Blood pH and gases in fetuses in preterm labor with and without systemic inflammatory response syndrome

Roberto Romero, Eleazar Soto, Stanley M. Berry, Sonia S. Hassan, Juan Pedro Kusanovic, Bo Hyun Yoon, Samuel Edwin, Moshe Mazor, Tinnakorn Chaiworapongsa

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective: Fetal hypoxemia has been proposed to be one of the mechanisms of preterm labor (PTL) and delivery. This may have clinical implications since it may alter: (i) the method/frequency of fetal surveillance and (ii) the indications and duration of tocolysis to an already compromised fetus. The aim of this study was to examine whether there is a difference in the fetal blood gas analysis [pH, PaO2 and base excess (BE)] and in the prevalence of fetal acidemia and hypoxia between: (i) patients in PTL who delivered within 72 hours vs. those who delivered more than 72 hours after cordocentesis and (ii) patients with fetal inflammatory response syndrome (FIRS) vs. those without this condition. Study design: Patients admitted with PTL underwent amniocentesis and cordocentesis. Ninety women with singleton pregnancies and PTL were classified according to (i) those who delivered within 72 hours (n30) and after 72 hours of the cordocentesis (n60) and (ii) with and without FIRS. FIRS was defined as a fetal plasma concentration of IL-6>11 pg/mL. Fetal blood gases were determined. Acidemia and hypoxemia were defined as fetal pH and PaO2 below the 5th percentile for gestational age, respectively. For comparisons between the two study groups, ΔpH and ΔPaO2 were calculated by adjusting for gestational age (Δobserved value mean for gestational age). Non-parametric statistics were employed. Results: No differences in the median Δ pH (-0.026 vs. -0.016), ΔPaO2 (0.25 mmHg vs. 5.9 mmHg) or BE (-2.4 vs. -2.6 mEq/L) were found between patients with PTL who delivered within 72 hours and those who delivered 72 hours after the cordocentesis (p>0.05 for all comparisons). Fetal plasma IL-6 concentration was determined in 63% (57/90) of fetuses and the prevalence of FIRS was 28% (16/57). There was no difference in fetal pH, PaO2 and BE between fetuses with and without FIRS (p>0.05 for all comparisons). Moreover, there was no difference in the rate of fetal acidemia between fetuses with and without FIRS (6.3 vs. 9.8%; p>0.05) and fetal hypoxia between fetuses with or without FIRS (12.5 vs. 19.5%; p>0.05). Conclusions: Our data do not support a role for acute fetal hypoxemia and metabolic acidemia in the etiology of PTL and delivery.

Original languageEnglish
Pages (from-to)1160-1170
Number of pages11
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume25
Issue number7
DOIs
StatePublished - 1 Jul 2012

Keywords

  • Base excess
  • Cordocentesis
  • Fetal blood gases
  • Hypoxia
  • Intra-amniotic infection
  • PaO
  • Pregnancy

Cite this

Romero, R., Soto, E., Berry, S. M., Hassan, S. S., Kusanovic, J. P., Yoon, B. H., Edwin, S., Mazor, M., & Chaiworapongsa, T. (2012). Blood pH and gases in fetuses in preterm labor with and without systemic inflammatory response syndrome. Journal of Maternal-Fetal and Neonatal Medicine, 25(7), 1160-1170. https://doi.org/10.3109/14767058.2011.629247