Rh血型同种免疫妊娠中胎儿血红蛋白、氧含量与乳酸浓度的关系。

Relationship of fetal hemoglobin and oxygen content to lactate concentration in Rh isoimmunized pregnancies.

作者信息

Soothill P W, Nicolaides K H, Rodeck C H, Clewell W H, Lindridge J

出版信息

Obstet Gynecol. 1987 Feb;69(2):268-71.

Abstract

Fetal blood samples were obtained fetoscopically from 32 Rh isoimmunized pregnancies at 18-32 weeks' gestation, and the hemoglobin concentration, plasma lactate concentration, and oxygen content were measured. When the hemoglobin concentration was more than 8 g/dL, the umbilical arterial and venous lactate concentrations were equal. Abnormal elevations of lactate were found in the umbilical artery at hemoglobin concentrations below 8 g/dL (oxygen content 2 mmol/L) and in the umbilical vein at hemoglobin concentrations below 4 g/dL (oxygen content 2 mmol/L); the arterial lactate values were higher than the venous. These results show that lactate is produced by the human fetus stressed by anemic hypoxia and suggest that compensatory cardiovascular mechanisms are unable to maintain adequate oxygenation to all tissues when the umbilical venous oxygen content falls below 2 mmol/L.

摘要

在妊娠18至32周时，通过胎儿镜从32例Rh血型免疫的孕妇获取胎儿血样，并测量血红蛋白浓度、血浆乳酸浓度和氧含量。当血红蛋白浓度超过8 g/dL时，脐动脉和静脉的乳酸浓度相等。在血红蛋白浓度低于8 g/dL（氧含量2 mmol/L）时，脐动脉乳酸异常升高；在血红蛋白浓度低于4 g/dL（氧含量2 mmol/L）时，脐静脉乳酸异常升高；动脉乳酸值高于静脉。这些结果表明，乳酸由贫血性缺氧应激的人类胎儿产生，提示当脐静脉氧含量低于2 mmol/L时，代偿性心血管机制无法维持对所有组织的充分氧合。