w.978-3-642-77469...w. kunzel m. kirschbaum (eds.) oxygen: basis of the regulation of vital...
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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 DOl: 10.1007/978-3-642-77469-0
e-ISBN-13: 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. Kirschbaum (eds.). p. cm. Includes bibliographical references and index.
1. Fetal anoxia - Congresses. 2. Oxygen - Physiological transport - Congresses. 3. Fetus - Respiration and cry - Congresses. 4. Maternal-fetal exchange - Congresses. I. KtinzeL W. (Wolfgang). 1936-. II. Kirschbaum, Michael, [DNLM: 1. Fetal Anoxia - congresses. 2. Fetus - physiology - congresses, 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
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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 implemented 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 Achenbach 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
II Acute Oxygen Deficiency During Pregnancy and Birth. Influence on the Fetus
Oxygen Supply to the Fetus and Fetal Hypoxemia
A. M. RUDOLPH
The Role of the Sympathetic Nervous System in Preventing Brain Damage During Perinatal Asphyxia
65
71
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
Abstracts
Brain Blood Flow and the Dynamics of Circulatory Centralization During Acute Asphyxia in Intact and Chemically Sympathectomized Fetal Sheep
138
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
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
156
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
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
Restricted Fetal Oxygen Supply: A Cause of Intrauterine Growth Retardation?
205
209
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
Contributors XIII
Dr. R. FABER Frauenklinik der UniversiUit, Philipp-Rosenthal-StraBe 55 0-7010 Leipzig, Germany
Dr. M. A. HANSON Fetal and Neonatal Research Group, Dept. of Obstetrics & Gynecology, University College and Middlesex School of Medicine, University College London, 86-96 Chenies Mews London WC1E 6HX, UK
Prof. Dr. M. A. HEYMANN Cardiovascular Research Inst., Gyneco!. & Reproductive Sciences, University of California, Box 0544, Room HSE 1403 San Francisco, CA 94143-0130, USA
Priv.-Doz. Dr. M. HOHMANN, Univ.-Frauenklinik und Hebammenschule, KlinikstraBe 32 6300 GieBen, Germany
Dr. P. HOPE Special Care Baby Unit, John Radcliffe Hospital, Headington Oxford OX3 9DU, UK
Prof. Dr. Dr. h.c. A. HuCH Dept. fUr Frauenheilkunde, Klinik u. Polik!. f. Geburtshilfe, FrauenklinikstraBe 10 8091 Zurich, Switzerland
Prof. Dr. Dr. h.c. R. HuCH Dept. fUr Frauenheilkunde, Klinik u. Polik!. f. Geburtshilfe, FrauenklinikstraBe 10 8091 Zurich, Switzerland
Dr. N. K. IVES Special Care Baby Unit, John Radcliffe Hospital, Headington Oxford OX3 9DU, UK
Dr. R. A. JACOBS Lawson Research Institute St. Joseph's Health Centre, 268 Grosvenor Street London, Ontario N6A 4V2, Canada
Dr. J. JELINEK Milupa AG, Scientific Department, BahnstraBe 14-30 6382 FriedrichsdorflTs., Germany
XIV Contributors
Prof. Dr. A. JENSEN Univ.-Frauenklinik und Hebammenschule, KlinikstraSe 32 6300 GieSen, Germany
Dr. Dr. M. KIRSCHBAUM Univ.-Frauenklinik und Hebammenschule, KlinikstraSe 32 6300 GieSen, Germany
Dr. A. KRIETE Institut fur Anatomie und Zytobiologie, Aulweg 123 6300 GieSen, Germany
Prof. Dr. W. KONZEL Univ.-Frauenklinik und Hebammenschule, KlinikstraSe 32 6300 GieSen, Germany
Dr. P. KUMAR Department of Physiology, University of Birmingham, Vincent Drive Birmingham B15, UK
Prof. Dr. A. KURTZ Institut fur Physiologie I, UniversitatsstraSe 31 8400 Regensburg, Germany
Dr. U. LANG Univ.-Frauenklinik und Hebammenschule, KlinikstraSe 32 6300 GieSen, Germany
Prof. Dr. W. MOLL Inst. fur Physiologie, UniversitatsstraSe 31 8400 Regensburg, Germany
Dr. J. MOORCRAFT Special Care Baby Unit, John Radcliffe Hospital, Headington Oxford OX3 9DU, UK
Dr. K. H. NICOLAIDES Dept. of Obstetrics & Gynecology, King's College Hospital, Denmark Hill London, SE5 9RS, UK
Dr. A. NIENARTOWICZ, formerly: lost. fur Physiologie, UniversitatsstraSe 31 8400 Regensburg, Germany
Contributors XV
Dr. J. G. NIJHUIS University Hospital Nijmegen, Dept. Obstetr. & Gynecol., P.O. Box 9101 6500 HB Nijmegen, The Netherlands
Dr. H. PARISH Bristol-Myers & Squibb, Donaustaufer Str. 378 8400 Regensburg, Germany
Priv.-Doz. Dr. U. POHL Institut fUr Physiologie der Med. Universitat, Ratzeburger Allee 160 2400 Lubeck 1, Germany
Dr. G. K. RADDA MRC Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Headington Oxford OX3 9DU, UK
Dr. B. RAJAGOPALAN MRC Biochemical and Clinical Magnetic Resonance Unit, John Radcliffe Hospital, Headington Oxford OX3, 9DU, UK
Dr. B. S. RICHARDSON Lawson Research Institute St. Joseph's Health Centre 268 Grosvenor Street London, Ontario N6A 4V2, Canada
Dr. R. ROBEL Frauenklinik der Universitat, Philipp-Rosenthal-StraBe 55 0-7010 Leipzig, Germany
Prof. Dr. K.-E. RUCK HABERLE Frauenklinik der Universitat, Philipp-Rosenthal-StraBe 55 0-7010 Leipzig, Germany
Primarius Dr. R. RUDELSTORFER Landesfrauenklinik Wels, Linzer Str. 89 4600 Wels, Austria
Prof. Dr. A. M. RUDOLPH Cardiovascular Research Institute, University of California, Box 0544, HSE 1403 San Francisco, CA 94143-0130, USA
XVI Contributors
Dr. A. RUJDER Peschelanger 9 8000 Munchen 83, Germany
Dr. T. M. SMITS
Dept. of Surgery, University Hospital, Oostersingel 59 9713 EZ Groningen, The Netherlands
Dr. A. SUE-TANG Lawson Resea:ch Institute St. Joseph's Health Centre 268 Grosvenor Street London, Ontario N6A 4V2, Canada
Prof. Dr. B. VIEHWEG Frauenklinik der Universitat, Philipp-Rosenthal-StraBe 55 0-7010 Leipzig, Germany
Prof. Dr. G. WEGENER Institut fUr Zoologie, Universitat Mainz, SaarstraBe 21 6500 Mainz 1, Germany
Dr. B. A. WILLIAMS Fetal and Neonatal Research Group, Dept. of Obstetrics & Gynecology, University College and Middlesex School of Medicine, University College London, 86-96 Chenies Mews London WC1E 6HX, UK
Dr. M. WINKLER Frauenklinik der Universitat, Philipp-Rosenthal-StraBe 55 0-7010 Leipzig, Germany
Prof. Dr. K. H. WULF Univ.-Frauenklinik und Hebammenschule, Josef-Schneider-Str. 4 8700 Wurzburg, Germany