RELATIONSHIP BETWEEN THE OVINE FETAL UMBILICAL ARTERY BLOOD-FLOW WAVE-FORM AND UMBILICAL VASCULAR-RESISTANCE

Ultrasonic umbilical artery blood flow velocity waveform indexes decrease throughout gestation as umbilical blood flow increases. However, it is not known whether the decrease in indexes such as systolic/diastolic ratio is a direct result of a change in umbilical vascular resistance. Umbilical artery blood flow was measured as vasoactive agents angiotensin II, arginine vasopressin, norepinephrine, serotonin, and the thromboxane AZ sympathomimetic agent U-46619 were infused into the inferior vena cava of chronically instrumented ovine fetuses. Angiotensin II, arginine vasopressin, norepinephrine, serotonin, and U-46619 all significantly increased fetal arterial pressure levels. Angiotensin II, arginine vasopressin, and U-46619 significantly reduced umbilical blood flow and fetal heart rate. All five pressor agents increased umbilical vascular resistance. Systolic/diastolic ratios were obtained from pulsatile umbilical blood flow tracings. Systolic/diastolic ratios before infusions were significantly correlated with baseline values of umbilical blood flow (r = -0.55) and umbilical vascular resistance (r = 0.52). Systolic/diastolic ratios decreased with increasing infusion rates of angiotensin II, arginine vasopressin, norepinephrine, and serotonin, and increased with infusion of U-46619. There was no significant correlation between systolic/ diastolic ratio and either umbilical blood flow or umbilical vascular resistance during infusion of angiotensin II, arginine vasopressin, or serotonin. Systolic/diastolic ratio decreased with increasing umbilical vascular resistance during norepinephrine infusion (r = -0.44). Systolic/diastolic ratio changed in the predicted direction only when umbilical vascular resistance was increased by infusion of U-46619 (r = 0.80). We conclude that umbilical artery waveform analysis is not an adequate predictor of acute changes in umbilical blood flow or vascular resistance. © 1990, Mosby. All rights reserved.