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Anesth Analg 2006;103:439-442
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000222468.76942.d8

OBSTETRIC ANESTHESIA

Hypoxemic Fetoplacental Vasoconstriction: A Graduated Response to Reduced Oxygen Conditions in the Human Placenta

Ramiah Ramasubramanian, MD, Raymond F. Johnson, BS, John W. Downing, MD, Beth H. Minzter, MD, and Ray L. Paschall, MD

From the *Department of Anesthesiology, Providence Milwaukie Hospital, Milwaukie, Oregon; {dagger}Department of Anesthesiology, Vanderbilt University, Nashville, Tennessee; and {ddagger}Department of Anesthesiology, Columbia University, New York, New York.

Address correspondence and reprint requests to John W. Downing, MD, Department of Anesthesiology & Division of Obstetric Anesthesia, Vanderbilt University School of Medicine, 4202 Vanderbilt University Hospital, 1211 22ndAvenue South, Nashville, TN 37232-7580. Address e-mail to john.downing{at}vanderbilt.edu.

We investigated the characteristics of hypoxemic fetoplacental vasoconstriction (HFPV) in the dual perfused, single isolated human placental cotyledon. Fetal arterial blood pressures (FAP) were measured in four cotyledons (Group 1) equilibrated with 21% oxygen (O2), 5% carbon dioxide (CO2), and nitrogen (N2) [control] followed by 5% CO2 in N2 for 30 min. FAP (mean ± sd) increased from 69.8 (± 6.4) to 105 (± 3.0) mm Hg (P < 0.05), confirming the utility of HFPV in the human placenta. Eight more cotyledons (Group 2) were exposed sequentially and alternately at 15-min intervals to the control gases and to gas blends containing 15%, 12%, 5%, and 0% O2 with 5% CO2 and N2. FAP increased significantly (P < 0.05) in a stepwise fashion from 68.7 (± 3.7) to 70.5 (± 3.3) mm Hg with 15% O2; from 69.3 (± 3.8) to 72.4 (± 4.3) mm Hg with 12% O2; from 67.8 (± 3.2) to 74.5 (± 3.4) mm Hg with 5% O2; and from 69.7 (± 3.4) to 77.9 (± 5.9) mm Hg with 0% O2, suggesting that HFPV is a graduated response to reduced O2 conditions in the human placenta.




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[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.