Decreased placental oxygenation capacity in pre-eclampsia: clinical application of a novel index of placental function preformed at the time of delivery.
OBJECTIVE
We have previously described placental oxygenation capacity as an index of placental function. The aim of this study was to utilize this test to evaluate placental gas exchange capacity in pre-eclampsia and fetal growth restriction (FGR).


METHODS
Two nested case-control studies were conducted between: (i) pre-eclamptic appropriate-for-gestational-age fetus (AGA) and non-pre-eclamptic AGA; and (ii) pre-eclamptic FGR and non-pre-eclamptic FGR based on gestational age match. Umbilical A-V gas differences were compared between groups.


RESULTS
Pre-eclamptic AGA was associated with smaller A-V pO(2) and A-V pCO(2) differences compared to non-pre-eclampsia (A-V pO(2), 7.1+/-3.8 mm Hg vs. 11.3+/-5.9 mm Hg, P=0.001; A-V pCO(2), 7.8+/-5.7 mm Hg vs. 10.7+/- 5.9 mm Hg, P=0.01). Pre-eclamptic FGR was associated with smaller A-V pO(2) and A-V pCO(2) differences compared to non-pre-eclampsia (A-V pO(2), 6.6+/-3.1 mm Hg vs. 10.8+/-8.1 mm Hg, P<0.001; 6.7+/-4.5 mm Hg vs. 10.9+/-10.3 mm Hg, P=0.044). Pre-eclamptic FGR also had significantly lower venous pO(2) but not arterial pO(2) (Venous pO(2), 20.3+/-6.3 mm Hg vs. 25.4+/-11.9 mm Hg, P=0.003).


CONCLUSIONS
Pre-eclampsia decreases the placental oxygenation capacity as measured by the umbilical arterial-venous oxygen difference.
Matsuo
Koji
K
Department of Obstetrics, Gynecology, and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD 21201, USA. kmats001@umaryland.edu
Malinow
Andrew M
AM
Harman
Chris R
CR
Baschat
Ahmet A
AA
D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005317:Fetal Growth Retardation / Q000097:blood / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008431:Maternal-Fetal Exchange / Q000502:physiology; D010100:Oxygen / Q000097:blood / Q000502:physiology*; D036801:Parturition / Q000097:blood / Q000502:physiology*; D010920:Placenta / Q000098:blood supply / Q000503:physiopathology*; D011225:Pre-Eclampsia / Q000097:blood / Q000503:physiopathology*; D011247:Pregnancy
D010100:Oxygen