Cardiovascular effects of induced decompression sickness in sheep fetus

Ten chronically catheterized near-term sheep fetuses were used to study the effect of induced intravascular bubbling on fetal placental vascular dynamics and fetal regional blood flows. Fetal blood pressure and heart rate were measured, and radioactive microspheres were administered to fetuses before and 5, 10, 15, and 20 min after a simulated no-decompression dive to 100 fsw (4 ATA) for 25 min. A decrease in brain blood flow was the only effect observed 5 min after decompression. Fifteen minutes later arterial hypertension was evident. Eight fetuses displayed arrhythmia, but there was no significant change in heart rate, myocardial blood flow, or resistance. There was a reduction in blood flow, and a concomitant increase in vascular resistance, in the gut, kidneys, placental membranes, and skeletal muscle, as well as in the brain. Total placental blood flow was unchanged throughout the postdive period, although placental vascular resistance was elevated 20 min after surfacing. Analysis of the placental blood flow at the cotyledonary level in 6 animals revealed no uniform response to decompression. The results are consistent with the hypothesis that the instrumented fetus suffers widespread vascular embolization and disruption of organ blood flows. We conclude that the observed changes in the fetal cardiovascular system, however, are not precipitated by an initial effect of decompression on the fetal placental circulation.