Effects of calcium channel-blocker tokolysis on the foetal circulation

The Ca++-antagonist nifedipine has been successfully employed in the treatment of non-gravid hypertension, and was found to inhibit uterine contractions in the perimenstrual period, as well as during premature labour in animal models. The use of antihypertensive drugs in pregnancy introduces the possibility of iatrogenic foetal distress. It has been established that nifedipine crosses the placental barrier in the sheep and causes a fall in mean arterial pressure and tachycardia in both the ewe and the foetus. This paper examines the effects of nifedipine on the foetus when administered to the pregnant ewe. Catheters and electrodes were implanted by surgical procedures in 15 ewes and foetal lambs between days 118 and 122 of gestation. The redistribution of foetal blood flow was measured by the radioactive microsphere injection technique. The infusion of nifedipine caused a 9% increase in the combined ventricular output (CVO) from 446 to 509 ml/min/kg in the foetus. Foetal lung blood flow increased from 29 +/- 6 to 69 +/- 14 ml/min/kg while figures for the skeletal muscle flow were 109 +/- 34 and 141 +/- 41.6 ml/min/kg. Heart and brain blood flow, expressed as percentages of CVO showed variations of 4.3 and 5.6 per cent, respectively. Blood flow in the gut, placental membranes, skin, kidney and spleen was reduced. The present results show that nifedipine, in addition to its known effects causes a redistribution of the foetal circulation.     

Effects of a beta-sympathomimetic drug on the foetal and maternal cardiovascular system in a chronic sheep model

The effects of the beta-sympathomimetic agent terbutalin (1-/3.5 dihydroxyphenyl/-allilaminoethane sulphonate) on maternal and foetal circulation were studied in 11 ewe at 110-130 days of pregnancy. None of them exhibited uterine contractions. Catheters were implanted in the carotid artery and jugular vein, together with four stainless steel electrodes on the limbs. Terbutalin was added intravenously in Ringer-lactate (5%) infusion (1 ml/min). The following maternal and foetal parameters were measured simultaneously: heart rate, central arterial pressure, blood glucose levels, ECG. Intravenous administration of 100 micrograms terbutalin resulted in a 19% increase of maternal and 10% enhancement of foetal heart rate. Maternal systolic blood pressure rose by 9%, whereas diastolic blood pressure fell by 7%. Maternal and foetal blood glucose levels was fairly constant during the entire experiment. In further six experiments terbutalin was administered into the foetal circulation (1 ml/3 min). The same effects on foetal heart rate and pulse pressure were observed as after injecting into the maternal circulation, however but the time necessary for the maximum action to develop was significantly shorter.     

Normal fluctuations in the concentration of corticosteroid and adrenocorticotrophin in the plasma of foetal and pregnant sheep.

Changes in the concentration of adrenocorticotrophin and corticosteroid in the plasma of pregnant and foetal sheep have been followed at different times of day. Wide fluctuations were seen in the concentrations of both in the foetus and ewe, although no evidence for a diurnal rhythm in the ewe was obtained. The foetal plasma adrenocorticotrophin was higher at 07.00-11.00 h than at 21.00-01.00 h, but no corticosteroid rhythm was observed. A consistently close relationship between maternal and foetal hormone concentrations was not observed. The diurnal rhythm in adrenocorticotrophin concentration in the foetus is discussed in relation to rhythms in indicators of central nervous activity.     

Effects of naloxone on the breathing, electrocortical, heart rate, glucose and cortisol responses to hypoxia in the sheep fetus

Continuous infusions of naloxone HC1 (0.5 mg/kg or 3.8 mg/kg) or saline were given intravenously to fetal sheep at 119 to 137 days of gestation during a one hour period of air administration and a one hour period of hypoxia induced by having ewes breathe 9% O2, 3% CO2 and 88% N2. Fetal carotid PaO2 fell to 13.0 +/- 0.5 mmHg during hypoxia with no change in pH. During hypoxia, plasma cortisol concentration increased significantly more in naloxone-infused fetuses than controls. Ewes, whose fetuses received naloxone, showed a significant increase in cortisol during hypoxia whereas no increase was observed in controls. There were no significant differences between saline and naloxone-infused fetuses during hypoxia in fetal breathing incidence, amplitude, frequency, number of deep inspiratory efforts per hour, heart rate, electrocortical activity or in the rise in plasma glucose caused by hypoxia. Results suggest that endogenous opiates may have a role in modulating cortisol production in the ewe and fetus during hypoxia but do not have a role in mediating the decrease in incidence of breathing activity or rise in plasma glucose. During air administration, naloxone significantly increased fetal breath amplitude, fetal and maternal plasma glucose, fetal heart rate, and the number of electrocortical changes per hour. This suggests endogenous opiates may have a more important role in the normoxic pregnant ewe and fetus.     

Ultrastructural changes in the placenta of the ewe following foetal infusion of cortisol.

The placental changes which followed continuous infusion of cortisol into the sheep foetus in the later stages of gestation were, like the hormonal changes, broadly similar to those of spontaneous parturition. There was, however, a premature separation of foetal and maternal tissues in certain areas of the placental cotyledons, and this separation appeared to protect the foetal epithelium from the degenerative changes which normally take place in the short space of time between the birth of the lamb and the delivery of the foetal membranes. The results suggest that an experimental model in which premature labour is induced by the administration of cortisol to the foetus is probably incomplete, and that additional factors almost certainly contribute to the cascade phenomenon of spontaneous parturition.     

Effects of ethanol infusion on foetal EEG and breathing movements

Ethanol (0.3 g/kg and 0.5 g/kg administered over 2 hours) was infused intravenously into 15 chronically instrumented pregnant ewes between 128 to 135 days of gestation (0.85 to 0.92 gestation time, term 147 days). Brainstem dissection above the pons was made in 7 foetuses. Foetal breathing movements were suppressed for 7 hours following a 30 ml ethanol infusion. Low voltage foetal electrocortical activity was suppressed or replaced by an intermediate voltage electrocortical activity for 5 and 3 hours following the 60 ml and 30 ml ethanol infusions, respectively. In brainstem dissected foetuses the effects of ethanol infusion on the foetal EEG were similar. Foetal blood gases and pH were not altered. These data suggest that ethanol moves across the foetal blood-brain barrier and suppresses foetal breathing movements by a direct central mechanism.     

Effects of moderate hypoxia on fetal electrocortical activity, eye movements, and breathing activity in sheep

Isocapnic hypoxaemia (delta PaO2 = -8.0 +/- 0.5 mmHg; delta CaO2 = -2.86 +/- 0.20 ml/dl) was produced in fetal sheep by having the ewe breathe for one hour a gas mixture (v/v) of 10.5% O2 and 1.5% CO2 in N2. Mean fetal heart rate, blood pressure, and incidence of low voltage electrocortical activity were not affected. However, the incidence of rapid-eye-movements and breathing activity was reduced by about 40%. Breathing movements during hypoxaemia had a mean inspiratory time, breath interval, and tracheal pressure amplitude which did not differ significantly from those during control experiments in which the ewe breathed air from the plastic bag. These observations suggest that hypoxia decreases the incidence of breathing movements but does not affect the amplitude or pattern of breathing activity and that it may reduce the incidence of eye movements and breathing activity through a common mechanism.     

The actions of vasoactive compounds in the foetus and the effect of perfusion through the placenta on their biological activity

In acute experiments on the in utero foetal lamb, angiotensin II was a more potent pressor agent that either noradrenaline or adrenaline, and the response to angiotensin II was not consistently modified by the combined administration of alpha and beta-adrenergic blocking agents. A significant reduction in the pressor response of the foetus to angiotensin II and noradrenaline occurred with infusion of these compounds to the foetus by the umbilical artery when compared with the response obtained with infusions of the same doses of these drugs by the umbilical vein. Moreover, the concentration of angiotensin II (pg. ml-1) present in the foetal circulation was less following umbilical arterial infusions compared with umbilical vein infusions of the same doses. A similar reduction in the pressor activity of adrenaline and the cardio-stimulant effect of isoprenaline occurred when these drugs were infused by the umbilical artery. It is concluded that the foetus, like the adult animal, is more sensitive to angiotensin II than to catecholamines and that the biological activities of noradrenaline, angiotensin II, adrenaline and isoprenaline are reduced by perfusion through the foetal placenta.     

Characterization and metabolism of ovine foetal lipids

1. Total phospholipid concentrations in liver, kidney and brain of the 140-day ovine foetus were only half of those in comparable maternal tissues. 2. Phosphatidylcholine was the predominant phospholipid in all foetal tissues examined. The most striking difference between foetal and maternal tissues in individual phospholipids was in the heart; foetal heart contained more ethanolamine plasmalogen than choline plasmalogen, whereas in adult tissue the concentration of these was reversed. Sphingomyelin content of foetal brain was only one-sixth of that of maternal brain tissue. 3. Oleic acid (18:1) was the predominant acid in the phospholipid extracted from foetal tissues, except in brain where palmitic acid (16:0) was slightly higher. In phospholipids from adult tissues there was a higher proportion of unsaturated fatty acids (linoleic acid, 18:2, and linolenic acid, 18:3) and a correspondingly lower proportion of oleic acid (18:1). The distribution of fatty acids in the neutral lipid fraction of foetal and maternal tissues was very similar; oleic acid (18:1) was generally the principal component. 4. (14)C derived from [U-(14)C]-glucose and [U-(14)C]fructose infused into the foetal circulation in utero was incorporated into the neutral lipids and phospholipids of heart, liver, kidney, brain and adipose tissue. 5. Phospholipid analysis revealed that the specific activity of phosphatidic acid was higher in liver than in other tissues. The specific activity of phosphatidylethanolamine was less than that of phosphatidylcholine in heart, but in other tissues they were about the same. The specific activities of phosphatidylinositol and phosphatidic acid in brain were very similar and were higher than the other components. The specific activity of phosphatidylserine was highest in liver and brown fat. 6. The pattern of incorporation of (14)C derived from [(14)C]glucose and [(14)C]fructose into foetal neutral lipids was similar. Diglyceride accounted for most of the radioactivity in brain, whereas triglyceride had more label in heart, liver, kidney and fat.     

Effects of naloxone on breathing movements during hypercapnia in the fetal lamb

To determine whether endogenous opioids influence the fetal breathing response to CO2 we have investigated the effect of the opiate antagonist, naloxone on the incidence, rate, and amplitude of breathing movements during hypercapnia in fetal lambs in utero. In 20 experiments in six pregnant sheep (130-145 days gestation) hypercapnia was induced by giving the ewe 4-6% CO2-18% O2 in N2 to breathe for 60 min. After 30 min of hypercapnia either naloxone (13 experiments) or saline (7 experiments) was infused intravenously for the remaining 30 min. During hypercapnia breath amplitude increased from 5.8 +/- 0.5 to 9.1 +/- 1.2 mmHg (P less than 0.001), and infusion of naloxone was associated with a further significant increase to 15.7 +/- 1.2 mmHg (P less than 0.001). Naloxone had no effect on the incidence or rate of breathing movements during hypercapnia. After hypercapnia there was a significant decrease in the incidence of fetal breathing movements in the naloxone group (14.7 +/- 3.2%). Infusion of saline during hypercapnia had no effect on incidence, rate, or amplitude of fetal breathing movements. These results suggest that endogenous opioids act to suppress or limit breath amplitude during hypercapnia but do not affect rate or incidence of breathing movements.     

Water exchange between the pregnant ewe,the foetus and its amniotic and allantoic fluids

Water exchange between the ewe and its foetus was measured in two Merino ewes maintained with continuous feeding under thermoneutral conditions from about day 90 of gestation to term. Catheters were established in the maternal pulmonary artery (MPA), the foetal dorsal aorta (FDA) and the amniotic and allantoic sacs. Doses of tritiated water were given into either the MPA or the FDA on five occasions, three for one ewe and two for the other, at least 6 days apart and samples were taken from all catheters for 31 h following the dose. An open, eight-compartment restricted model was developed which simultaneously fitted the tracer data and the ewes water balance, determined by measurement and calculation. The ewes delivered live lambs at term. Water was exchanged between ewe and foetus at 16–43 l h^–1 whereas net flow to the foetus averaged 82 ml day^–1. Turnover times were 20–39 min in the ewes body water, 2–7 min in foetal body water, 10–58 min in amniotic water and 3–22 min in allantoic water; the whole-body half-times were 4.5–5.7 days. The data suggest that intramembranous exchange was the major contributor to water exchange in amniotic and allantoic fluids. The mean residence time of water in the rumen (39–52 min) was shorter than in non-pregnant sheep, suggesting that blood flow to the rumen increased during mid to late gestation.     

In vivo brown fat response to hypothermia and norepinephrine in the ovine fetus

The goal of this study was to assess the response of fetal brown fat in vivo to hypothermia and norepinephrine infusion. In 10 unanaesthetized, chronically-prepared fetal sheep (133 +/- 2 days of gestation) cold water was passed through tubing encircling the fetus in utero and plasma glycerol concentration was measured as an indicator of brown fat activity. Following cooling for 60 min, amniotic fluid temperature fell 7.79 degrees C to 31.66 +/- 1.73 degrees C (n = 8, P less than 0.001) and maternal temperature fell 0.63 degree C to 38.63 +/- 0.08 degrees C (n = 9, P less than 0.001). Eight of the fetuses were subjected to a second experiment in which norepinephrine was infused intravenously for 15 min. During infusion fetal arterial temperature fell 0.38 degrees C to 39.05 +/- 0.25 degrees C (n = 7, P less than 0.05). Amniotic fluid temperature (n = 7, NS) and maternal arterial temperature (n = 7, NS) remained constant. Glycerol concentration during the infusion increased from 0.73 to 1.27 mg/dl, a 74% increase over control (n = 8, P less than 0.001). Although clearly detectable, these glycerol responses to hypothermia and norepinephrine stimulation are one-third or less of those achieved after birth, indicating that thermogenesis remains quiescent in the near-term fetal sheep, despite powerful stimuli for activation.     

The effects of naloxone on the changes in breathing and behaviour induced by morphine in the foetal sheep

In the foetal sheep, administration of morphine induces apnoea followed by hyperpnoea; during hyperpnoea the foetus arouses. We tested the hypothesis that naloxone, an opiate antagonist, would block these responses. In 14 foetal sheep between 123 and 140 days of gestation, we measured electrocortical activity (ECoG), eye movements (EOG), diaphragmatic activity (EMGdi), blood pressure and amniotic pressure. Morphine (1 mg/kg) was injected in the foetal jugular vein during low-voltage ECoG. Saline or naloxone (0.1, 0.5 and 2.0 mg) were given, in randomized order, before the morphine injection, shortly after morphine injection during apnoea, and during maximum hyperpnoea. Saline alone had no effect on breathing or behaviour. When saline and naloxone preceded the morphine injection the length of apnoea was 26.6 +/- 7.7 and 19.5 +/- 7.0 min (SEM, P = 0.25) while the length of sustained hyperpnoea was 104.8 +/- 11.4 and 29.6 +/- 8.4 min respectively (P = 0.001). When administered during the maximum breathing response, naloxone decreased the length of breathing from 92.2 +/- 8.4 (saline) to 8.8 +/- 2.9 min (P = 0.001). Respiratory output (fEMGdi x f) also decreased from 6545 +/- 912 arbitrary units post saline to 3841 +/- 629 arbitrary units after naloxone (P = 0.05). Arousal disappeared with the decrease in breathing response. The negligible effect of naloxone on apnoea and its strong inhibition of hyperpnoea suggest that morphine may act on two distinct central regions or on two subtypes of opioid receptors to produce apnoea, hyperpnoea and arousal.     

Reduction of biliverdin and placental transfer of bilirubin and biliverdin in the pregnant guinea pig.

Biliverdin was reduced to bilirubin in pregnant and foetal guinea pigs, and the 100000 g supernatant from homogenates of foetal liver, placenta and maternal liver showed high biliverdin reductase activity. The placental transport of unconjugated bilirubin and biliverdin was compared by injecting unlabelled and radiolabelled pigments into the foetal or maternal circulation and analysing blood collected from the opposite side of the placenta. Injected bilirubin crossed the placenta from foetus to mother and vice versa, but injected biliverdin did not appear to cross without prior reduction to bilirubin. The guinea-pig placenta is apparently more permeable to bilirubin than biliverdin. Reduction of biliverdin to bilirubin in the foetus may, therefore, be essential for efficient elimination of haem catabolites from the foetus in placental mammals.     

Hormonal factors in the control of heart rate in normoxaemic and hypoxaemic fetal, neonatal and adult sheep

The relationship of plasma levels of adrenaline, noradrenaline, arginine vasopressin (AVP) and plasma renin activity (PRA) to heart rate were studied in normoxaemic and hypoxaemic fetal, neonatal and adult sheep. The mean heart rate response of fetuses at the end of a 30 minute period of 10% oxygen delivery to the maternal ewe was tachycardia. However bradycardia, usually of a transient nature, was observed in 9 of the 12 fetuses (P less than 0.05). Multiple regression analysis was used to determine the contribution of blood gas, blood pressure and plasma hormone levels to the variance in heart rate in the perinatal sheep. 22% of the variance in fetal heart rate was provided by PRA and age from conception (P less than 0.001). Tachycardia was the invariable heart rate response of the neonates and adults to hypoxaemia. 61% of the variance in neonatal heart rate was contributed by PaO2, PaCO2, AVP, PRA and systolic blood pressure (SBP, P less than 0.001). PaO2 and plasma levels of adrenaline were significantly related to adult heart rate (P less than 0.001). Those fetuses which developed bradycardia had lower PaO2 but higher AVP and PRA during hypoxaemia than those which did not develop bradycardia. The major determinant of the area of the fetal bradycardia response was found, by multiple regression analysis, to be plasma adrenaline concentration (P less than 0.05). Thus different hormonal factors may play a role in the regulation of heart rate in normoxaemic and hypoxaemic fetal, neonatal and adult sheep.     

Blood flow redistribution during isocapnic hypoxia in foetal lamb

Circulatory responses to hypoxaemia were studied in 16 foetal lambs in 120-129 and 135-145 days of gestation (term: 147 days). Under general anaesthesia catheters were inserted into the foetal vessels and the umbilical blood was measured during antipyrine infusion by the Fick steady-state diffusion method. The combined ventricular output and actual organ blood flows were calculated from injections of radionuclide-labelled microspheres into a forelimb and a hindlimb vein. Isocapnic hypoxia was produced by giving the ewe a breathing gas mixture of 9% O2 and 3% CO2 in N2 for 30 min. A significant increase was found in the blood flow of the myocardium, the lungs, the brain and in the combined ventricular output between 0.80 and 0.95 gestation times. Under isocapnic hypoxaemia blood flow increased to the brain, heart and adrenals, whilst it decreased to the lungs, kidneys, gut and carcass. The observed changes were different at the two measurement times. Under hypoxia, depending on the gestation time, the blood flow increased in the diencephalon, midbrain, hypophysis and in the cervical cord. In the cerebral, cerebellar and lumbosacral cord it remained unchanged, while decreasing in the chorioid plexus and in the hippocampus. In the gestation period under examination the foetal circulation undergoes significant redistribution.     

Studies on experimental growth retardation in sheep. The effects of maternal hypoxaemia

Intrauterine growth retardation in fetal sheep was caused by removal of endometrial caruncles prior to conception. Such fetuses are chronically hypoxaemic and to establish their ability to withstand additional episodes of hypoxia, the effects of administration of 9% O2 to the pregnant ewe was investigated. Fetuses were studied at 135-140 days. During maternal hypoxia the small fetuses showed a greater tendency to further hypoxaemia and acidaemia, but the differences compared with controls were not large. Whilst the initial response to hypoxaemia was a fall in heart rate in the small fetuses, unlike the controls, the heart rate returned to normal within 15 min. Metabolite responses to hypoxia in the small fetuses were less than normal and the changes in plasma insulin concentrations were uncommonly small. In contrast the plasma cortisol and ACTH responses to hypoxia were larger than normal in the small fetus. The results are discussed in relation to the altered physiological state of the growth-retarded fetal sheep.     

Effects of pituitary adenylate cyclase activating polypeptide (PACAP) and vasoactive intestinal polypeptide (VIP) on the cardiovascular system in sheep.

The cardiovascular effects of PACAP and VIP were studied in intact conscious sheep; PACAP (0.008, 0.04, 0.2, and 1.0 nmol/min) and VIP (0.07, 0.2, 0.6, and 1.8 nmol/min) were infused in conscious sheep for periods of 10 min. For each peptide there was a dose-dependent increase in heart rate. At the highest doses tested, pulse pressure and mean arterial pressure tended to increase and decrease, respectively. However, only the decrease in mean arterial pressure following the highest dose of VIP reached significance. At the highest doses tested, heart rate increased nearly threefold during the infusion while mean arterial pressure declined by 18.5%. In individual animals the decrease in blood pressure and increase in heart rate occurred simultaneously, so that we were unable to conclude whether the increase in heart rate was due to a baroreceptor reflex.     

Ultrastructural changes in the placenta of the ewe after long-term intravascular infusion of 2-bromo-alpha-ergocryptine (CB154) into mother or fetus.

The fine structural appearance of the placenta of the ewe has been examined following long-term infusion of CB154 into either the fetus or the pregnant ewe. Binucleate cells which usually contain aggregations of spherical membrane-bound electron-dense inclusions, are a characteristic component of the chorionic epithelium of the sheep. Following CB154 infusion into either the fetus or ewe at 111 to 137 days of gestation, binucleate cells were partially or completely depleted of the droplets which are present in binucleate cells of control animals at a similar gestational age. No obvious changes in the maternal epithelial syncytium were observed after CB154 administration. Infusion of CB154 into the fetus alone was also followed by degenerative changes in some binucleate cells which ranged from condensation of nuclei to complete cell fragmentation. Either a direct or an indirect action of CB154 on binucleate cells is suggested by these observations. Hypoprolactinaemia followed CB154 infusion in all treated animals; its possible influence on binucleate cell activity is discussed.     

The effect of dietary protein on the amino acid supply and threonine metabolism in the pregnant rat

To characterise the effects of dietary protein content on threonine metabolism during pregnancy, rats were fed diets containing 18% or 9% protein and then killed at different stages of gestation. Serum threonine concentrations fell significantly faster in the animals fed the diet containing 9% protein when compared to those fed the diet containing 18% protein. On day 4 of gestation the rate of threonine oxidation was higher in maternal liver homogenates prepared from the animals fed the diet containing 18% protein. The rate of threonine oxidation by liver homogenates fell as gestation proceeded in both diet groups. The activity of threonine dehydrogenase in the maternal liver was unaffected by dietary protein content at all stages of gestation. Serine-threonine dehydratase activity in homogenates of the maternal liver was transiently increased during the early stages of gestation in the animals fed high protein diets but was unchanged in the low protein groups. There was an increase in serine-threonine dehydratase activity in the kidney during the later stages of gestation but this was unaffected by the protein content of the maternal diet. These data show that the changes in free threonine concentrations cannot be accounted for through changes in the oxidation rate and suggest that some other factor influences the unusual metabolism of this amino acid during gestation.