AN EARLY DIAGNOSIS OF FOETAL DISTRESS BY ESTIMATING THE MATERNAL BLOOD GAS LEVELS DURING INTRAPARTUM PERIOD

 Background: The purpose of this study was to find out the affect of maternal asphyxia influencing the foetus by comparison of the maternal arterial blood gas (ABGs) and acid base levels of normal full term females with the ABGs and acid base values of term females showing any subjective signs of foetal asphyxia during intrapartum period. Methods: In this case control study maternal ABGs and acid base levels of 40 normal term pregnant ladies were compared with 40 other term pregnant females with subjective signs of foetal asphyxia (i.e., foetal heart rate >160 bpm or <120 bpm, meconium staining liquor during intrapartum period or Apgar score <5 at one minute after delivery to confirm the foetal distress. Lactic acid and pH were also estimated to assess the acid base balance. Result: There was considerable difference of lactic acid (LA) and Pco2 levels which were significantly increased (p<0.025) in asphyxiated mothers (AM) as compared with control mothers (CM). No significant difference was observed regarding pH values, bicarbonate ions (HCO3 ), base excess (BE), carbon dioxide content (CO2ct) and percentage saturation of oxygen (%O2SAT) levels in both CM and AM groups. The levels of haemoglobin (Hb), packed cell volume (PCV), partial pressure of oxygen (PO2) and oxygen content (O2ct ) in AM group were found significantly lower (p<0.0001) as compared to CM group. Conclusion: We conclude that routine antepartum blood gases estimation will cover all the cases of maternal asphyxia and also mothers with signs of subjective foetal asphyxia like meconium staining, decrease foetal kick counts etc, this will be an additive successful diagnostic and therapeutic approach adapted to confirm the severity of the dangerous perinatal conditions which are responsible for high perinatal mortality rate. Greater awareness may eventually leads to the early diagnosis of the problem on authentic grounds, can also tell us the severity of asphyxia and later on helpful in proper management for a better outcome.