OXYGEN: Basis of the Regulation of Vital Functions in the Fetus

243 Pages·1992·5.19 MB·English

by  K.-H. Wulf (auth.), Professor Dr. med. Wolfgang Künzel, Dr. Dr. med. Michael Kirschbaum (eds.)

W. Kunzel M. Kirschbaum (Eds.)
OXYGEN:
Basis of the Regulation
of Vital Functions
in the Fetus
With 84 Figures and 16 Tables
Springer-Verlag
Berlin Heidelberg New York
London Paris Tokyo
Hong Kong Barcelona
Budapest
Professor Dr. med. WOLFGANG KONZEL
Gf. Direktor der Frauenklinik und Hebammenschule
der lustus-Liebig-Universitat
KlinikstraBe 32, 6300 GieBen
Bundesrepublik Deutschland
Dr. Dr. med. MICHAEL KIRSCHBAUM
Frauenklinik der lustus-Liebig-Universitat
KlinikstraBe 32, 6300 GieBen
Bundesrepublik Deutschland
ISBN-13: 978-3-642-77471-3 e-ISBN-13: 978-3-642-77469-0
DOl: 10.1007/978-3-642-77469-0
Library of Congress Cataloging-in-Publication Data
Oxygen: basis of the regulation of vital functions in the fctus / W. KtinzeL M. Kirsch
baum (eds.). p. cm.
Includes bibliographical references and index.
1. Fetal anoxia - Congresses. 2. Oxygen - Physiological transport - Congresses. 3. Fe
tus - Respiration and cry - Congresses.
4. Maternal-fetal exchange - Congresses. I. KtinzeL W. (Wolfgang). 1936-. II. Kirsch
baum, Michael, [DNLM: 1. Fetal Anoxia - congresses. 2. Fetus - physiology - congres
ses, 3. Maternal-Fetal Exchange - congresses. 4. Oxygen - physiology - congresses. 5.
Oxygen Consumption - physiology - congresses. WQ 210.5 098]
RG629.A550991992
618.3'2 - dc20
DNLMIDLC
for Library of Congress 92-20354
CIP
This work is subject to copyright. All rights are reserved, whether the whole or part of the
material is concerned. specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in othcr ways, and storage in data
banks. Duplication of this publication or parts thereof is permitted only under the
provisions of the German Copyright Law of September 9, 1965, in its current version, and
permission for use must always be obtained from Springcr-Verlag. Violations are liable for
prosecution under the German Copyright Law.
© Springer-Verlag Berlin Heidelberg 1992
Softcover reprint of the hardcover I st edition 1992
The use of general descriptive names, registered names. trademarks, etc. in this publication
does not imply, even in the absence of a specific statement. that such names are excmpt from
the relevant protective laws and regulations and therefore free for gcneral use.
Product liability: The publisher cannot guarantee the accuracy of any information about
dosage and application contained in this book. In every individual case the user must chcck
such information by consulting the relevant literature.
23/53145/5 4 3 2 1 0 - Printed on acid-free paper
Preface
One of the main sources of energy in human life is the steady supply of
oxygen. Permanently high or low concentrations of oxygen are, however,
hazardous and incompatible with life. Little is known about where the critical
threshold lies and which regulatory and adaptive mechanisms are imple
mented in hazardous situations to ensure the continuation of human life.
From the very beginning the fetus in utero is in an environment of low
oxygen partial pressure (p02). Adaptive mechanisms work to guarantee its
development and oxygen supply. These regulatory mechanisms are, however,
not well understood. Does the fetus sense its own oxygen need and, if so, how
is this regulated and how does it interact with nutritional factors. Is fetal
growth adjusted to the reduced oxygen supply in dangerous situations, and is
the initiation of labor a result of a fall in p02 during gestation? It may be
speculated that many cases of obstetric pathology are related to fetal oxygen
deprivation which may result in fetal death.
This volume is a collection of papers presented at a symposium which was
held on 14 November 1989 to mark the 175th anniversary of the Frauenklinik
in Giessen, FRG. The participants came from various fields of research; they
included biochemists, biologists, physiologists, obstetricians, pediatricians,
and anatomists, all of whom devote their investigations to one subject,
namely oxygen as a basis of the regulation of vital functions in the fetus. I
would like to thank all of them for coming to Giessen and contributing to this
symposium.
I would also like to thank the many helpers for their assistance. Particular
thanks are due to Dr. Michael Kirschbaum for organizing this meeting, Frau
lakobi and Frau Hedrich for their excellent secretarial work, Frau Achen
bach for slide projection, and all the staff of the Frauenklinik who offered
their help. Finally, I wish to thank Springer-Verlag for its courtesy and
generosity in the process of seeing the manuscript through to press.
Giessen, ] une 1992 W. Kiinzel
Contents
I Oxygen Supply of the Fetus During Pregnancy and Birth
Fetal Oxygen Supply - Historical Considerations
K.-H. WULF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Oxygen and Animal Metabolism: General and Comparative Aspects
G. WEGENER ....................................... 12
Maternal Vascular Adaptation to Improve Oxygen Supply
W. MOLL, A. NIENARTOWICZ, R. BAUSTAoTER, H. PARISH,
and A. RUIOER ..................................... 25
Oxygen Deficiency During Fetal Development and Delivery -
Speculations About Clinical Conditions
W KUNZEL, M. HOHMANN, and G. BRAEMS ................. 33
Fetal Breathing Movements in Normoxia and in Hypoxia
G. S. DAWES ....................................... 46
Maternal Respiration - Its Effect on the Fetus
A. HuCH and R. HuCH ............................... 52
Abstracts
Influence of Maternal Oxygen Inhalation on Uteroplacental
and Fetal Perfusion Measured by Doppler Sonography in Patients
with Preterm Labor
K.-E. RUCKHABERLE, R. ROBEL, R. FABER, B. VIEHWEG,
and M. WINKLER .................................... 63
VIII Contents
Interpretation of FHR Patterns of SGA Fetuses in Correlation to
Fetal Blood Gas Values Obtained Via Cordocentesis
E. CETIN, K. H. NICOLAIDES, and B. ARABIN 65
II Acute Oxygen Deficiency During Pregnancy and Birth.
Influence on the Fetus
Oxygen Supply to the Fetus and Fetal Hypoxemia
A. M. RUDOLPH 71
The Role of the Sympathetic Nervous System in Preventing Brain
Damage During Perinatal Asphyxia
A. JENSEN ......................................... 77
The Response and Vulnerability of Cerebral Blood Vessels
to Hypoxemia
M. KIRSCHBAUM, A. KRIETE, R. H. BODEKER, and W. KONZEL 108
Breathing Movements in the Human Fetus in Normoxia
and Hypoxia
J. G. NUHUIS ....... : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Fetal Hypoxemia as a Signal for Parturition
J. R. G. CHALLIS, A. D. BOCKING, B. S. RICHARDSON, A. N. BROOKS,
A. SUE-TANG, K. AKAGI, and R. A. JACOBS ................. 122
Regional Abnormalities of Cerebral Energy Metabolism Following
Birth Asphyxia
N. M. BOLAS, B. RAJAGOPALAN, P. HOPE, J. MOORCRAFT, N. K. IVES,
and G. K. RADDA ................................... 129
Fetal Heat Flux and Oxygen Tension During Asphyxia
R. RUDELSTORFER 138
Abstracts
Brain Blood Flow and the Dynamics of Circulatory Centralization
During Acute Asphyxia in Intact and Chemically
Sympathectomized Fetal Sheep
A. JENSEN and U. LANG ............................... 147
Contents IX
Dynamics of Circulatory Centralization During Acute Asphyxia in
Pre term and Term Fetal Sheep
A. JENSEN, U. LANG, and G. BRAEMS ..................... 150
Regional Brain Blood Flow and Oxygen Delivery in Guinea Pig
Fetuses Near Term
J. JELINEK, A. M. CARTER, and A. JENSEN .................. 152
Plasma and Tissue Concentrations of Catecholamines During
Normoxemia, Hypoxemia, and Asphyxia in Fetal Guinea Pigs Near
Term
J. JELINEK and A. JENSEN .............................. 154
Cardiovascular Effects of Endotoxin and Asphyxia in Fetal Sheep
Near Term
A. JENSEN, U. LANG, and G. BRAEMS 156
III Regulatory Mechanisms of Fetal Oxygen Consumption
Indications for the Involvem!ent of a Hemoprotein as an Oxygen
Pressure Sensor Protein in the Carotid Body
H. ACKER ......................................... 161
Role of Erythropoietin in the Regulation of Red Cell Production in
Children Before and After Birth
K.-U. ECKARDT, A. KURTZ, and C. BAUER .................. 166
Oxygen Availability Determines Oxygen Consumption of Fetal
Skeletal Muscle Cells in Monolayer Culture: Preliminary Report
G. BRAEMS and A. JENSEN ............................. 174
Endothelial Cells as Part of a Vascular Oxygen-Sensing System:
Hypoxia-Induced Release of Autacoids
U. POHL .••.•....••...•....•••••••...••••••.•..•.• 178
Oxygen Transport in the Early Embryo
R. BAUMANN ....................................... 188
Laser Doppler Flowmetry and Fetal Oxygenation
1. G. AARNOUDSE and T. M. SMITS ....................... 194
X Contents
Abstracts
Blood Flow to the Yolk Sac Placenta as a Function of Arterial
Oxygen Content
A. M. CARTER and A. DETMER 205
IV Chronic Oxygen Deficiency During Pregnancy:
Impact of the Fetus
Development of Chemoreflexes Affecting Breathing:
Influence of Chronic Hypoxia
M. A. HANSON, B. A. WILLIAMS, and P. KUMAR 209
Restricted Fetal Oxygen Supply:
A Cause of Intrauterine Growth Retardation?
J. F. CLAPP III ...................................... 217
Regulation of Perinatal Pulmonary Blood Flow: Role of Oxygen
M. A. HEYMANN .................................... 223
Abstracts
Cardiovascular Responses to Acute Asphyxia in Carotid Sinus
Denervated and Intact Fetal Sheep Near Term
A. JENSEN and M. A. HANSON 233
Subject Index ...................................... 235
Contributors
Prof. Dr. J. G. AARNOUOSE
Dept. of Obstetr. & Gynecol., University Hospital, Oostersingel 59
9713 EZ Groningen, The Netherlands
Prof. Dr. H. ACKER
Max-Planck-Institut fUr Systemphysiologie, Rheinlanddamm 201
4600 Dortmund 1, Germany
Dr. K. AKAGI
Lawson Research Institute St. Joseph's Health Centre,
268 Grosvenor Street
London, Ontario N6A 4V2, Canada
Priv.-Doz. Dr. B. ARABIN
Klinikum Steglitz, Frauenklinik und Poliklinik,
Abt. f. Gynakol. Endokrinologie, Hindenburgdamm 30
1000 Berlin 45, Germany
Prof. Dr. C. BAUER
Physiologisches Institut der Universitat Zurich, Winterthurer StraBe 190
8057 Zurich, Switzerland
Prof. Dr. R. BAUMANN
Institut fUr Physiologie, Universitatsstr. 31
8400 Regensburg, Germany
Dr. R. BAUSTAoTER
DoblerstraBe 32
8399 Rotthalmiinster, Germany
Dr. A. D. BOCKING
Lawson Research Institute St. Joseph's Health Centre,
268 Grosvenor Street
London, Ontario N6A 4V2, Canada
XII Contributors
Dr. R. H. BOOEKER
Institut fUr Medizinische Informatik, Heinrich-Buff-Ring 44
6300 GieBen, Germany
Dr. N. M. BOLAS
SMIS limited, Alan Turing Road, Surrey Research Park, Guildford
Surrey GU2 5YF, UK
Dr./Univ. Gent G. Braems
Univ.-Frauenkiinik und Hebammenschule, KlinikstraBe 32
6300 GieBen, Germany
Dr. A. N. BROOKS
MRC Unit in Reproductive Biology, University of Edinburgh
Edinburgh, UK
Prof. Dr. A. M. CARTER
Department of Physiology, University of Odense, J. B. Winsl0wsvej 19
5000 Odense C, Denmark
Dr. E. CETIN
Univ.-Krankenh. Eppendorf, Frauenklinik, MartinistraBe 52
2000 Hamburg 20, Germany
Professor Dr. J. R. G. CHALLIS
Lawson Research Institute St. Joseph's Health Centre,
268 Grosvenor Street
London, Ontario N6A 4V2, Canada
Dr. James F. CLAPP III
Case Western Reserve University, School of Medicine at MetroHealth
Medical Center, 2500 MetroHealth Drive
Cleveland, OH 44109-1998, USA
Professor Dr. G. S. DAWES
Nuffield Department of Obstetrics, John Radcliffe Hospital
Oxford OX3 9DU, UK
A. DETMER
Department of Physiology, University of Odense, 1. B. Winsl0wsvej 19
5000 Odense C, Denmark
Dr. K.-U. Eckardt
Institut fUr Physiologie I, UniversiUitsstraBe 31
8400 Regensburg, Germany