The Effects of Acute Uterine Ischemia on Fetal Circulation1

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Abstract
The effects of acute maternal hemorrhage on uterine blood flow and fetal circulation were investigated in pregnant sheep. Nine chronically instrumented pregnant sheep (114–128 d gestation), phlebotomized from the iliac artery at the point of origin of the uterine artery, were studied at baseline, after acute hemorrhage, and immediately and two h after replacement of the blood. Maternal hemorrhage caused a reduction in uterine blood flow as well as both fetal hypoxemia and acidemia. Changes in fetal organ blood flow measured by radionuclide-labeled microspheres showed that blood flow to the brain, heart, and adrenal glands increased (p<0.05), whereas blood flow to the other major organs did not change significantly. Rapid replacement of blood restored all parameters to baseline values. We conclude that acute maternal hemorrhage causes a reduction in uterine blood flow, fetal hypoxemia, and acidemia with a secondary increase in blood flow to the high priority organs. Rapid replacement of blood reverses these effects.

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