SUMMARY1. Foetal plasma vasopressin levels were measured by bio-assay in chronically catheterized sheep from 110 to 145 days gestation.2. In foetuses in good condition resting circulating vasopressin concentrations were generally undetectable ( < 5 Itu./ml.). In 15 % of the samples low concentrations (5-10 uu./ml.) were observed.3. Hypoxaemia in the foetus was caused by allowing the ewe to breathe 9 % 02-3 % CO2 in N2 for 1 hr. Plasma vasopressin levels rose in the foetus to 119 + 32 /zu./ml., whereas the hormone levels in the ewe were not routinely increased. In the foetus, the rise in plasma vasopressin levels was significantly related to the fall in pH and Pa ,0 during the hypoxia. 4. In foetuses in which the cervical vagosympathetic trunks were cut, the rise in plasma vasopressin levels (to 48 + 25 ,uu./ml.) during hypoxaemia was less than in intact foetuses. The increase was related only to the fall in arterial pH and the regression coefficient was less than in intact foetuses.5. During hypoxaemia arterial pressure rose and heart rate fell in the normal foetuses. The rise in arterial pressure was greatest when the plasma vasopressin concentration was highest.6. Spontaneous episodes of hypoxaemia (Paw,, < 15 mmHg) and/or acidaemia (pH < 7.30) occurred in four intact foetuses and four foetuses in which the cervical vagosympathetic trunks were cut; all of the latter lambs died in utero. Plasma vasopressin levels were elevated and the concentrations were inversely related to arterial pH.7. Intravenous infusions of vasopressin to foetuses increased plasma vasopressin levels to 6-202 #su./ml.; the rate of clearance of the hormone was three times that in adult ewes. There was a large increase in arterial pressure and bradyeardia. The hypertensive effects of vasopressin were relatively much greater in the foetus than in adult ewes.
To examine the relationship between fetal O2 consumption and fetal breathing movements, we measured O2 consumption, umbilical blood flow, and cardiovascular and blood gas data before, during, and after fetal breathing movements in conscious chronically catheterized fetal lambs. During fetal breathing movements, O2 consumption increased by 30% from a control value of 7.7 +/- 0.7 (SE) ml X min-1 X kg-1. Umbilical blood flow was 210 +/- 21 ml X min-1 X kg-1 before fetal breathing movements; in 9 of 16 samples it increased by 52 +/- 12 ml X min-1 X kg-1, while in the other 7 it decreased by 23 +/- 9 ml X min-1 X kg-1. Umbilical arterial and venous O2 partial pressures and pH fell during fetal breathing movements, and the fall was greater when umbilical blood flow was decreased. Partial CO2 pressure rose in both vessels, and again the increase was greatest when umbilical blood flow fell during fetal breathing movements. Also associated with a fall in umbilical blood flow was the transition from low-amplitude irregular to large-amplitude regular fetal breathing movements. It is concluded that fetal breathing movements increase fetal O2 demands and are associated with a transient deterioration in fetal blood gas status, which is most severe during large-amplitude breathing movements.
To investigate the fetal ability to compensate for a sustained reduction in O2 delivery (DO2; umbilical blood flow X umbilical venous O2 content), studies were carried out on eight chronically instrumented fetal lambs made hypoxemic for 7.8 +/- 0.8 (+/- SE) h by lowering maternal inspired O2 concentration to 9-10%. After 1.7 h of hypoxemia, fetal arterial PO2 had fallen from 18.4 +/- 1.2 to 10.4 +/- 0.5 mmHg. Umbilical venous O2 content fell initially by 41.1 +/- 1.8%, but the fall in DO2 was only 23.7 +/- 5.6%, caused by a 29.3 +/- 7.9% rise in umbilical blood flow. Fetal O2 consumption (VO2) was increased significantly by 29.5 +/- 15.2%. However, fetal vascular pH (7.332-7.281) and base excess (0.5 to -4.3 meq/l) were decreased while blood lactate levels were increased (1.55-7.22 mM). With continued hypoxemia, the metabolic acidemia worsened and led to progressive declines in umbilical venous O2 content and DO2. However, VO2 was maintained at the control level until delivery had fallen by 72.5% and arterial pH was 6.843, at which time VO2 decreased by 37.5 +/- 10.7%. It is concluded that the ability of the fetus to compensate for sustained hypoxemia is limited by the progressive metabolic acidemia.
To examine the fetal cardiovascular responses to a sustained reduction in O2 delivery (DO2), studies were conducted on 13 chronically instrumented fetal lambs (128-138 days gestation) made hypoxemic for 7.9 +/- 0.5 h by lowering maternal inspired O2 concentration to 9-10%. Fetal descending aortic PO2 fell initially from 18.0 +/- 1.0 to 10.7 +/- 0.6 mmHg, whereas pH decreased progressively from 7.326 +/- 0.006 to 6.843 +/- 0.023. Blood flow to the cerebral hemispheres, myocardium, and adrenal glands rose maximally by 110.2 +/- 22.5, 253.7 +/- 41.1, and 338.7 +/- 55.0%. Cerebral hemispheric DO2 fell progressively, whereas DO2 to the myocardium and adrenal was maintained until 7.9 h, when it fell significantly. There was also a rise in blood flow to brown adipose tissue. Blood flow to the gut and skeletal muscle was maintained, whereas flow to the spleen and kidney fell. DO2 to all these tissues fell markedly because of the progressive decline in blood O2 content. It is concluded that fetal cardiovascular function was well maintained in the face of severe hypoxemia and marked acidemia.
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