and was reduced equally in both hemorrhage groups by 32% below day 3 prehemorrhage values. At 7 days after hemorrhage, red blood cell mass increased 27.8% ± 2.6% (SE) above day 3 baseline values in the control fetuses. In the nonsupplemented hemorrhaged fetuses, red blood cell mass was not different from prehemorrhage values after 7 days (±3.7% ± 4.1%), whereas red blood cell mass increased by 29.9% ± 6.1% above prehemorrhage values in the iron-supplemented hemorrhage group (P <.001). CONCLUSION: Intra-amniotic iron supplementation resulted in full restoration of red blood cell mass within 7 days after a large loss of blood in fetal sheep, whereas restoration failed without iron supplementation. Intra-amniotic iron treatment may be of therapeutic value in restoring red blood cell mass in human fetuses with certain types of anemia such as that resulting from fetal or fetomaternal hemorrhage.

KW - Erythropoietin

KW - Fetal hemorrhage

KW - Intra-amniotic injection

KW - Iron

KW - Red blood cell mass

KW - Sheep

UR - http://www.scopus.com/inward/record.url?scp=0033033135&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033033135&partnerID=8YFLogxK

U2 - 10.1016/S0002-9378(99)70177-8

DO - 10.1016/S0002-9378(99)70177-8

M3 - Article

C2 - 9914606

AN - SCOPUS:0033033135

VL - 180

SP - 214

EP - 220

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 1 I

ER -