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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, MD, PhD, HonD, Istvan / Vetter, Klaus / Winn, MD, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Decreased placental oxygenation capacity in pre-eclampsia: clinical application of a novel index of placental function preformed at the time of delivery

Koji Matsuo1 / Andrew M. Malinow1, 2 / Chris R. Harman1 / Ahmet A. Baschat1

1Department of Obstetrics, Gynecology, and Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA

2Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA

Corresponding author: Koji Matsuo, MD Department of Obstetrics, Gynecology, and Reproductive Sciences University of Maryland Medical Center University of Maryland School of Medicine 22S Greene Street P.O. Box 290 Baltimore, MD 21201 USA Tel.: +1-410-328-5959 Fax: +1-410-328-0279

Citation Information: Journal of Perinatal Medicine. Volume 37, Issue 6, Pages 657–661, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/JPM.2009.121, August 2009

Publication History

Received:
2008-12-22
Revised:
2009-05-04
Accepted:
2009-06-02
Published Online:
2009-08-13

Abstract

Objective: We have previously described placental oxygenation capacity as an index of placental function. The aim of this study was to utilize this test to evaluate placental gas exchange capacity in pre-eclampsia and fetal growth restriction (FGR).

Study design: Two nested case-control studies were conducted between: (i) pre-eclamptic appropriate-for-gestational-age fetus (AGA) and non-pre-eclamptic AGA; and (ii) pre-eclamptic FGR and non-pre-eclamptic FGR based on gestational age match. Umbilical A-V gas differences were compared between groups.

Results: Pre-eclamptic AGA was associated with smaller A-V pO2 and A-V pCO2 differences compared to non-pre-eclampsia (A-V pO2, 7.1±3.8 mm Hg vs. 11.3±5.9 mm Hg, P=0.001; A-V pCO2, 7.8±5.7 mm Hg vs. 10.7± 5.9 mm Hg, P=0.01). Pre-eclamptic FGR was associated with smaller A-V pO2 and A-V pCO2 differences compared to non-pre-eclampsia (A-V pO2, 6.6±3.1 mm Hg vs. 10.8±8.1 mm Hg, P<0.001; 6.7±4.5 mm Hg vs. 10.9±10.3 mm Hg, P=0.044). Pre-eclamptic FGR also had significantly lower venous pO2 but not arterial pO2 (Venous pO2, 20.3±6.3 mm Hg vs. 25.4±11.9 mm Hg, P=0.003).

Conclusion: Pre-eclampsia decreases the placental oxygenation capacity as measured by the umbilical arterial-venous oxygen difference.

Keywords: Intrauterine growth restriction; oxygenation; placenta; pre-eclampsia; umbilical cord blood gas

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