Abstract
Although paroxysmal atrial tachycardia is a recognized cause of nonimmune hydrops fetalis, the mechanism by which it produces edema is unknown. We operated on 5 fetal lambs at 122-135 days gestation to study the relationship between atrial tachycardia and hydrops. We attached pacer wires to the left or right atria, inserted catheters into the inferior vena cava and aorta, and placed a reference catheter into the amniotic sac. After 3 days of recovery, we measured arterial blood gas tensions, hematocrit, plasma protein concentration, and aortic and venous pressures during a control period and while pacing at 300-320 beats/min. Summary of results: (X±sx: difference significant, p<0.05) During atrial pacing venous pressure doubled and plasma protein concentration decreased. All 5 fetuses had peripheral edema, enlarged livers and ascites (85±23 ml, protein concentration 2.1±0.6 g/dl). Since the ascitic fluid protein concentration was less than that of plasma and since arterial pH did not change we conclude that the edema was the result of increased venous pressure rather than an asphyxia-induced increase in capillary permeability to protein.
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