Parameters of neonate serum acid-base state and gas composition in multifetal pregnancy

Abstract

Aim: to study ABS parameters, blood gas composition and complete blood count in newborns upon multiple pregnancy depending on the order of twin birth, neonate weight, and accompanying chronic hypoxia. Materials and Methods. Laboratory parameters assessed in the twin-collected venous blood were analyzed: hemoglobin (Hb) and hematocrit (Ht) level, count of red blood cells (RBC), platelets (PLT) and white blood cells (WBC), base excess (BЕ), partial pressure of oxygen (рО2) and carbon dioxide (рСО2), оxygen saturation (sО2), standard and total carbon dioxide level (НСО–3, tСО2). Results. The second vs. first twin after vaginal delivery had decreased level of рН (7.30 ± 0.08 and 7.35 ± 0.09; р = 0.03, respectively), рО2 (18.2 ± 13.1 and 27.1 ± 10.7 mm Hg; р = 0.03), sО2 (29.7 ± 22.7 and 41.8 ± 20.3 %; р < 0.001). Metabolic acidosis exacerbated in case of birth interval extending more than 30 minutes. The hypotrophic vs. normotrophic neonates had a decreased WBC (14.2 ±5.9 vs. 15.9 ± 6.5×109/L; р = 0.02), рО2 (19.3 ± 13.6 vs. 22.6 ± 10.6 mm Hg; р = 0.03), sО2 (27.9 ± 19.5 vs. 33.8 ± 20.6 %; р = 0.04). PH and PLT level were lower in newborns with intraventricular hemorrhages (7.29 ± 0.07 and 243.1 ± 75.4×109/L), whereas ВЕ magnitude was higher (–4.9 ± 5.2 mmol/L) than in those lacking intraventricular hemorrhages (7.34 ± 0.06; р = 0.03; 265.4 ±71.6×109/L; р < 0.001; –3.2 ± 4.2 mmol/L; р = 0.02, respectively). Conclusion. During the vaginal delivery, a birth interval should not exceed 30 minutes. In case of diagnosing fetal growth retardation and hypoxia during pregnancy, caesarean section is an optimal option.