FACTORS RESPONSIBLE FOR THE STIMULATION OF THE ADRENAL MEDULLA DURING ASPHYXIA IN THE FOETAL LAMB

Brief asphyxial state following immediate cord clamping accelerates onset of left-to-right shunting across the ductus arteriosus after birth in preterm lambs

Reversal of shunting across the ductus arteriosus from right-to-left to left-to-right is a characteristic feature of the birth transition. Given that immediate cord clamping (ICC) followed by an asphyxial cord clamp-to-ventilation (CC-V) interval may augment left ventricular (LV) output and central blood flows after birth, we tested the hypothesis that an asphyxial CC-V interval accelerates the onset of postnatal left-to-right ductal shunting. High-fidelity central blood flow signals were obtained in anesthetized preterm lambs (gestation 128 ± 2 days) after ICC followed by a nonasphyxial (∼40 s, n = 9) or asphyxial (∼90 s, n = 9) CC-V interval before mechanical ventilation for 30 min after birth. Left-to-right ductal flow segments were related to aortic isthmus and descending aortic flow profiles to quantify sources of ductal shunting. In the nonasphyxial group, phasic left-to-right ductal shunting was initially minor after birth, but then rose progressively to 437 ± 164 ml/min by 15 min (P < 0.001). However, in the asphyxial group, this shunting increased from 24 ± 21 to 199 ± 93 ml/min by 15 s after birth (P < 0.001) and rose further to 471 ± 190 ml/min by 2 min (P < 0.001). This earlier onset of left-to-right ductal shunting was supported by larger contributions (P < 0.001) from direct systolic LV flow and retrograde diastolic discharge from an arterial reservoir/windkessel located in the descending aorta and its major branches, and associated with increased pulmonary arterial blood flow having a larger ductal component. These findings suggest that the duration of the CC-V interval after ICC is an important modulator of left-to-right ductal shunting, LV output and pulmonary perfusion at birth.NEW & NOTEWORTHY This birth transition study in preterm lambs demonstrated that a brief (∼90 s) asphyxial interval between umbilical cord clamping and ventilation onset resulted in earlier and greater left-to-right shunting across the ductus arteriosus after birth. This greater shunting 1) resulted from an increased left ventricular output associated with a higher systolic left-to-right ductal flow and increased retrograde diastolic discharge from a lower body arterial reservoir/windkessel, and 2) was accompanied by greater lung perfusion after birth.

Current paradigms and new perspectives on fetal hypoxia: implications for fetal brain development in late gestation

The availability of oxygen to the fetus is limited by the route taken by oxygen from the atmosphere to fetal tissues, aided or diminished by pregnancy-associated changes in maternal physiology and, ultimately, a function of atmospheric pressure and composition of the mother's inspired gas. Much of our understanding of the fetal physiological response to hypoxia comes from experiments designed to elucidate the cardiovascular and endocrine responses to transient hypoxia. Complementing this work is equally impactful research into the origins of intrauterine growth restriction in which animal models designed to restrict the transfer of oxygen from the maternal to the fetal circulation were used. A common assumption has been that outcomes measured after a period of hypoxia are related to cellular deprivation of oxygen and reoxygenation: an assumption based on a focus on what we can see "under the streetlights." Recent studies demonstrate that availability of oxygen may not tell the whole story. Transient hypoxia in the fetal sheep stimulates transcriptomics responses that mirror inflammation. This response is accompanied by the appearance of bacteria in the fetal brain and other tissues, likely resulting from a hypoxia-stimulated release of bacteria from the placenta. The appearance of bacteria in the fetus after transient hypoxia complements the recent discovery of bacterial DNA in the normal human placenta and in the tissues of fetal sheep. An understanding of the mechanism of the physiological, cellular, and molecular responses to hypoxia requires an appreciation of stimuli other than cellular oxygen deprivation: stimuli that we would have never known about without looking "between the streetlights," illuminating direct responses to the manipulated variables.

Greater sympathoadrenal activation with longer preventilation intervals after immediate cord clamping increases hemodynamic lability at birth in preterm lambs

This study tested the hypothesis that varying degrees of hemodynamic fluctuations seen after birth following immediate cord clamping were related to development of asphyxia with longer cord clamp-to-ventilation intervals, resulting in higher perinatal circulating levels of the catecholamines norepinephrine (NE) and epinephrine (Epi), and thus increased heart rate, blood pressures, and cardiac contractility after birth. Anesthetized preterm fetal lambs were instrumented with 1) aortic (AoT) and pulmonary trunk (PT) micromanometers to obtain pressures and the maximal rate of pressure rise (dP/dt_max) as a surrogate measure of ventricular contractility, and 2) an AoT catheter to obtain samples for blood gas and catecholamine analyses. After delivery, immediate cord clamping was followed by ventilation ∼40 s (n = 7), ∼60 s (n = 8), ∼90 s (n = 9), or ∼120 s later (n = 8), with frequent blood sampling performed before and after ventilation. AoT O₂ content fell rapidly after immediate cord clamping (P < 0.001), with an asphyxial state evident at ≥60 s. Plasma NE and Epi levels increased progressively with longer cord clamp-to-ventilation intervals, with an exponential relation between falling AoT O₂ content and rising catecholamines (R² = 0.64-0.67). Elevated circulating catecholamines persisted for some minutes after ventilation onset, with postbirth surges in heart rate, AoT and PT pressures, and AoT and PT dP/dt_max linearly related to log_e of catecholamine levels (R² = 0.41-0.54, all P < 0.001). These findings suggest that 1) a greater degree of asphyxia-induced sympathoadrenal activation (reflected in elevated circulating catecholamine levels) occurs with longer intervals between immediate cord clamping and subsequent ventilation, and 2) this activation is a major determinant of hemodynamic fluctuations evident with birth.

Evaluation of serial venous and arterial lactate concentrations in healthy anesthetized sheep undergoing ovariectomy

OBJECTIVE

To determine if lactate concentrations in jugular venous and auricular arterial blood differ in anesthetized sheep.

STUDY DESIGN

Prospective, controlled experimental study.

ANIMALS

Twelve healthy adult ewes, 4-7 years and weighing 62-77 kg.

METHODS

Jugular venous blood was collected before anesthesia (PreOv ) for measurement of lactate concentration, packed cell volume and total protein. Ewes were administered a standard anesthesia protocol. Jugular venous (IntraOv ) and auricular arterial (IntraOa ) blood samples were obtained 40 minutes after induction of anesthesia, and again in recovery (PostOv and PostOa ). An additional blood sample was drawn 6 weeks post-operatively from non-fasted sheep (NF_Lact). Lactate concentrations were compared among PreOv , IntraOv and IntraOa , PostOv and PostOa , and between PreOv and NF_Lact with paired t-test and repeated measure analyses of variance (anova) with PreOv as a covariate (p ≤ 0.05).

RESULTS

IntraOv lactate concentration had decreased from PreOv There were significant differences between arterial and venous IntraO and PostO lactate concentrations. There was no significant difference between IntraO and PostO, or PreOv and NF_Lact.

CONCLUSIONS AND CLINICAL RELEVANCE

Lactate concentrations were significantly lower in anesthetized sheep compared to non-anesthetized sheep. Lactate concentrations in venous blood were higher than in arterial blood. Therefore, anesthetic status and sampling site should be considered when interpreting lactate concentrations, and the sampling site should be consistent for repeated measurements.

Renal sympathetic nerve activity during asphyxia in fetal sheep

The sympathetic nervous system (SNS) is an important mediator of fetal adaptation to life-threatening in utero challenges, such as asphyxia. Although the SNS is active well before term, SNS responses mature significantly over the last third of gestation, and its functional contribution to adaptation to asphyxia over this critical period of life remains unclear. Therefore, we examined the hypotheses that increased renal sympathetic nerve activity (RSNA) is the primary mediator of decreased renal vascular conductance (RVC) during complete umbilical cord occlusion in preterm fetal sheep (101 ± 1 days; term 147 days) and that near-term fetuses (119 ± 0 days) would have a more rapid initial vasomotor response, with a greater increase in RSNA. Causality of the relationship of RSNA and RVC was investigated using surgical (preterm) and chemical (near-term) denervation. All fetal sheep showed a significant increase in RSNA with occlusion, which was more sustained but not significantly greater near-term. The initial fall in RVC was more rapid in near-term than preterm fetal sheep and preceded the large increase in RSNA. These data suggest that although RSNA can increase as early as 0.7 gestation, it is not the primary determinant of RVC. This finding was supported by denervation studies. Interestingly, chemical denervation in near-term fetal sheep was associated with an initial fall in blood pressure, suggesting that by 0.8 gestation sympathetic innervation of nonrenal vascular beds is critical to maintain arterial blood pressure during the rapid initial adaptation to asphyxia.

Noninvasive measurement of isovolumetric contraction time during hypoxemia and acidemia: Fetal lamb validation as an index of cardiac contractility

OBJECTIVES

The objectives of this study are firstly to clarify how the Doppler isovolumetric contraction time (ICT) is influenced by arterial oxygen pressure (PaO2) or pH, and secondly to confirm the relationship between the Doppler ICT and myocardial contractility during hypoxemia and/or acidemia in the fetal lamb.

MATERIAL AND METHODS

In 12 pregnant ewes, fetal hypoxemia and acidemia were induced by giving ewes a variable mixture of gases for 120 min. The chronological change of fetal PaO2, pH, Doppler ICT and maximum first derivative of the left ventricular pressure waveform (Max dp/dt) was recorded every 30 min.

RESULTS

Doppler ICT and PaO2 had no significant regression. On the other hand, Doppler ICT and pH demonstrated a significant negative regression. Moreover, one critical given pH point was indicated with statistical significance at 7.20 and the prolongation of the Doppler ICT was found more markedly in the range below the pH of 7.20 compared with the range above 7.20. A significant negative linear regression was found between the Doppler ICT and the Max dp/dt.

CONCLUSION

The measurement of Doppler ICT enables us to predict severe acidosis and a decrease of myocardial contractility in the fetus.

Biologic markers of pain in the vulnerable infant

Detecting and quantifying pain in infants and young children is a complex task because young children cannot communicate this subjective phenomenon. In the 1950s, it was postulated that there might be "wound hormones" produced in injured tissues that activated the pituitary-adrenal axis. Research in adults demonstrated that plasma levels of different hormones, including corticosteroids, cathecholamines, growth hormone, and insulin, changed in response to emotionally and physically stressful stimuli. Stress response is the term given to those hormonal and metabolic changes that follow injury or trauma, but the debate as to whether increased stress response is a sign of pain or whether decreased stress response is a sign of diminished pain has not been resolved yet. Following the study of systemic response to surgery, the ability of anesthetic agents to substantially attenuate intraoperative and postoperative stress response has been reported. In newborns, a strong correlation between preoperative stress and postoperative complication rate was found. The full extent of the vulnerable infant's pain is still poorly understood, but further research of known biologic markers and newly discovered ones could promote our understanding of the pain response and increase our ability to prevent undesirable outcome.

Sympathetic control of the cardiovascular response to acute hypoxemia in the chick embryo

In response to an acute hypoxemic insult, the mammalian fetus shows a redistribution of the cardiac output in favor of the heart and brain. Peripheral vasoconstriction contributes to this response and is partly mediated by the release of catecholamines. Two mechanisms of catecholamine release in the fetus are reported: 1) neurogenic sympathetic stimulation and 2) a nonneurogenic mechanism via a direct effect of hypoxemia on chromaffin tissues. In the present study, the effects of sympathetic blockade on plasma catecholamine release and cardiac output distribution in response to acute hypoxemia were studied in the chick embryo at different stages of incubation. Only at the end of the incubation period, sympathetic blockade markedly attenuated the increase in plasma catecholamine concentrations and resulted in a greater fraction of the cardiac output distributed to the carcass. However, these effects did not prevent a significant increase in cardiac output to the brain and heart during acute hypoxemia. These data imply that in the chick embryo the contribution of neurogenic mechanisms to the catecholaminergic response to acute hypoxemia becomes greater by the end of the incubation period.

Stress response and mode of ventilation in preterm infants

AIM

To assess the change in stress response in preterm babies changed from patient triggered ventilation (PTV) to conventional mandatory ventilation (CMV) and vice versa; to determine outcome in relation to stress hormone concentrations.

METHODS

A randomised controlled study was conducted in two district general hospital neonatal intensive care units. Thirty babies, treated initially with CMV, were randomly assigned to remain on CMV or to change to PTV. A second group of 29 babies, treated initially with PTV, were randomly assigned to remain on PTV or to change to CMV. The babies were less than 32 weeks of gestation, ventilated within 72 hours of birth, with clinical and radiological features compatible with respiratory distress syndrome (RDS). Stress hormone concentrations and clinical distress score were measured before and 20 minutes after allocation of mode of ventilation.

RESULTS

Babies changed from CMV to PTV had significantly reduced adrenaline concentrations (median change -0.4 nmol/l) compared with those who remained on CMV. There was no increase in adrenaline in babies changed from PTV to CMV. There were no significant changes in noradrenaline concentrations or clinical distress score. Babies who died had significantly higher adrenaline and noradrenaline concentrations than those who survived.

CONCLUSION

A change in mode of ventilation significantly reduces adrenaline concentrations. Raised catecholamine values are associated with a poor outcome.

Hypoxia-induced catecholamine secretion in isolated newborn rat adrenal chromaffin cells is mimicked by inhibition of mitochondrial respiration

1. In newborn mammals, systemic hypoxia provokes catecholamine secretion from the adrenal medulla. In contrast to adults, this release is independent of sympathetic innervation. We have studied the cellular processes involved in hypoxia-induced catecholamine secretion, employing fluorimetric techniques to measure changes in [Ca2+]i, NADH and mitochondrial potential, and voltammetric techniques to record changes in PO2 and catecholamine secretion. 2. In adrenal chromaffin cells freshly dissociated from newborn rats, severe hypoxia increased [Ca2+]i and secretion of catecholamines, indicating that the response of the newborn adrenal medulla to hypoxia is an intrinsic property of these cells. Discrete quantal secretory events were identifiable, suggesting an exocytotic mechanism of secretion. 3. Hypoxia-induced secretion was only seen when PO2 fell below 5 mmHg, similar to the threshold arterial PO2 reported to stimulate release in vivo. Such oxygen tensions also inhibited mitochondrial metabolism, shown by an increase in NADH autofluorescence. We therefore explored the involvement of mitochondria in oxygen sensing. Inhibition of mitochondrial respiration either by CN- at complex IV or by rotenone at complex I mimicked severe hypoxia, reversibly increasing both [Ca2+]i and catecholamine secretion. The CN(-)-induced depolarization of the mitochondrial inner membrane potential preceded the increase in [Ca2+]i by approximately 6 s. 4. The effects of severe hypoxia and CN- on [Ca2+]i and catecholamine secretion were not additive, suggesting a common mechanism. 5. Chemical anoxia failed to increase [Ca2+]i in a significant proportion of cells dissociated from 2- to 4-week-old rats. Thus, the sensitivity to hypoxia is specific to adrenal chromaffin cells dissociated from newborn rats. 6. These data indicate that hypoxia-induced catecholamine secretion in the newborn adrenal medulla is mediated by reversible inhibition of mitochondrial respiration, leading to an increase in [Ca2+]i and catecholamine secretion.

Neuronal markers, peptides and enzymes in nerves and chromaffin cells in the rat adrenal medulla during postnatal development

Neuronal markers, peptides and enzymes were analyzed in the rat adrenal medulla during the postnatal period, i.e., when the 'functional' splanchnic innervation is assumed to 'mature'. Nerve fibers were present on day 2 as indicated by neurofilament 10 (NF10)- and growth associated protein 43 (GAP43)-like immunoreactivities (LIs). Acetylcholinesterase (AChE)- and enkephalin (ENK)-immunoreactive (IR) fibers, presumably of preganglionic nature, increased in number and intensity during the postnatal period. In contrast, calcitonin gene-related peptide (CGRP)- and galanin (GAL)-IR fibers were almost fully developed on day 2. Thus, the presumably sensory innervation of the adrenal gland seems to precede the development of the autonomic nerves. The AChE- and ENK-IR fibers may exert a suppressive effect on ENK-, CGRP- and neurotensin (NT)-LIs in chromaffin cells, since the levels of these peptides were high in the early postnatal period and then decreased. On the other hand, GAL-LI in chromaffin cells was low also in young rats, while GAP43-IR cells were observed at all stages. Neuropeptide tyrosine (NPY) was expressed in many chromaffin cells at all stages and its turnover rate seemed to decrease towards the adult stage. The expression of the catecholamine synthezising enzymes changed only marginally during development. These results indicate that the preganglionic fibers, but not the sensory axons, in the splanchnic nerve are involved in the developmental control of expression of some, but not all, peptides in the chromaffin cells and that these changes thus may reflect the maturation of a 'functional' transmission.

Decreased postnatal testosterone and corticosterone concentrations in rats following acute intermittent prenatal hypoxia without alterations in adult male sex behavior

The prenatal and postnatal testosterone surges in the male rat are associated with neurobehavioral sexual differentiation of the brain. Both surges can be attenuated by maternal stress or other environmental factors that activate the maternal and/or fetal hypothalamic/pituitary/adrenal (HPA) axis during the last week of gestation. Since hypoxia is known to activate the HPA axis, we studied its effect during gestation on sexual differentiation in the male rat. We examined the influence of intermittent hypoxic exposure during gestation with respect to the postnatal testosterone surge and corticosterone levels, and subsequent development of adult reproductive and nonreproductive sexually dimorphic behaviors. Plasma testosterone and corticosterone concentrations of male neonates were measured after maternal exposure to acute, intermittent, prenatal hypoxia (9% O2 6 h/day from Day 15 to 21 of gestation). Relative to normoxic controls, acute, intermittent, prenatal hypoxia significantly attenuated the postnatal testosterone surge. Postpartum plasma corticosterone levels in these animals were also suppressed. In adulthood, prenatally hypoxic animals exhibited normal masculine sex behavior. Lordosis behavior in response to estrogen and progesterone priming was not significantly different between treatment groups. Saccharin preference, a nonreproductive, sexually dimorphic behavior, was not significantly influenced by prenatal hypoxic exposure. These results demonstrate that in the male acute intermittent prenatal hypoxia attenuates the postnatal testosterone surge. However, this reduction failed to result in significant alterations in the expression of sex related behaviors in adulthood.

Fetal catecholamine responses to vibroacoustic stimulation

OBJECTIVE

The aim of this study was to determine whether fetal vibroacoustic stimulation caused a surge of catecholamines from the fetal sympathoadrenal system.

STUDY DESIGN

A randomized, prospective, controlled trial was performed at The Queen Mother's Hospital, Glasgow. Circulating catecholamine levels in cord blood from a group of fetuses who received vibroacoustic stimulation 1 to 2 minutes before delivery by elective cesarean section (n = 25) were compared with those from a group of controls (n = 23) (Mann-Whitney U test). Fetal heart rate response to vibroacoustic stimulation was recorded in 10 additional pregnancies under identical experimental conditions.

RESULTS

No differences were found in norepinephrine or epinephrine levels between the vibroacoustic stimulation group and the control group. A positive fetal heart rate response was observed in seven of 10 fetuses tested. Fetal norepinephrine levels were also found to be influenced by maternal blood pressure and administration of ephedrine.

CONCLUSIONS

Under these conditions vibroacoustic stimulation does evoke the characteristic fetal heart rate response, but it does not induce a surge of catecholamines from the fetal sympathoadrenal system. Therefore it is unlikely that the immediate fetal heart rate response to vibroacoustic stimulation is induced by a surge in systemic catecholamines.

Randomised double-blind controlled trial of effect of morphine on catecholamine concentrations in ventilated pre-term babies

A sick premature baby who requires intensive care will undergo many uncomfortable procedures. It is now accepted that such babies perceive pain and need adequate analgesia, but little is known about the effects of sedation in these patients. We investigated the use of morphine to provide analgesia and sedation for ventilated preterm babies in a randomised, double-blind, placebo-controlled trial. 41 mechanically ventilated babies who had been treated with surfactant (Curosurf) for hyaline membrane disease were randomly assigned morphine in 5% dextrose (100 micrograms/kg per h for 2 h followed by 25 micrograms/kg per h continuous infusion) or 5% dextrose (placebo). Plasma catecholamine concentrations were measured 1 h after the first dose of surfactant and 24 h later. Blood pressure was measured at study entry and after 6 h. The morphine and placebo groups showed no differences in method of delivery, Apgar scores, birthweight, gestation, or catecholamine concentrations at baseline. Morphine-treated babies showed a significant reduction in adrenaline concentrations during the first 24 h (median change -0.4 [95% CI -1.1 to -0.3] nmol/L p < 0.001), which was not seen in the placebo group (median change 0.2 [-0.6 to 0.6] nmol/L, p = 0.79). There was a non-significant reduction in noradrenaline concentration in the morphine group. Blood pressure showed a slight but non-significant fall (median -4 mm Hg) in morphine-treated babies. The incidence of intraventricular haemorrhage, patent ductus arteriosus, and pneumothorax, the number of ventilator days, and the numbers of deaths did not differ significantly between the groups. Morphine, in the dose regimen we used, is safe and effective in reducing adrenaline concentrations in preterm ventilated babies.

Some aspects of perinatal maturation and adaptation

Physiological challenges facing the perinatal individual are huge. This is partly because of the marked and abrupt change from the intrauterine to the extrauterine environment, but also because the physiological responses to that change depend upon systems whose maturation is affected markedly by birth. Perinatal maturation appears, therefore, both to precede and accompany the physiological adaptations required for neonatal survival. This review does not provide a comprehensive coverage of perinatal physiology but directs attention towards evaluating constraints on foetal and neonatal thermogenesis, especially those imposed by post-natal availability of metabolic fuels in body reserves deposited before birth and acquired in colostrum and milk after birth. The relative importance of the supply of carbohydrate from body reserves and colostrum is examined. Carbohydrate is the major rate-limiting substrate with respect to heat production. It is shown that in the normal birth environments of several species, including the horse, colostral supply of lactose is not adequate to meet the entire carbohydrate needs of the neonate. It must, therefore, draw on its body glycogen reserves to sustain the required rates of heat production during the first day after birth. Gastrointestinal maturation and growth play a major part in the initial and continued provision of substrates for general metabolism and growth. Pre-natal and post-natal development of the stomach and intestines in a number of species are considered, including their disproportionately large growth compared with the body as a whole during the first 1-3 days after birth. Possible contributions to gastro intestinal growth and body growth of milk-borne growth factors such as epidermal growth factors and the insulin-like growth factors are considered. The role, as a possible significant stimulus to gastrointestinal growth and maturation immediately after birth, of the high levels of these growth factors in colostrum is evaluated.

Autonomic and arginine vasopressin modulation of the hypoxia-induced atrial natriuretic factor release in immature and mature ovine fetuses

OBJECTIVE

This study investigated the maturational change in the atrial natriuretic factor response to hypoxia in ovine fetuses and the role of the autonomic nervous system and arginine vasopressin in modulating this response.

STUDY DESIGN

Chronically catheterized ovine fetuses from 110 to 135 days' gestation were subjected to 30 minutes of hypoxia. The fetuses were either intact, treated with hexamethonium to block the autonomic nervous system, or treated with a pressor antagonist of arginine vasopressin.

RESULTS

Hypoxia elevated plasma atrial natriuretic factor levels by 1635 +/- 265 pg/ml in immature fetuses; this response was greater than the increase of 748 +/- 189 pg/ml in mature fetuses (p < 0.0001). Blockade of the autonomic nervous system reduced the atrial natriuretic factor response and suppressed the vascular pressure changes to hypoxia in immature but not in mature fetuses. A vasopressin pressor antagonist suppressed the atrial natriuretic factor but not vascular pressure responses to hypoxia in mature fetuses.

CONCLUSIONS

This study demonstrates that the immature fetus manifested a greater atrial natriuretic factor response to hypoxia than did the mature fetus. This enhanced response appeared to be dependent on the modulatory effects of the autonomic nervous system on vascular pressures during hypoxia. In addition, arginine vasopressin appeared to augment the atrial natriuretic factor response to hypoxia in the mature fetus independent of vascular pressure changes.

Catecholamines in experimentally growth-retarded rat fetus

This study was designed to evaluate the sympathoadrenal system in rat IUGR fetuses prepared by the Wigglesworth method. Samples were obtained on day 20 of gestation. In the amniotic fluid, concentrations of norepinephrine (NE) and particularly epinephrine (E) were significantly higher in IUGR fetuses than in normally developed fetuses (NE: p less than 0.05, E: p less than 0.01). L-Dopa and three catecholamines in the adrenal glands were decreased in IUGR fetuses. The mol ratios (L-dopa: dopamine: NE: E) were 1: 4: 35: 63 in IUGR fetuses and 1: 5: 39: 87 in normal fetuses. The ratio for epinephrine to L-dopa was significantly lower in IUGR fetuses (p less than 0.05). Adrenal phenylethanolamine-N-methyltransferase activities showed no difference between the two groups. From these results, adrenal epinephrine synthesis in IUGR fetuses was thought to be normal. Because of the depletion of adrenal epinephrine in IUGR fetuses, the plasma epinephrine concentrations were significantly lower after acute hemorrhagic shock (p less than 0.01). However, the plasma concentrations of dopamine and norepinephrine were significantly higher (dopamine: p less than 0.01, NE: p less than 0.001) in IUGR fetuses. These findings suggest that the hypersecretion of adrenal epinephrine is a protective response to chronic stress and the decrease of adrenal epinephrine may be a causative factor for the reduced reserves in the defense mechanism of IUGR fetuses.

Release of glucose from the liver of fetal and postnatal sheep by portal vein infusion of catecholamines or glucagon

1. The blood flow to the liver in fetuses near term, newborn and adult sheep was measured by the Fick principle, using radionuclide-labelled plastic microspheres, before and during infusion of adrenaline, noradrenaline or glucagon. 2. Glucose output and lactate consumption by the liver in sheep of each age group were calculated by application of the Fick principle using the concentration gradients of these metabolites measured in blood samples obtained, simultaneously with blood flow measurements, from catheters chronically implanted in the inflow and outflow vessels of the liver. 3. Catecholamines were infused into the portal vein of fetuses near term at a rate comparable with that at which they are known to be secreted in the sheep fetus during moderate to severe hypoxia. The cardiovascular and metabolic responses to these infusions were found to be comparable with those that occur in the fetus during hypoxia. 4. Catecholamines increased glucose output from the liver in all except the immediate post-partum animals. Catecholamines were less effective than glucagon in promoting glucose release. The mean increments in glucose output during adrenaline infusion were 0.055 +/- 0.015 mmol min-1 (100 g liver)-1 in the fetus, 0.122 +/- 0.024 mmol min-1 (100 g)-1 in the 2-week-old lambs, 0.078 +/- 0.019 mmol min-1 (100 g)-1 in young lambs and 0.049 +/- 0.012 mmol min-1 (100 g)-1 in the adult sheep. During glucagon infusion the mean glucose output increments were 0.146 +/- 0.023 mmol min-1 (100 g)-1 in the fetus, 0.274 +/- 0.085 mmol min-1 (100 g)-1 in the 2-week-old and young lambs and 0.180 +/- 0.054 mmol min-1 (100 g)-1 in the adult. Adrenaline was more potent than noradrenaline, suggesting that the major glycogenolytic response might be beta-receptor mediated. 5. In the immediate newborn period the output of glucose from the liver was high (0.20 +/- 0.05 mmol min-1 (100 g liver)-1 and was not statistically significantly increased by infusion either of glucagon or of catecholamines which resulted in similar increments of glucose output of about 0.128 +/- 0.133 mmol min-1 (100 g)-1. It is probable that the high output of glucose reflected the high endogenous circulating levels of catecholamines and glucagon in these animals at birth and that further infusions failed to add significantly to the already near-maximal glucose release.(ABSTRACT TRUNCATED AT 400 WORDS)

Does ephedrine influence newborn neurobehavioural responses and spectral EEG when used to prevent maternal hypotension during caesarean section?

The recovery of 16 infants born by elective caesarean section with spinal anaesthesia, in which either ephedrine or fluid load was used to prevent maternal hypotension, were studied using Scanlon's neurobehavioural tests and a computerized EEG. Neurobehavioural testing showed no differences between the ephedrine and the non-ephedrine groups of infants at ages of 3 h, 1 day, 2 days and 4-5 days, whereas the spectral EEG showed significant differences between the two groups during the first 2 h after delivery, which had disappeared 24 h later. It is suggested that small doses of ephedrine given to the mother i.v. to prevent hypotension during spinal anaesthesia have short-lived effects on the neonate's central nervous system, which will be detected in the spectral EEG, but not in neurobehavioural tests.

Beta-adrenoceptor agonists and hypoxia in sheep fetuses

Sheep fetuses, near term, were studied to test the influence of a tocolytic beta agonist, terbutaline, on fetal responses to hypoxia. After fetal exteriorization the drug was administered intravenously to the mother in three different doses: The max group comprised 11 ewes receiving 67-134 micrograms min-1. Seven ewes were given 30 micrograms min-1 and eight ewes were infused with 10 micrograms min-1. Seventeen fetuses served as controls. Hypoxia was induced by intermittent complete occlusions of the maternal abdominal aorta. Maternal terbutaline levels were high (range 50-748 nmol l-1) in the max group and the 30-micrograms group, whereas those in the 10-micrograms group were in the clinical range (range 11-58 nmol l-1). Fetuses in the max and 30-micrograms groups reacted to moderate hypoxia with excessive responses of heart rate, blood pressure myocardial contractility and ST waveform changes and a 50% mortality rate during severe hypoxia as compared with 12% in the control animals. Ten micrograms min-1 did not decrease the survival but caused an increase in myocardial workload and a negative energy balance during severe hypoxia.

Electrocardiographic waveform changes and catecholamine responses during acute hypoxia in the immature and mature fetal lamb

The aim of the present study was to investigate the changes in electrocardiographic waveform and the release of catecholamines in the fetal lamb during nonacidemic fetal hypoxia. Chronically instrumented fetal lambs were subjected to reproducible hypoxia by reduction of the maternal placental blood flow. This was achieved by complete obstruction of the maternal aorta for 60 seconds. The fetuses were divided into an immature (119 to 126 days, n = 10) and a mature group (129 to 141 days, n = 6). Both groups of fetuses had a marked fall in oxygen tension (from 2.43 +/- 0.12 to 1.46 +/- 0.12 and 2.22 +/- 0.15 to 1.11 +/- 0.17 kilopascals [kPa] in the immature and mature groups, respectively) and in oxygen saturation (from 48% +/- 3% to 17% +/- 2% and 49% +/- 3% to 15% +/- 3%, respectively), but only modest changes occurred in pH and carbon dioxide tension. Basal fetal catecholamine concentrations did not differ between the groups but increased more significantly in the mature group with acute hypoxia. An increase in the T wave amplitude of the fetal electrocardiogram occurred in both groups during the latter part of occlusion with peak values shortly after removal of the occlusion. A linear correlation was found between the plasma epinephrine concentration and the T/QRS ratio in the mature group. Fetuses in both groups showed a marked bradycardia of similar magnitude during the occlusion but differed during the early phase of heart rate recovery by a slower acceleration of heart rate in the mature group. In connection with this marked bradycardia, the mature group showed a significant rise in mean arterial blood pressure at end of the occlusion. We suggest that fetal maturity has a significant influence no only on the release of catecholamines during nonacidemic hypoxia but also on the cardiovascular reaction pattern and changes in the ST waveform.

Effects of insulin infusion on plasma catecholamine concentration in fetal sheep

To evaluate the response of the sympathoadrenal system in fetal sheep receiving exogenous insulin infusion, we measured plasma catecholamine levels in 14 chronically catheterized fetal sheep before and during an infusion of insulin for 2 days. Catecholamine values were measured in fetal arterial plasma by an electrochemical detection method. Fetal plasma norepinephrine and epinephrine concentrations increased significantly during insulin infusion. Significant inverse correlations were observed between the log norepinephrine concentration and fetal arterial oxygen content and glucose values. A significant direct correlation between the log norepinephrine concentration and fetal arterial carbon dioxide concentration was also observed. The log epinephrine concentration correlated inversely with plasma glucose concentration. Increases in fetal heart rate during both the noninfused and insulin-infused states correlated significantly with increases in norepinephrine concentration. We conclude that the sympathoadrenal system is activated during fetal insulin infusion, potentially supporting some of the fetal cardiovascular responses to insulin infusion.

Developmental expression of proenkephalin A mRNA and phenylethanolamine N-methyltransferase mRNA in foetal sheep adrenal medulla

The ontogenic expression of proenkephalin A (ProEnk A) mRNA and phenylethanolamine N-methyltransferase (PNMT) mRNA was examined in the foetal sheep adrenal medulla by the use of specific oligodeoxyribonucleotide probes. Northern blot analysis of RNA extracts from foetal adrenals demonstrated that ProEnk A mRNA was expressed as early as 60 days of gestation, a time at which the foetal adrenal is not functionally innervated. In situ hybridization on sections of foetal adrenals revealed that at 110-140 days gestation ProEnk A mRNA was expressed in chromaffin cells at the outer margin of the adrenal medulla but at earlier stages of gestation (e.g. 95 days) appeared to be expressed homogeneously throughout the whole of the adrenal medulla. In comparison, PNMT mRNA was expressed preferentially in cells at the outer margin of the adrenal medulla from the earliest stage detectable. Both PNMT mRNA and ProEnk A mRNA co-localized in cells at the outer margin of foetal adrenal of late gestations (110-140 days), a similar pattern to that seen in the adult adrenal medulla. These results indicate that, as with adult animals, in foetuses of late gestation, adrenal enkephalins are co-stored within adrenaline cells. It is likely therefore that enkephalins are co-released from the foetal adrenal with adrenaline in response to intra-uterine stress.

Direct adrenal medullary catecholamine response to hypoxia in fetal sheep

The present study was designed to investigate the direct response of fetal adrenomedullary cells to hypoxia, and the possible change in this responsiveness with maturation. Ovine fetal adrenomedullary cells, when exposed to 30 min of hypoxia induced by perfusing with Krebs-Henseleit solution equilibrated with 1% O2, released significantly greater amounts of total catecholamine into the perfusate, compared to basal conditions. After a 1-h control period, a second 30-min hypoxic episode stimulated a catecholamine response which was significantly smaller in magnitude than the first. Following the two hypoxic episodes, the cells were capable of responding to 50 mM KCl with a large increase in total catecholamine release. During the first hypoxic episode, the release of both norepinephrine and epinephrine was stimulated by equal magnitude. Fetal adrenomedullary cells obtained from fetuses at 100, 120, and 130 days gestation showed similar responsiveness to the same hypoxic stimulus, and these responses were not different from that observed in maternal adrenomedullary cells. On the contrary, responsiveness to KCl-induced depolarization was greatest in cells obtained from fetuses at 130 days gestation when compared to that in the younger fetuses. This increased responsiveness to KCl was accompanied by a greater catecholamine store in the adrenal medulla of the fetuses at this gestational age. These results suggest that ovine fetal adrenomedullary cells can respond directly to hypoxia by releasing catecholamines. This direct responsiveness became desensitized after repeated exposure. Finally, a decrease in direct responsiveness to hypoxia associated with maturation could be demonstrated.

The physiology of stress and its relationship to mechanisms of disease and therapeutics

Although stress reactions are organized to protect the homeostatic state of animals, they contain elements that may either enhance or diminish susceptibility to disease processes; in many instances, however, stress reactions themselves may induce pathologic change. It is important, therefore, that the veterinary clinician recognize the elements of a stress reaction and understand the mechanisms of disease with which they interact. This article provides a classification of stress stimuli that can be applied when considering interactions between stress reactions and disease processes.

Neonatal adaptation to stress of parturition and dystocia

The fetal animal undergoes a tremendous transition from intrauterine to extrauterine life at parturition. In this article, the maternal-fetal interactions of parturition are discussed with the aim of examining the normal stress reactions of parturition. Dystocia is discussed from the standpoint of additional distress of the newborn, with an aim toward the development of rational therapeutic support.

Postnatal development of catecholamines and response to hypoxia in adrenals and paraganglia of rabbits

The postnatal development of catecholamine levels in adrenals and paraganglia in newborn rabbits has been analyzed. At birth, the dominant catecholamine was noradrenaline, contributing 66% of the total catecholamine pool at day 1, 55% of which came from the paraganglia. There was a rapid postnatal increase of adrenaline, which constituted 67% of the total catecholamines at day 6 and 97% in the adult. After hypoxia at day 1, the noradrenaline levels decreased in paraganglia but not in adrenals, while adrenaline levels did not significantly change in either organ.

The slope of fetal heart rate deceleration is predictive of fetal condition during repeated umbilical cord compression in sheep

The relationship between components of fetal heart rate deceleration and fetal arterial blood gas values or plasma catecholamine concentrations was investigated by repeated complete umbilical cord compression in chronically instrumented fetal lamb. Fetal arterial pH and bicarbonate levels decreased, while plasma norepinephrine and epinephrine concentrations increased more than tenfold. The slope of the descending limb of the fetal heart rate deceleration curve decreased and correlated strongly with fetal arterial pH, bicarbonate, and logarithmic plasma norepinephrine and epinephrine concentrations. Fetal arterial pH and bicarbonate levels were significantly lower in the group with lower fetal heart rate deceleration slope, and a greater plasma catecholamine concentration in this group suggested a redistribution of blood flow to vital organs. Therefore, during repeated umbilical cord compression, the fetal acid-base and hormonal state was predicted by the fetal heart rate deceleration slope. This relationship may be applicable to human fetuses in the diagnosis of fetal distress caused by umbilical cord compression during labor.

Catecholamine and blood pressure levels in paralysed preterm ventilated infants

The effect of pancuronium administration on catecholamine levels and blood pressure was investigated. Noradrenaline levels prior to paralysis amongst infants fighting the ventilator were high, but were significantly reduced following treatment with pancuronium. There was no significant change in either blood pressure or adrenaline levels. Increasing peak inspiratory pressure (approx. 4 cmH2O) immediately prior to paralysis effectively prevented the hypoventilation previously associated with the administration of the first dose of pancuronium.

Respiratory and neuroendocrine responses of piglets to hypoxia during postnatal development

Breathing response to 12% and 6% O2 in N2 (at isocapnia) was measured in anaesthetized piglets, 1-5 and 19-25 days old, before and after 3 mg kg-1 i.v. naltrexone. The degree of interaction between the anaesthetic and naltrexone was assessed. At the end of each hypoxic trial, arterial blood was sampled for measurements of pH and gas tensions, (Met)enkephalin-Arg6-Phe7, adenosine, noradrenaline and adrenalin. Whereas respiration in older animals was stimulated by hypoxia, young piglets had a biphasic response with a pronounced ventilatory decrease in response to severe hypoxia (6% O2/N2). In young animals there was a greater ventilatory response with naltrexone than without the drug, and the biphasic hypoxic response was ameliorated or reversed by naltrexone. Levels of adrenalin increased and those of encephalin, adenosine and noradrenaline tended to increase during hypoxia in the younger age group. Levels of adenosine showed significant increase when data from both age groups and levels of hypoxia were pooled. Combined with previously reported physiological evidence regarding adenosine in hypoxic depression, we conclude that the present results are compatible with a role of opioid peptides and adenosine in the early postnatal response to hypoxia.

Current concepts on the electrophysiology of the myocardium

Each heart beat is triggered by a characteristic change in the electrical potential that exists across the membranes of the cells of the heart. This 'cardiac action potential' is shown in figure 1 A and it is the result of currents of ions (figure 1 B) which flow across the cell membrane via so-called ion channels. During diastole the cell is at 'rest' and the cell interior is negative; this resting potential is the result of positive K ions flowing out of the cell via one type of K channel. This particular K current is known as iK, 1. During the upstroke (phase 0) of the action potential the cell is depolarized and the cell interior becomes positive because of a large influx of positive Na ions into the cell. This Na current (iNa) is short lived but despite this the cell remains depolarized for several hundred milliseconds during the characteristic plateau (phase 2) of the action potential because positive Ca ions now flow into the cell. Although this Ca current (iCa) is an important factor underlying the plateau phase, it is helped because the efflux of K ions via iK, 1 is curtailed as a result of a special property known as anomalous rectification. Finally the action potential is brought to an end as the Ca current gradually declines (inactivates) whereas the movement of K out of the cell (via a second set of K channels) gradually increases. This K current is known as iK.(ABSTRACT TRUNCATED AT 250 WORDS)

Metabolic and cardiovascular effects on fetal sheep of sustained reduction of uterine blood flow

The effects on the fetus and placenta of graded reductions of uterine blood flow to 30-90% of control have been studied in sheep at days 125-143 of pregnancy. Reduction of uterine flow to 70-90% of control had little effect upon fetal oxygenation or heart rate or blood pressure but elevated fetal plasma catecholamine concentration. Reduction of flow to 30-50% of control depressed fetal arterial and umbilical venous PO2 but had little effect upon oxygen consumption unless the umbilical venous value fell below about 14 mmHg when it was depressed by up to 30%. Placental oxygen consumption did not fall and was therefore maintained at the expense of the fetus. Fetal arterial pressure rose by 10-12 mmHg and heart rate fell by about 30 beats/min during the first 10-15 min then rose above its initial value. Plasma adrenaline and noradrenaline concentrations rose progressively at a rate which increased with greater degrees of asphyxia. When uterine blood flow was reduced below one-half of normal, net placental consumption of glucose fell and there was evidence of substantial provision of glucose and lactate from the fetus. Fetal production of lactate increased sharply and much of this appeared to be consumed by the placenta at a rate sufficient to account entirely for the deficit in net glucose consumption. The results are consistent with the hypothesis that the fetus senses even small changes in uterine blood flow that are alone insufficient to elicit significant blood gas changes. When the fall in uterine flow caused by arterial compression is relatively large, nutrient supply to the placenta is maintained at the expense of the fetus and as a result of fetal glucose and lactate production. The elevation of fetal arterial PCO2 appears to enhance fetal responses to hypoxia. The results are discussed in relation to the fetal responses to brief and prolonged reductions in uterine blood flow.

Neonatal adaptation: greater sympathoadrenal response in preterm than full-term fetal sheep at birth

A marked increase in sympathoadrenal activity at birth has been described in animals and humans. Studies to determine whether the magnitude and duration of the catecholamine surge at birth in preterm lambs is similar to full-term lambs were undertaken using an acutely exteriorized fetal lamb. To maintain a physiologically stable preparation, all preterm lambs were given natural sheep surfactant intratracheally before the first breath. Base-line catecholamine values were similar in the full-term and preterm lambs. After umbilical cord cutting there was a marked increase in circulating norepinephrine (NE) and epinephrine (E) in both full-term and preterm animals. The preterm animals exhibited a delayed but exaggerated elevation of both NE and E relative to term animals. The peak preterm value for NE (3.8 +/- 1.2 ng/ml) occurred at 60 min and exceeded the peak NE value 1.2 ng/ml observed at 15 min in full-term animals. The peak E concentration in preterm animals was over 9 ng/ml between 2 and 3 h of age, whereas full-term animals reached a peak value of 1.1 ng/ml at 5 min. Heart rate and blood pressure rose abruptly to peak values by 5-15 min in full-term animals. Changes in heart rate and mean arterial pressure were less profound and more gradual in preterm animals. Full-term animals also demonstrated a five-to sevenfold increase in plasma free fatty acids, whereas concentrations in preterm animals increased only two- to threefold. There was a similarly blunted response in blood glucose in preterm animals. The catecholamine surge at birth may be an important adaptive phenomenon with physiological implications.

Depression of uterine blood flow during total umbilical cord occlusion in sheep

The effect of total umbilical cord occlusion upon maternal blood flow in the internal iliac and median uterine arteries was studied in eight chronically instrumented pregnant sheep. Occlusion of the umbilical cord was performed with an inflatable balloon occluder around the total cord. Blood flow was measured with electromagnetic flow transducers. Total umbilical cord occlusion of short duration (mean 40.1 s) caused a significant decrease in the maternal internal iliac and median uterine arteries at the end of the occlusion to respectively 93.9% and 91.7% of the control values. The decrease in internal iliac and median uterine artery blood flow is attributed to an elevated fetal capillary pressure in the placenta, leading to an increased fetal placental tissue pressure which in turn compresses the maternal placental capillaries, resulting in a heightened vascular resistance and a decrease in uterine blood flow.

Pulmonary artery balloon counterpulsation for right ventricular failure: I. Experimental results

The effects of pulmonary artery balloon counterpulsation (PABC) as a circulatory assist for the failing right ventricle were investigated. Sixteen anesthetized dogs underwent instrumentation to measure cardiac output and to record pressures in both ventricles, the pulmonary artery, and the aorta. Autonomic control of the heart was surgically and pharmacologically ablated. A specially designed counterpulsation balloon was inserted through the right ventricular (RV) outflow tract into the pulmonary artery. Pulmonary hypertension, induced acutely by the microembolization of the pulmonary circulation with glass beads combined with infusion of serotonin, served as a model for development of acute RV failure. Immediate effects of PABC were investigated in 10 dogs during normal function and failure of the right ventricle at different levels of preload. After further embolization which caused progressive cardiogenic shock, the effects of 10 minutes of PABC, and of its withdrawal, were examined. In all cases, PABC immediately decreased RV preload and afterload. In the failing right ventricle, counterpulsation also significantly increased cardiac output. Progressive cardiogenic shock was successfully reversed by PABC; after 10 minutes of counterpulsation, increases in cardiac output (+53%), arterial pressure (+55%), and RV minute work (+62%) were observed, paralleled by a fall in RV preload (-22%). After PABC was discontinued, the circulatory status again began to deteriorate. We conclude that PABC effectively improves function of the failing right ventricle caused by acute pulmonary hypertension.

Studies on equine prematurity 2: Post natal adrenocortical activity in relation to plasma adrenocorticotrophic hormone and catecholamine levels in term and premature foals

Adrenocortical and medullary function was investigated during the immediate post natal period in premature and full term foals. High plasma cortisol concentrations were characteristic of the term foals in the first 2 h after birth and these were accompanied by significant arteriovenous differences in plasma cortisol across the umbilical circulation at birth, indicating enhanced adrenal activity before delivery. No such arteriovenous differences were detected in the premature group and post natal changes in plasma cortisol were minimal. The apparent inability of the premature foal adrenal to secrete cortisol was not due to the lack of endogenous adrenocorticotrophic hormone (ACTH) because high levels of this hormone were found immediately after birth in both groups of foals. Tests on the sensitivity of the foal adrenal to exogenous ACTH1-24 (0.125 mg intramuscularly [im]) showed that a maximum response to this hormone could be elicited in term foals on the day of birth. Subsequently basal cortisol levels and the response of the adrenal to ACTH1-24 declined. By contrast, only a slight response was observed following the same dose of ACTH1-24 in the premature group. Exposure to Depot ACTH1-24 over 24 h enhanced the basal secretion of cortisol in both premature and term foals but no consistent response to the same ACTH test dose could be elicited in the former. A wide range of total plasma catecholamine concentrations was observed in both groups of newborn foals. The highest values were seen in acidotic animals and there was a significant inverse relationship between blood pH and total plasma catecholamine level at delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

The relationship between circulating catecholamines and ST waveform in the fetal lamb electrocardiogram during hypoxia

Previous studies from this laboratory have shown that changes in the ST waveform in the fetal electrocardiogram are a sign of fetal asphyxia. In the present study, seven chronically instrumented fetal lambs between 117 and 143 days' gestation were studied during 16 one-hour periods of maternally induced hypoxia. The aim was to test the hypothesis of a relationship between the concentration of circulating catecholamines and T-wave amplitude. The response to hypoxia was aged-dependent. Fetuses below 126 days of gestation did not react with electrocardiographic changes and output of epinephrine unless acidosis occurred. In more mature fetuses, hypoxia per se would induce a surge of epinephrine and changes in the ST waveform. Overall there was a strong correlation between the T/QRS ratio and the level of circulating epinephrine. During normoxia, epinephrine was undetectable (less than 0.1 nmol/L) in most fetuses; norepinephrine showed an increase at term. The analysis showed one fetus with chronic changes in the ST waveform (T/QRS ratio greater than 0.30) related to a marked increase in the plasma level of epinephrine in spite of normal blood gas values. These findings complement previous results in the acute and chronically instrumented fetal lamb and suggest that changes in the ST waveform expressed as T/QRS ratio identify a change to anaerobic myocardial metabolism mediated by beta-adrenergic stimulation.

Catecholamines in fetal pig plasma and the response to acute hypoxia and chronic fetal decapitation

Dopamine, norepinephrine and epinephrine were measured by radioenzymatic assay in blood plasma samples drawn from the umbilical arteries of 30 anaesthetised Landrace pig fetuses. Just prior to term, the concentrations of dopamine (0.46±0.14 ng·ml^-1) and norepinephrine (1.74±0.60 ng·mg^-1) were lower than earlier in gestation, whereas epinephrine concentrations at term (0.80±0.31 ng·ml^-1) were similar to those at mid-gestation, intervening stages of gestation having higher levels of plasma epinephrine. Fetal hypoxia was induced by clamping the umbilical cord for 2 min and the catecholamines determined in arterial blood samples immediately thereafter, then again 3 min after removal of the clamp. Inconsistent effects of cord clamping on catecholamine levels were seen at 55 days, but thereafter, in all but one instance, the hormone levels were increased. Fetuses near term tended to respond less than fetuses at 75 and 96 days gestation (term=114±1 day). Catecholamines were also present in the circulation of fetuses decapitated at 42 days gestation and studied at 109±1 days. The average concentrations of dopamine (1.12±0.27 ng·ml^-1) and norepinephrine (8.23±3.04 ng·ml^-1) were greater than in intact fetuses, the plasma epinephrine levels being comparable to, or slightly higher than, those in intact fetuses. The results demonstrate that catecholamines are present in the circulation of the intact and decapitated pig fetus and that the actual concentrations and the type of response to umbilical cord clamping are dependent on gestation age.