Major and collateral components of blood flow to pregnant sheep uterus.

In vivo measurements of vessel diameter, latex injections, and acrylic-cast studies indentified the middle uterine arteries as the main source of blood supply to the pregnant sheep uterus. Collateral circulation stemmed from the dorsal uterine arteries, and the ovarian arteries, and small cervical branches derived from the external iliac arteries (in decreasing order of importance). These morphological observations were related to estimates of collateral flow obtained during isolated, in situ perfusion of the pregnant sheep uterus carried out through the cannulated middle uterine arteries. Collateral blood flow was estimated from the shift of the flow-pressure curve produced by inflation of a balloon catheter advanced into the aorta below the renal arteries. Middle uterine artery flow to one horn increased from 162 +/- 23 ml/min in midgestation to 323 +/- 44 ml/min near term. Collateral uterine blood flow did not change significantly: 82 +/- 15 ml/min in midterm, 74 +/- 9 ml/min near term. Collateral flow consituted a larger fraction of inflow to the horn containing the fetus in 9 of 10 single pregnancies.