Correlation of fetal hypoxia with intra-abdominal pressure during childbirth in patients with obesity
Objective. To study the correlation of the parameters of the umbilical arterial blood acid-base status (ABS) and intra-abdominal pressure (IAP) during childbirth in patients with obesity. Subjects and methods. The investigators conducted a prospective randomized study involving 135 patients with spontaneous labor who were divided into 4 groups: 1) a control group of 38 persons; 2) 36 with first-degree obesity; 3) 40 with second-degree obesity; 4) 21 with third-degree obesity. IAP was investigated using the indirect transvesical method. The indicators of gas composition, ABS, and blood lactate concentration in the umbilical artery were studied. Results. The severity of fetal hypoxia was related to the level of IAP and the method of analgesia in labor. Correlation analysis of the relationship between the indicators of fetal hypoxia to the level of IAP showed that there was a strong correlation of pH, lactate, and IAP in labor pains (r=-0.73 and 0.73; p<0.001). When epidural analgesia was used, the mean lactate values were significantly lower, but pH and pO2 were higher (p<0.05) than those in the subgroups, in which narcotic analgesics were administered. Conclusion. The level of IAP during childbirth affects the severity of fetal hypoxia. The high level of IAP in labor is the most likely reason for the high rate and severity of neonatal asphyxia in parturient women with obesity. In parturient women with high baseline IAP levels, epidural analgesia is the method of choice for pain relief in labor.Salov I.A., Marshalov D.V., Petrenko A.P.
Keywords
obesity
intra-abdominal pressure
umbilical cord blood
acid-base status
oxygen status
Supplementary Materials
- Table 1. The average values of the studied indicators, taking into account the method of analgesia of childbirth (M ± σ)
- Table 2. Differences in mean values of WBD in patients with asphyxia and without asphyxia of the newborn at different stages of labor
- Table 3. Correlation matrix for factors affecting variability indicators CBS blood of the umbilical artery
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Received 30.03.2017
Accepted 28.04.2017
About the Authors
Igor A. Salov, Doctor of Medical Sciences, Professor, Head of the department of Obstetrics and Gynecology, V.I. Razumovsky Saratov State Medical University.410000, Russia, Saratov, Bolshaya Sadovaya str. 137. Тel.: +78452515121. E-mail: Sarhosp1@mail.ru
Dmitriy V. Marshalov, Candidate of Medical Sciences, Lecturer at the Department of Obstetrics and Gynecology, V.I. Razumovsky Saratov State Medical University.
410000, Russia, Saratov, Bolshaya Sadovaya str. 137. Тel.: +78452515121. E-mail: MarshalD@mail.ru
Aleksej P. Petrenko, Candidate of Medical Sciences, Lecturer at the Department of Emergency emergency and anesthesia-resuscitation, V.I. Razumovsky Saratov State Medical University. 410000, Russia, Saratov, Bolshaya Sadovaya str. 137. Тel.: +78452521591. E-mail: Lesha.petrenko.66@mail.ru
For citations: Salov I.A., Marshalov D.V., Petrenko A.P. Correlation of fetal hypoxia with intra-abdominal pressure during childbirth in patients with obesity. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 50-4. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.50-54
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