The correlation of biochemical monitoring versus umbilical flow velocity measurements of the human fetus.
The pulsatility index of the fetal umbilical arteries was evaluated in 14 high-risk pregnant patients delivered by cesarean section between 30 and 35 weeks of gestation. Transabdominal cord sampling by ultrasonic guidance was performed on 10 of these patients. Umbilical arterial and venous blood was obtained in all patients from the doubly clamped cord at the time of cesarean section. The blood samples were analyzed for respiratory gases, acid-base balance, and lactate concentrations. A significant relationship was found between the pulsatility index and pH, PCO2, and lactate concentrations measured on umbilical venous blood sampled in utero. The pulsatility index also correlated with the same variables measured on venous and arterial blood sampled at cesarean section. Umbilical venous blood obtained transabdominally had a significantly higher oxygen content than blood obtained at cesarean section. No significant correlation was found between umbilical venous oxygen content obtained at transabdominal cord sampling and the pulsatility index. At a pulsatility index greater than 1.5, lactate concentrations in umbilical venous blood increased sharply. There would appear to be a curvilinear relationship between umbilical blood flow and these indices of fetal oxygenation, such that moderate increases in pulsatility index were not associated with a significant increase in fetal lactate concentrations.
Ferrazzi
E
E
Department of Obstetrics-Gynecology, Ospedale Mangiagalli, University of Milano, Italy.
Pardi
G
G
Bauscaglia
M
M
Marconi
A M
AM
Gementi
B
B
Bellotti
M
M
Makowski
E L
EL
Battaglia
F C
FC
D000136:Acid-Base Equilibrium; D001783:Blood Flow Velocity; D001784:Blood Gas Analysis; D002585:Cesarean Section; D005069:Evaluation Studies as Topic; D005260:Female; D005312:Fetal Blood; D005333:Fetus / Q000502:physiology*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008991:Monitoring, Physiologic / Q000379:methods* / Q000592:standards; D011247:Pregnancy; D011674:Pulse; D014470:Umbilical Cord / Q000098:blood supply*
D006454:Hemoglobins; D007773:Lactates; D019344:Lactic Acid