Pathophysiology of fetal hypoxia with special reference to fetal sympathoadrenal system and its clinical evaluation

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1. The concentrations of L-dopa, dopamine, norepinephrine, epinephrine and DOPAC were examined in maternal blood, fetal blood, amniotic fluid and fetal urine at the time of elective cesarean section, normal delivery and abnormal delivery with fetal stress. The following results were obtained. (1) the fetal sympathoadrenal system was independent of the mother. (2) Sitting position of delivery was less stressful to the fetus during delivery compared with supine position of delivery. (3) Catecholamine concentrations in amniotic fluid may be a good indicator to assess the fetal stress. (4) Dopamine in amniotic fluid was produced in fetal kidney from circulating L-dopa and secreted adundantly via fetal urinary system and metabolized by monoamine oxidase in fetal membrane.2. Animal experiments were performed to investigate the biochemical disorders of brain following fetal hypozia as a causative factor of brain tissue injury, by measuring adenine nucleotides, glucose, lactate and catecholamines in fetal rat brain. The results were as follows. (1) Brain tissue ATP and glucose contents were markedly reduced with an accumu-lation of lactic acid following fetal hypoxia. (2) The maternal administration of glucose before fetal hypoxia has a favorable effect to prevent hypoxia-induced brain disorder, maintaining a high energy state in the brain during hypoxia. (3) Norepinephrine and dopamine existed in large amonut in fetal brain tissue.