Oxygen, glucose, and lactate uptake by fetus and placenta during prolonged hypoxemia
Abstract
Our aim was to compare the effects of short (4 h) and prolonged (24 h) periods of reduced uterine blood flow (RUBF) on fetal and placental uptake of O2, glucose, and lactate. In pregnant sheep, uterine and umbilical blood flows were measured under normal conditions and after 4 and 24 h of RUBF. A 50% reduction in uterine blood flow caused a 56% reduction in fetal arterial O2 saturation (SaO2). Umbilical blood flow increased from 325 +/- 33 to 378 +/- 32 ml.min-1.kg-1 (P < 0.05) after 4 h but was not different from pre-RUBF values after 24 h. O2 uptake by the gravid uterus was not altered by RUBF, due to an increase (84%) in uterine O2 extraction. Similarly, uteroplacental and fetal O2 consumptions and fetal glucose uptake were not affected by RUBF, whereas uteroplacental glucose uptake was significantly reduced after 4 h (by 42%) and 24 h (by 58%) of RUBF. Fetal lactate uptake was greatly reduced from 78.7 +/- 15.5 to -167 +/- 57 mumol.min-1.kg-1 after 4 h and to -198 +/- 80 mumol.min-1.kg-1 after 24 h of RUBF; negative values indicate placental lactate uptake from the fetal circulation. Thus, although RUBF significantly reduced fetal SaO2, fetal and uteroplacental O2 consumptions did not change. In addition, although fetal glucose uptake was not altered by RUBF, during RUBF the placenta became a major site of lactate clearance from the fetal circulation.
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In sheep, fetal oxygen consumption is maintained when fetal-placental hypoxia is induced by restricting uterine blood flow and, hence, uterine oxygen delivery for 24h.
“Similarly, in sheep, fetal oxygen consumption is maintained when fetal-placental hypoxia is induced by restricting uterine blood flow and, hence, uterine oxygen delivery for 24h (53, 263).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
Lactate production by ovine uteroplacental tissues is reduced by 24 h of placental-fetal hypoxemia induced by restricting uterine blood flow or placental growth by hyperthermia.
“Certainly, lactate production by ovine uteroplacental tissues is reduced by 24 h of placental-fetal hypoxemia induced by restricting uterine blood flow or placental growth by hyperthermia (263, 456).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
With shorter episodes of severe hypoxia (<48h) in pregnant sheep, there is evidence for activation of fetal glucogenesis and increased delivery of glucose and lactate to the placenta from the fetal circulation.
“With shorter episodes of severe hypoxia (<48h) in pregnant sheep, there is evidence for activation of fetal glucogenesis and increased delivery of glucose and lactate to the placenta from the fetal circulation (230, 263, 292).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
In contrast to oxygen, the ovine placenta appears to spare glucose for onward passage to the fetus during acute hypoxemia as fetal glucose delivery and consumption are maintained at the expense of utero-placental glucose consumption for periods of up to 24h.
“In contrast to oxygen, the ovine placenta appears to spare glucose for onward passage to the fetus during acute hypoxemia as fetal glucose delivery and consumption are maintained at the expense of utero-placental glucose consumption for periods of up to 24h (53,230,263,380,525).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
Consequently, there is little evidence for placental oxygen sparing in response to acute normobaric hypoxia in sheep, as may occur in the human placenta in response to the chronic hypoxia of high altitude.
“Consequently, there is little evidence for placental oxygen sparing in response to acute normobaric hypoxia in the sheep (230, 263, 380), as may occur in the human placenta in response to the chronic hypoxia of high altitude (271).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
Placental oxygen consumption is maintained at normal values for up to 48 h of hypoxemia.
“Placental oxygen consumption is maintained at normal values for up to 48 h of hypoxemia (230, 263).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
Initially, fetal oxygen consumption decreases in line with placental delivery but then recovers to normal values despite sustained low delivery by increasing oxygen extraction.
“Initially, fetal oxygen consumption decreases in line with placental delivery but then recovers to normal values despite the sustained low delivery by increasing oxygen extraction (230, 263, 380).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
In these circumstances, the normal rate of placental oxygen consumption may be maintained by oxidation of lactate derived from the lactacidemic, hypoxemic fetus.
“In these circumstances, the normal rate of placental oxygen consumption may be maintained by oxidation of lactate derived from the lactacidemic, hypoxemic fetus (230, 263).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
Umbilical flow increases transiently 1-4 h after inducing placental-fetal hypoxemia by uterine artery constriction in ewes, but then normalises as the period of restricted uterine flow is extended to 24h or more.
“Similarly, umbilical flow increases transiently 1-4 h after inducing placental-fetal hypoxemia by uterine artery constriction in ewes, but then normalises as the period of restricted uterine flow is extended to 24h or more (52, 230, 263, 380, 524).”
From Placental Origins of Chronic Disease (2016) · cites this paper as [263]
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- Authors
- Hooper, S. B., Walker, D. W., & Harding, R.
- Affiliations
- Monash University (AU)
- Venue
- American Journal of Physiology-Regulatory, Integrative and Comparative Physiology
- Publisher
- American Physiological Society
- Published
- 1995-02-01
- Volume
- 268
- Issue
- 2
- Pages
- R303-R309
- ISSN
- 0363-6119 (ISSN-L)
- 1522-1490
- OpenAlex
- W2338436696
- Cited by
- 35
- References
- 0
- Citations by year
- 2025: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2017: 1 · 2016: 3 · 2015: 2 · 2013: 1 · 2012: 2
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Regulatory, Integrative and Comparative Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- fetal hypoxemia, lactate clearance, umbilical blood flow, pregnant sheep
- MeSH terms
- Animals, Hypoxia, Arteries, Female, Fetal Blood, Fetus, Gases, Glucose, Hydrogen-Ion Concentration, Lactates, Oxygen, Oxygen Consumption, Placenta, Pregnancy, Regional Blood Flow, Sheep, Time Factors, Uterus, Lactic Acid
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