Relationship Between Hemodynamics Changes Of Ductus Venous And Inflammatory Mediators In The Ovine Fetus With Systemic Inflammatory Response Syndrome

Objective To study the hemodynamic characteristics of ductus venous , and its relationship to serum inflammatory cytokines of IL-6,TNF-αin ovine fetus with systemic inflammatory response syndrome .Methods Ten near-term ewes were radomly divided into two groups of experimental (n=5) and control group (n=5). All of the ovine fetuses received an umbilical vein or umbilical-portal vein centesis guided by ultrasound at the term of 120~130 days, following a LPS injection at a dosage of 10μg per kg fetal weight in experimental group and an equal amount of normal saline in control. Doppler examinations were performed at 0.5 hour before the LPS injection, and at 1 hours,3 hours, 6 hours after LPS injection for DV waveform PI values(PIV), DV maximum velocity during cardiac ventricle Systole (S) and diastolic (D), DV index(DVI) , DV blood flow(QDV), S/a, peak velocity index for the vein (PVIV=S-a/D), maximum velocity during atrial contraction("a"wave) .Fetal umbilical vein blood was sampled and tested for serum TNF-αand IL-6 by ELISA essay before injection, and at 1 hour, 3 hours, 6 hours after injection. The relationship between Doppler indices and inflammatory cytokines was also evaluated.Results LPS injection caused a time dependent rise in PIV, S wave, D wave, DVI , QDV, S/a and PVIV, and a time dependent decline in a wave, but no significant change in DDV after LPS injection. These values were significantly different from those in control animals (all P<0.05). Serum TNF-αand IL-6 increased after LPS injection compared with the baseline value, and significaty rose compared with levels in controls (all P<0.05). There was a strong positive correlation between PIV,and serum IL-6 or TNF-α(r =0.791 and 0.753, respectively, all P<0.05), a moderate negative correlation of"a"wave to them ( r = -0.58 and -0.57, respectively, all P<0.05), a mild positive correlation of S wave, DVI, D wave, QDV, S/a, PVIV to serum IL-6 (r = 0.554, 0.46, 0.49, 0.47, 0.48, 0.51, respectively,all P<0.05), but no significant correlation to serum TNF-α, and no significant correlation of DDV to serum IL-6 or TNF-αin experimental group.Conclusion LPS injection via umbilical vein during the latter part of pregnancy causes severe inflammatory response syndrome in ovine fetus, and results in significant changes in the Doppler hemodynamic indices and serum IL-6 and TNF-αlevels. There is a strong correlation of PIV and a wave value to serum inflammatory mediators. Therefore, the indices of PIV and a wave might be useful and easily measured parameters for prognosing fetal systemic inflammatory response syndrome.