To determine the effects of maternal ketamine anesthesia on fetal hemodynamic and cardiac function, a study was carried out on 8 chronically catheterized fetal lambs. Ketamine was administered intravenously to the mother every 15 min during 1 h. The fetal PO2 and pH remained within physiological limits whereas the PCO2 decreased from 44.35 ± 1.36 to 37.32 ± 4.75 Torr (p < 0.05). The following changes of the fetal heart systolic time intervals were observed: a progressive lenghtening of the preejection period (PEP) (from 52 ± 10 to 63 ± 11 ms, p < 0.01), a shortening of the ejection time (ET) and a significant increase of the PEP/ET ratio (from 0.32 ± 0.04 to 0.47 ± 0.01, p < 0.01). The two components of PEP, electromechanical delay and the isovolumetric contraction time were both prolonged. A progressive rise of fetal systolic and diastolic pressures was also noted (p < 0.01). Fetal heart rate increased (145 ± 33 to 190 ± 28 beats/min, p < 0.01) and cardiac beat-to-beat variability decreased (from 0.028 to 0.009, p < 0.01) during the ketamine anesthesia. This study demonstrates that maternal anesthesia with ketamine can alter indices of fetal myocardial function and other cardiac parameters used in fetal and neonatal monitoring, without affecting tissular oxygenation.

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