Carbon monoxide exchanges between the human fetus and mother: a mathematical model.

A mathematical model was developed to calculate maternal and fetal carboxyhemoglobin concentrations, [HbCO], as functions of time during and after exposure of the mother to various inspired CO concentrations. Effects of variation in alveolar ventilation rates, pulmonary and placental fiffusing capacities, cardiac output, endogenous carbon monoxide production and other factors were studied. Following a change in the inspired CO concentration, fetal HbCO lags behind maternal HbCO by several hours. During CO uptake, fetal HbCO eventually overtakes maternal, and approaches an equilibrium value as much as 10% higher than the mother's. During CO washout the fetal levels again lag behind the mothers. Results indicate that treatment of pregnant women who have elevated HbCO levels with 100% oxygen reduces the time necessary to reduce the maternal HbCO level as expected, but that the rate of fetal CO elimination is not increased as much as that of the mother. Changes in maternal and fetal HbCO were also calculated for a representative exposure to changing inspired CO levels produced by fluctuating levels of air pollution. Finally, the effects of carboxyhemoglobin on fetal oxygenation were studied, including the effects of high altitude and exercise.