Pulsatile Pressure-flow Relations and Pulse-wave Propagation in the Umbilical Circulation of Fetal Sheep

The relations between pulsatile pressures and flows in the umbilico-placental circulation have been investigated using chronically instrumented fetal sheep. Under resting conditions, mean arterial pressure fell by 30 +/- 6%, from 44 +/- 2 to 31 +/- 2 mm Hg between the aortic termination and the arteries feeding the cotyledons, and pressure waves were substantially damped during propagation between the two recording sites. This high flow resistance and wave attenuation are attributed to the very thick walls and extreme length of the umbilical arteries. Unique relations between pulsatile components of pressure and flow, characterized as vascular impedance spectra, were also observed. At rest, impedance to pulsatile flow was only slightly below resistance to steady flow, and impedance phase was positive at low frequencies. Pulse-wave reflections had more modest effects in this bed than others. Thus, oscillations in impedance spectra and percent wave transmission with increasing frequency, which are widely accepted manifestations of wave reflections, were relatively small. Positive impedance phases at low frequencies indicated that novel mechanisms influence phase relations between pressure and flow. A significant vascular compliance residing in the peripheral vascular beds could account for this findings. The vasodilator nitroprusside enhanced wave-reflection effects, whereas the vasoconstrictor angiotensin II reduced these effects. These changes were opposite to the effects of vasoactive substances in other systems, probably because these drugs act predominantly on the supply (umbilical) arteries rather than on the peripheral placental vasculature. When peripheral vascular resistance was selectively elevated by infusing 50-microns microspheres, reflection effects were enhanced: the pressure pulse in the umbilical artery was transmitted without attenuation, or was amplified, and impedance spectra more closely resembled patterns typical of other vascular beds. Specifically, impedance modulus fell sharply with increasing frequency, and impedance phase was negative at low frequency. In addition, we observed coordinated oscillations in impedance modulus and phase that are characteristic of beds that exhibit wave-reflection effects. These findings indicate that the specialized anatomy and control mechanisms observed in the umbilical circulation result in unique hemodynamic function, in which wave-propagation effects exert influences not readily predictable from studies on other systems.