Measures of acidosis with repetitive umbilical cord occlusions leading to fetal asphyxia in the near-term ovine fetus

Am J Obstet Gynecol. 2009 Feb;200(2):200.e1-7. doi: 10.1016/j.ajog.2008.10.022. Epub 2008 Dec 25.

Abstract

Objective: Increasing frequency of severe variable decelerations is associated with acidemia. However, there is little understanding of its development or normalization rate.

Study design: To quantify the time course of acidemia, 10 near-term fetal sheep underwent a series of mild (1 minute every 5 minutes), moderate (1 minute every 3 minutes), and severe (1 minute every 2 minutes) umbilical cord occlusions (UCO), lasting 1 hour each or until fetal arterial pH decreased to less than 7.00.

Results: Each minute of UCO resulted in base deficit (BD) and lactate increases at rates of 0.56 and 0.35 mmol/L per minute, respectively. During a 2 h recovery, BD and lactate normalized at rates of 0.09 and 0.04 mmol/L per minute. BD correlated highly with lactate (r = 0.95; P < .001).

Conclusion: Our findings in the near-term ovine fetus suggest that the knowledge of fetal BD deterioration and recovery rates can aid assessing fetal acidemia during labor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acidosis / diagnosis*
  • Animals
  • Female
  • Fetal Hypoxia / etiology
  • Fetal Hypoxia / physiopathology*
  • Pregnancy
  • Prenatal Diagnosis
  • Sheep
  • Term Birth
  • Umbilical Cord / blood supply*