This study investigates the hypothesis that following an intrauterine, intravascular transfusion (IVT), one of the physiologic adaptations might be an increase in the fetal urine production. The hourly fetal urine production rate (HFUPR) was measured for the first hour following 12 transfusions and for 24 h following 5 transfusions in anemic isoimmunized fetuses. The HFUPR was also measured in 5 control fetuses who underwent fetal blood sampling without transfusion. Fetal hemoglobin, hematocrit and blood viscosity were measured before and after each transfusion. The HFUPR fell significantly from a mean (SEM) of 19.2 (2.85) to 7.4 (2.2) ml/h, and remained low for at least 4 h posttransfusion returning to pretransfusion rates by 24 h. There was no change in the HFUPR in the control fetuses. The study suggests that in human fetuses the rapid excretion of excess fluid via the renal tract is not an acute adaptive response to an IVT.
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