Influence of sleep and myometrial activity on systemic and uteroplacental hemodynamics in pregnant ewes.

Little is known about the influence of sleep on systemic and uteroplacental hemodynamics during pregnancy. Experiments were therefore carried out on six chronically instrumented pregnant ewes (125-133 days of gestation) to investigate the influence of sleep on systemic and uteroplacental hemodynamics. Because nonlabor myometrial activity influences uteroplacental hemodynamics, we made measurements during quiet wakefulness, quiet sleep, and active sleep in the presence and absence of myometrial activity. Cardiac output, heart rate, and systemic arterial pressure were decreased in active sleep compared with quiet wakefulness; these variables were not significantly altered by myometrial activity. The interaction between sleep and myometrial activity was such that the lowest values of uteroplacental blood flow, as estimated from middle uterine artery blood flow to the pregnant uterine horn and, hence, uteroplacental oxygen delivery occurred during active sleep in the presence of myometrial activity (i.e., decreased approximately 19% compared with quiet wakefulness and the absence of myometrial activity). Further investigation is required to determine the possible fetal consequences of a reduced uteroplacental perfusion in the presence of myometrial activity during sleep.