Objective: To evaluate the relationship of anaerobic metabolism, as reflected by the calculated base deficit, with oxygen transport and left ventricular function in women with severe preeclampsia.
Methods: Forty women with singleton pregnancies and severe preeclampsia who met prescribed criteria for invasive hemodynamic monitoring had arterial blood gas and hemodynamic values obtained immediately after placement of a pulmonary artery catheter. Oxygen transport indices were stratified according to the admission base deficit.
Results: Linear regression analysis demonstrated a strong negative correlation between the calculated base deficit and the oxygen delivery index (r = -0.64), cardiac index (r = -0.62), and left ventricular stroke work index (r = -0.58). A baseline maternal base deficit exceeding -8.0 mEq/L consistently predicted fetal acidosis, fetal death, and maternal end-organ ischemic injury.
Conclusion: The calculated base deficit reliably reflects maternal oxygen transport dynamics and identifies patients at risk for end-organ injury. Ventricular contractility and oxygen delivery decline with mounting oxygen debt.