Effects of Hyperbaric Oxygen on Uteroplacental and Fetal Circulation

Abstract

The effects of hyperbaric oxygen (at 3 atmospheres absolute) on uteroplacental and fetal circulations were studied in pregnant ewes near term. The ewe was given spinal anesthesia, the fetus was marsupialized to the abdominal walls to protect the umbilical circulation, and the fetal head was covered with a saline-filled glove to prevent breathing. During hyperbaric oxygenation, maternal arterial blood P o 2 rose to 1,300 mm Hg while umbilical vein blood P o 2 rose to 300 mm Hg; umbilical arterial Po 2 rose to only 50 mm Hg. Maternal and fetal arterial pressures did not change significantly, but uteroplacental and umbilical flows decreased slightly. Ductus arteriosus blood flows decreased strikingly when the oxygen tension of the pulmonary blood rose; net pulmonary blood flow increased markedly because of a decrease in pulmonary vascular resistance produced by oxygen. Ascending aortic flow increased, but effective fetal cardiac output (aortic plus ductus arteriosus flows) decreased. These studies indicate that the fetal pulmonary vascular bed is sensitive to oxygen in that it undergoes vasodilatation when the oxygen tension of the blood passing through it rises; the ductus arteriosus responds to the same stimulus by constricting. Hyperbaric oxygenation seems to establish a circulatory pattern in the fetus similar to that of the early neonatal period.