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WEINER CARL P. MD; WILLIAMSON, ROGER A. MD
Obstetrics & Gynecology: February 1989
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Hematologic and respiratory blood gas parameters were studied in 21 fetuses with severe or early-onset (at or before 34 weeks) growth retardation and in 44 age-matched control fetuses. Diagnostic categories included uteroplacental insufficiency (N=7) and uteroplacental insufficiency with associated fetal structural abnormality (N=7), aneuploidy (N=5), and congenital infection (N=2). The mean (± 1 SEM) gestational age was 29.3 ± 1 week. Compared with the control group matched for gestational age, the growth-retarded fetuses had higher hematocrits regardless of etiology. The platelet count was reduced in growth-retarded fetuses with aneuploidy (P<.05). Leukopenia was observed in a fetus with congenital infection and in the group of fetuses with uteroplacental insufficiency unassociated with a structural abnormality (P<.05). Leukocytosis was seen in growth-retarded aneuploid fetuses (P<.01). The pH, pO 2 and percent oxygen saturation were each lower in growth-retarded fetuses with either uteroplacental insufficiency or aneuploidy, and the pCO 2 and bicarbonate were higher compared with controls (each P ≥ .05). Appropriately grown aneuploid fetuses had normal hematologic and respiratory blood gas measurements but were significantly more likely not to be trisomic (P=.04). Fetuses with uteroplacental insufficiency unassociated with a structural anomaly had significantly higher umbilical artery systolic/ diastolic ratios than both the control group (P=.0002) and the group with uteroplacental insufficiency and a structural anomaly (P< .008). This investigation confirms previous studies of fetuses suffering uteroplacental insufficiency and extends the observations to other etiologies. Fetal blood sampling supplied information not obtainable with other techniques of fetal assessment. (Obstet Gynecol 73:225, 1989)

© 1989 The American College of Obstetricians and Gynecologists