Rizzo G, Capponi A, Soregaroli M, Arduini D, Romanini C
Department of Obstetrics and Gynecology, University of Rome Tor Vergata, Italy.
Biol Neonate. 1995;68(3):163-8. doi: 10.1159/000244233.
The objective of this study was to examine the acid-base status in blood obtained at cordocentesis in growth-retarded fetuses with absent end-diastolic velocity in the umbilical artery and divided according to the presence or absence of pulsations in the umbilical vein. Twenty-six growth-retarded fetuses free from structural and chromosomal abnormalities were considered for this study. All the fetuses had absent end-diastolic velocity in the umbilical artery associated in 11 cases (42.3%) with pulsations in the umbilical vein. Gas analysis of fetal blood obtained by cordocentesis was performed immediately after the Doppler recordings. Hypoxemia, acidemia and hypercapnia were defined respectively as the presence of pH or pO2 values 2 standard deviations below the normal mean for gestation and of pCO2 values 2 standard deviations above the normal mean for gestation. Fetuses with umbilical vein pulsations had lower values of pH (p < or = 0.001) and pO2 (p < or = 0.05) and higher values of pCO2 (p < or = 0.001) when compared to those without pulsations. All fetuses with pulsations were hypoxemic and hypercapnic and the incidence of acidemia was 90.9%. Fetuses with continuous blood flow in the umbilical vein, although frequently hypoxemic (80%), have pCO2 and pH values within the normal range in 40 and 52.3% of the cases, respectively. In conclusion, in fetuses with absent end-diastolic velocity in the umbilical artery the presence of umbilical vein pulsations identifies a subgroup of fetuses with a more severe compromise of acid-base status. This may be useful in the selection of the timing of delivery of such fetuses.
本研究的目的是检测脐动脉舒张末期血流消失的生长受限胎儿在经皮脐血穿刺时获取的血液的酸碱状态，并根据脐静脉搏动情况进行分组。本研究纳入了26例无结构和染色体异常的生长受限胎儿。所有胎儿脐动脉舒张末期血流均消失，其中11例（42.3%）伴有脐静脉搏动。在完成多普勒记录后，立即对经皮脐血穿刺获取的胎儿血液进行气体分析。低氧血症、酸血症和高碳酸血症分别定义为pH值或pO2值低于妊娠正常均值2个标准差，以及pCO2值高于妊娠正常均值2个标准差。与无脐静脉搏动的胎儿相比，有脐静脉搏动的胎儿pH值（p≤0.001）和pO2值（p≤0.05）更低，pCO2值（p≤0.001）更高。所有有搏动的胎儿均存在低氧血症和高碳酸血症，酸血症发生率为90.9%。脐静脉持续血流的胎儿虽然经常出现低氧血症（80%），但分别有40%和52.3%的病例pCO2值和pH值在正常范围内。总之，在脐动脉舒张末期血流消失的胎儿中，脐静脉搏动的存在可识别出酸碱状态受损更严重的胎儿亚组。这可能有助于选择此类胎儿的分娩时机。
