Can fetal mortality be reduced by estimating maternal blood gas levels during intrapartum period?

ABSTRACT

The purpose of this study was to observe the affect of maternal asphyxia influencing the fetus and compare the maternal arterial blood gases [ABGs] and acid base levels of normal full term females with the full term females showing any subjective signs of fetal asphyxia during intrapartum period. In this case control study maternal ABGs and acid base levels of 40 normal term pregnant ladies were compared with 40 other term pregnant females with subjective signs of fetal asphyxia [i.e. fetal heart rate > 160bpm or< 120bpm, meconium staining of liquor, or Apgar score < 7 at one minute] during intrapartum period. Lactic acid and pH were also estimated to assess the acid base balance. There was considerable difference of lactic acid [LA] and Pco2 levels, which were significantly increased [P<0.025] in asphyxiated mothers [AM] as compared with control mothers [CM]. No significant difference was observed regarding pH values, ,bicarbonate ions [HCO[3]], base excess[BE],carbon dioxide content [CtCO[2]] andpercentage saturation of oxygen [%O[2]SAT] levels in both CM and AM groups. The levels of hemoglobin [Hb], packed cell volume [PCV], partial pressure of oxygen [PO[2]] and oxygen content [O[2]CT] in AM group were found significantly lower [P<0.0001] as compared to CM group. This study reveals a strong correlation between the fetal asphyxia and the mothers suffering from anemia, hypoxia or acidemia which may cause the fetal asphyxia during intrapartum period and need for proper investigations like blood gas and acid base analysis during intrapartum period for intervention in earlier phases of labor to prevent feto-ma-ternal mortality