Bon C, Raudrant D, Poloce F, Champion F, Thoulon J M, Pichot J, Revol A
Service de biochimie, Hôtel-Dieu, Lyon.
Ann Biol Clin (Paris). 1997 Sep-Oct;55(5):455-9.
Acid-base state and oxygenation of fetal blood were evaluated in a group of 73 appropriate for gestational age fetuses between 17 and 41 weeks of gestation; fetal blood was obtained by cordocentesis. We measured, on umbilical venous blood, pH, pCO2, bicarbonates and total CO2, pO2 and percent oxygen saturation; we obtained following results: pH = 7.309 +/- 0.054; pCO2 = 5.99 +/- 0.85 kPa; HCO3 = 22.16 +/- 1.90 mmol/l; total CO2 = 22.53 +/- 1.97 mmol/l; pO2 = 6.02 +/- 1.68 kPa; SaO2 = 0.71 +/- 0.18. In comparison with adult normal values, our results report in fetuses a frequent state of mild and mixed acidosis (in about 80% of cases), rather gazeous; pH is significantly correlated with pCO2 (r = -0.799), moreover there is also a metabolic origin in acidosis. We observed progressive modifications of acid-base state and oxygenation in fetal blood with advancing gestational age: decrease of pH and pO2, increase of pCO2 and bicarbonates; these changes appear mainly from 35th week of gestation, except for bicarbonates, which increase regularly during gestational period we have studied. Fetal acid-base state may be explained by physiological differences due to fetal life conditions, in comparison with adult life conditions. Results obtained in this population of normal fetuses can be considered as reference values for studied parameters.
对一组73例孕龄17至41周、孕周与胎龄相符的胎儿进行了酸碱状态和胎儿血氧评估;通过脐静脉穿刺获取胎儿血液。我们检测了脐静脉血的pH值、二氧化碳分压(pCO2)、碳酸氢盐和总二氧化碳、氧分压(pO2)以及氧饱和度百分比;结果如下:pH = 7.309 ± 0.054;pCO2 = 5.99 ± 0.85千帕;碳酸氢盐(HCO3)= 22.16 ± 1.90毫摩尔/升;总二氧化碳 = 22.53 ± 1.97毫摩尔/升;pO2 = 6.02 ± 1.68千帕;血氧饱和度(SaO2)= 0.71 ± 0.18。与成人正常值相比,我们的结果显示胎儿中存在频繁的轻度混合性酸中毒状态(约80%的病例),以气态为主;pH值与pCO2显著相关(r = -0.799),此外酸中毒也有代谢起源。我们观察到随着孕周增加,胎儿血液的酸碱状态和氧合发生渐进性变化:pH值和pO2降低,pCO2和碳酸氢盐升高;这些变化主要从妊娠第35周开始出现,但碳酸氢盐在我们研究的妊娠期内呈规律性升高。与成人生活条件相比,胎儿的酸碱状态可能由胎儿生活条件导致的生理差异来解释。该正常胎儿群体的研究结果可作为所研究参数的参考值。