SUMMARY We studied the relationship of fetal and maternal vascular pressures to umbilical and uterine blood flow in the unanesthetized ewe and in the sheep fetus in utero by placing electromagnetic flow transducers around both the common umbilical and uterine arteries. Reductions in umbilical arterial pressure or elevations in umbilical venous pressure decreased umbilical blood flow without affecting either the uterine arterial blood flow or other maternal cardiovascular variables which were studied. Elevations in uterine venous pressure or reductions in uterine arterial pressure decreased uterine arterial flow but these interventions had no effect on umbilical blood flow until fetal hypoxemia and bradycardia occurred. When the bradycardia of the fetal hypoxic response was inhibited by atropine, alterations in maternal vascular pressure had no effect on umbilical arterial flow. These data do not support the presence of a "sluice" or "waterfall" effect in the umbilical-placental circulation of the sheep fetus in utero.THE Poiseuille-Hagen law, which describes the relationship of flow, resistance, and perfusion pressure in rigid tubes, conventionally is used to analyze organ blood flow.' Recently both theoretical 2 -3 and other experimental'-5 analyses have defined another hemodynamic system variously termed the waterfall, 5 capilleron, 6 or sluice 7 model. This model states that blood flow (Q 1 ) through a system of collapsible channels which are surrounded by a pressure (P c ) exceeding venous outflow pressure (P o ) is directly proportional to the difference between inflow pressure (P t ) and surrounding pressure (P c ), and inversely proportional to the resistance of the rigid vascular elements (/?), but is unaffected by outflow pressure (P o ) as long as P o is lower than Pc-Q' = (Pt -Pc)/R, when P c > P o .Power and Longo 7 and Motoyama et al. 8 proposed that the uterine vascular system that surrounds the umbilical circulation of the sheep fetus generates a placental tissue pressure; this exceeds umbilical venous pressure and thereby regulates umbilical blood flow by this sluice mechanism. Their conclusions are based on experimental data obtained from acute studies, most of which involved perfusion of isolated placentomes.To test the validity of the waterfall theory in vivo and study the relationship of fetal and maternal vascular pressures to umbilical and uterine blood flow in the sheep, we developed a preparation for the study of variables affecting placental flows in the standing, unanesthetized ewe and the fetal lamb in utero.
MethodsOperations were performed on 18 pregnant Western ewes with time-dated gestations of 100-140 days. They were Received June 23, 1975; accepted for publication October 28, 1975. fasted 24-48 hours, given epidural anesthesia with 2 ml of 1% tetracaine HC1 (20 mg), and placed supine on the operating table. Polyvinyl catheters (inner diameter, 0.132 cm; outer diameter, 0.229 cm) were inserted through the maternal femoral artery and vein and advanced into the descending aorta a...