Limited role of fetal blood sampling in prediction of outcome in intrauterine growth retardation.
Fetal acid-base status was evaluated on 66 blood samples taken for rapid karyotyping from 58 growth-retarded fetuses. Before blood sampling, doppler blood flow studies of the umbilical artery showed end-diastolic frequencies to be absent in 32 fetuses (group 1) and present in 26 (group 2). Fetuses with chromosomal (n = 4) or structural (n = 8) abnormalities were excluded from subsequent analysis. Gestational age at blood sampling (27.8 [95% CI 26.5-29.1] vs 32.2 [30.4-34.1] weeks) and time from sampling to delivery (median 2 (range 0-35] vs 14 [0-77] days) were significantly lower in group 1 than group 2. There were no perinatal deaths in group 2 whereas mortality in group 1 was 65.4%. There were significant differences between the groups at blood sampling in pH, pO2, pCO2, base equivalents, and nucleated-red-cell count, but within group 1 these measurements were similar in surviving fetuses and those who died perinatally. Since acid-base determination does not predict perinatal outcome in growth-retarded fetuses, fetal blood sampling has a limited role in monitoring fetal wellbeing.
Nicolini
U
U
Royal Postgraduate Medical School, Queen Charlotte's and Chelsea Hospital, London, UK.
Nicolaidis
P
P
Fisk
N M
NM
Vaughan
J I
JI
Fusi
L
L
Gleeson
R
R
Rodeck
C H
CH
D000137:Acid-Base Imbalance / Q000097:blood*; D000222:Adaptation, Physiological; D000293:Adolescent; D000328:Adult; D001783:Blood Flow Velocity; D001784:Blood Gas Analysis; D005069:Evaluation Studies as Topic; D005260:Female; D005312:Fetal Blood / Q000032:analysis*; D005317:Fetal Growth Retardation / Q000097:blood* / Q000175:diagnosis / Q000235:genetics / Q000401:mortality; D005323:Fetal Monitoring / Q000379:methods; D005865:Gestational Age; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000235:genetics; D011379:Prognosis; D013997:Time Factors; D014463:Ultrasonography; D014469:Umbilical Arteries