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Fetal Acidosis and Hyperlacticaemia Diagnosed by Cordocentesis in Pregnancies Complicated by Maternal Diabetes Mellitus
Author(s) -
Bradley R. J.,
Brudenell J. M.,
Nicolaides K. H.
Publication year - 1991
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1991.tb01633.x
Subject(s) - medicine , fetus , acidosis , gestation , diabetes mellitus , endocrinology , pregnancy , lactic acidosis , obstetrics , genetics , biology
Fetal blood samples were obtained by cordocentesis (ultrasound guided needle aspiration) from 28 pregnant Type 1 diabetic women between 20 and 40 weeks' gestation. Analysis of the deviations from normal values of blood pH and plasma lactate showed significant acidosis ( p < 0.001) and hyperlacticaemia ( p < 0.01) in the third trimester, but not in the second trimester. Blood Po 2 and Pco 2 levels did not differ significantly from normal values. The pH showed significant correlations with Po 2 ( r = 0.54; p < 0.01), Pco 2 ( r = −0.70; p < 0.001), lactate ( r = −0.46; p < 0.05), fetal glycosylated haemoglobin ( r = −0.53; p < 0.01), and maternal glycosylated haemoglobin ( r = −0.57; p < 0.01). Plasma lactate showed significant correlations with Po 2 ( r = −0.54; p < 0.01), Pco 2 ( r = 0.50; p < 0.05), and pH ( r = −0.46; p < 0.05). Neither pH nor lactate showed significant correlations with birthweight. These observations suggest that some fetuses of diabetic women are significantly acidotic and hyperlacticaemic in the third trimester. This may provide a possible explanation for the phenomenon of late intrauterine fetal death in pregnancies complicated by maternal diabetes mellitus.