Effect of endothelium-derived relaxing factor inhibition on the umbilical-placental circulation in fetal lambs in utero.

Objective: The purpose of this study was to examine whether basal endothelium-derived relaxing factor release contributes to regulation of resting umbilical-placental vascular resistance.

Study Design: Because N omega-nitro-L-arginine selectively inhibits the synthesis of nitric oxide, a major endothelium-derived relaxing factor, we investigated the effects of N omega-nitro-L-arginine on umbilical-placental vascular resistance in 10 fetal lambs in utero. We inserted catheters and fitted an umbilical artery electromagnetic flow transducer around the common umbilical artery to measure umbilical blood flow and catheterized the left umbilical arterial hypogastric branch to allow selective umbilical-placental infusion (60 minutes) of pH-matched saline solution (control) or N omega-nitro-L-arginine.

Results: In seven normal fetal lambs, N omega-nitro-L-arginine increased umbilical-placental vascular resistance and arterial pressures and decreased umbilical blood flow (p less than 0.05); percentage changes from baseline were 50.8% +/- 18.3%, 40.3% +/- 8.1%, and -9.9% +/- 6.4%, respectively. In three mildly asphyxiated (compromised) fetuses, these changes were 101.4% +/- 28.7%, 31.2% +/- 4.8%, and -37.9% +/- 12.0%.

Conclusion: These data support the hypothesis that the basal endothelium-derived relaxing factor release plays a role in regulating resting umbilical-placental vascular resistance.