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正常妊娠晚期羊水和血液的酸碱测定

Acid-base determinations in amniotic fluid and blood of normal late pregnancy.

作者信息

Fadel H E, Northrop G, Misenhimer H R, Harp R J

出版信息

Obstet Gynecol. 1979 Jan;53(1):99-104.

PMID:32503
Abstract

Amniotic fluid (AF) and arterial blood were obtained almost simultaneously from 59 healthy third-trimester pregnant women. Oxygen and carbon dioxide tensions (Po2, Pco2), pH, bicarbonate (Bicarb), total carbon dioxide (TCO2), lactate (L), and pyruvate (P) concentrations were measured. Only AF-Bicarb, AF-TCO2, AF-pH, and AF-P showed a statistically significant correlation, negative, with gestational age. AF-Po2, AF-pH, AF-Bicarb, and AF-TCO2, were lower, and AF-Pco2 was higher than in maternal blood. Amniotic fluid lactate was about 6 times, and AF-P was 2 times higher than maternal blood levels. The latter, the low bicarbonate, and the high Pco2 all contributed to the acidic pH of AF. Amniotic fluid pH was affected by fetal and maternal variables, notably maternal pH. There was no correlation between AF-Po2 and Pao2 (arterial oxygen tension), between AF-Pco2 and Paco2 (arterial carbon dioxide tension), or between AF-L and blood L. AF-Po2, AF-Pco2, and AF-L may correlate better with the intrauterine fetal status than AF-pH. Normal values obtained in this study should be useful as a baseline to monitor changes in the intrauterine environment in abnormal prgenancies.

摘要

从59名健康的孕晚期孕妇中几乎同时获取羊水(AF)和动脉血。测量了氧分压和二氧化碳分压(Po2、Pco2)、pH值、碳酸氢盐(Bicarb)、总二氧化碳(TCO2)、乳酸(L)和丙酮酸(P)的浓度。只有羊水碳酸氢盐、羊水总二氧化碳、羊水pH值和羊水丙酮酸与孕周呈负相关且具有统计学意义。羊水氧分压、羊水pH值、羊水碳酸氢盐和羊水总二氧化碳低于母血,而羊水二氧化碳分压高于母血。羊水乳酸约为母血水平的6倍,羊水丙酮酸为母血水平的2倍。后者、低碳酸氢盐和高二氧化碳分压共同导致了羊水的酸性pH值。羊水pH值受胎儿和母体变量影响,尤其是母体pH值。羊水氧分压与动脉血氧分压(Pao2)、羊水二氧化碳分压与动脉血二氧化碳分压(Paco2)或羊水乳酸与血乳酸之间均无相关性。与羊水pH值相比,羊水氧分压、羊水二氧化碳分压和羊水乳酸可能与宫内胎儿状况的相关性更好。本研究获得的正常值可作为监测异常妊娠时宫内环境变化的基线。

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