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Third-Trimester Arterial Blood Gas and Acid Base Values in Normal Pregnancy at Moderate Altitude

HANKINS, GARY D. V. MD; CLARK, STEVEN L. MD; HARVEY, CAROL J. RNC, MS; UCKAN, EDA M. RNC, MSN; COTTON, DAVID MD; VAN HOOK, JAMES W. MD
Obstetrics & Gynecology: September 1996
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Objective To report arterial blood gas and acid base values of normal nulliparous patients at moderate altitude for commonly used maternal positions.

Methods Ten normotensive nulliparous women between 36 and 38 weeks' gestation volunteered to undergo radial and pulmonary artery cannulation as part of a larger study. Following instrumentation, baseline assessments were made in the left lateral recumbent position after a 30-minute stabilization period. Sequential measurements were then obtained in the left lateral, right lateral, supine, knee-chest, sitting, and standing positions. Blood samples were analyzed in duplicate for oxygen content on a blood gas analyzer. Statistical analysis was performed by analysis of variance of repeated measures with significance defined at P ≤ .05.

Results There was no significant difference in arterial blood gas or acid base values between any positions in this antepartum population of term healthy women. The composite mean values were as follows: pH 7.46, arterial carbon dioxide pressure (PaCO2) 26.6 mmHg, arterial oxygen pressure 88.3 mmHg, bicarbonate 18.2 mEq/L, saturated arterial hemoglobin level 0.96.

Conclusion Arterial blood gas and acid base values are not altered by maternal position in the late third trimester of pregnancy. The PaO2 in these women studied at moderate altitude was lower than previously reported for healthy pregnant women studied at sea level. Appropriate interpretation of arterial blood specimens of pregnant women should take into account both the pregnancy and altitude at which the women reside.

Address reprint requests to: Gary D. V. Hankins, MD, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0587

© 1996 The American College of Obstetricians and Gynecologists