Norepinephrine effects on fetal cardiovascular and endocrine systems.

Abstract

Norepinephrine (NE) was infused intravenously into near-term chronically catheterized sheep fetuses for 30 min. Infusions of 0.39, 1.2, 3.9, 12, and 39 micrograms/min caused a 1- to 300-fold increase in plasma NE concentration. Fetal arterial pressure increased in a dose-dependent manner up to a maximum of 72 +/- 5% above basal levels at 6-7 min and gradually declined thereafter. Venous pressure increased during the four highest infusion rates to a maximum at 6-7 min followed by a return toward normal. Fetal blood volume underwent a rapid dose-dependent decrease by a maximum of 12 +/- 1% during 39-micrograms/min infusions of NE. Heart rate initially decreased by up to 40 beats/min during the 3.9-, 12-, and 39-micrograms/min infusions, returned to normal within 10 min, and increased to 50 beats/min above control by the end of the 30-min infusion. Plasma concentrations of arginine vasopressin, epinephrine, and plasma renin activity did not change during or after the four lowest infusion rates. Thus fetal vascular pressures and blood volume are altered in a dose-dependent manner over a broad range of plasma NE concentrations. In addition, NE does not appear to affect other circulating vasoactive hormones within its physiological range of concentrations.