title: Fetal and maternal transcutaneous PCO2 levels during labour and the influence of epidural analgesia.
abstract: The Departments of Obstetrics and Gynaecology of the Hvidovre University of Copenhagen and the Free University of Amsterdam collaborated in a study on the relationship of maternal and fetal acid-base state in the intrapartum period. Transcutaneous PCO2 levels of mother (tcPCO2m) and fetus (tcPCO2f) were continuously recorded in 52 patients during labour. TcPCO2f and tcPCO2m correlated significantly (r = 0.42, P < 0.002). During the first stage of labour, a rather stable level was found for tcPCO2f (7.7 +/- 1.6 kPa) and tcPCO2m (4.4 +/- 0.8 kPa). TcPCO2m decreased significantly to 3.8 +/- 0.7 kPa (P < 0.01) in the hour before full cervical dilatation, probably due to maternal hyperventilation as a reaction to painful uterine contractions. TcPCO2f likewise showed a tendency to a decrease to a mean value of 7.4 +/- 1.5 kPa. In eight cases epidural analgesia was applied because of painful uterine contractions. Prior to the epidural analgesia, tcPCO2m (3.8 +/- 0.8 kPa) and tcPCO2f (6.7 +/- 1.7 KPa) were significantly lower in this subgroup compared to the total population. After pain relief by application of epidural analgesia, tcPCO2m and tcPCO2f returned to the population mean.
authors.affiliation: Department of Obstetrics and Gynaecology, St. Laurentius Hospital, Roermond, The Netherlands. mbergman@plex.nl
authors.forename: M G
authors.initials: MG
authors.lastname: Bergmans
authors.forename: H P
authors.initials: HP
authors.lastname: van Geijn
authors.forename: T H
authors.initials: TH
authors.lastname: Hasaart
authors.forename: T
authors.initials: T
authors.lastname: Weber
authors.forename: C
authors.initials: C
authors.lastname: Nickelsen
mesh_terms: D000136:Acid-Base Equilibrium; D015360:Analgesia, Epidural / Q000009:adverse effects*; D002245:Carbon Dioxide / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007743:Labor, Obstetric / Q000378:metabolism* / Q000502:physiology; D008431:Maternal-Fetal Exchange / Q000502:physiology*; D011247:Pregnancy; D012044:Regression Analysis
chemical_list: D002245:Carbon Dioxide